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Want to make a difference: Translational Research (MD/PhD) or Public Health (MD)?

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Hi all,

I hugely appreciate this forum and the questions and answers posted here every day. I'm hoping that some of you with experience in the fields that am most passionate in can offer me some guidance. Thanks in advance.

I have three more semesters of undergrad before I graduate (including this one) and the impending freedom that lies beyond undergraduate boarders is starting to get a bit daunting. I have every intention of going to medical school but I need some more perspective so that I can make a the most informed decision about which of these two medical paths will be right for me: Public Health/Health Policy or Bench/Translational Research.

Both of these "tracks" have the potential to impact numbers of lives well beyond those that I can physically treat in my hypothetical future office, which is one of their greatest draws. More than anything, I want to pursue something that puts my world/country/state/city in a better place, even if it's only by a small margin.

I have been fortunate enough to have some fantastic undergraduate experiences in both Bench Research and Public Health (Improving access to health care for poor/marginalized populations), which is actually makes this decision harder because I KNOW that I love research. I love the nitty-gritty: mastering techniques, tweaking experiments, trying and re-trying to get results, and waking up before sunrise to spend the day running westerns and getting clean images (sometimes). However, I have also seen first hand how neglected poor refugees, immigrants, even citizens are in this current health system. It breaks my heart that someone can live in the richest country on earth and end up on the streets because they don't speak English and can't get adequate mental health care. I KNOW that this is also something that I could devote my life to.

Considering the fact that I really love both of these career paths but (I think) can only choose one (8-year md/phd vs. 4 year MD + debt), it seems like the best way to make this decision is by comparing their potentials for impact.

Public Health/Health Policy/ Global Health:
Pros:
Has the potential to change entire countries (or cities on a smaller scale) when coupled with increasing access to education (health + education = development), offers the possibility of global travel, and you can see your work on the ground first hand.
Cons: Poor pay, global health seems like a fairly saturated field at the moment, the potential for mundanity and bureaucratic tape.
Bench/Clinical/Translational Research:
Pros:
Potential to impact lives across the globe and address problems/diseases affecting every corner of it, I really love spending time in the lab, 8 years of MD/PhD honestly sounds like an exciting marathon, No debt, extremely intellectually stimulating.
Cons: the effects Biomedical innovations are often times only felt by wealthy countries/economic classes, the most interesting research seems EXTREMELY competitive and I don't think I'd be as interested in a research career if I wasn't working on the most impactful/cutting edge stuff. I believe that I'm an intelligent person, but I am unsure if I have the intellectual chops of people like Francis Collins etc. Are all of the most impactful scientists super-geniuses?


TLDR: I love research and public health/policy. Which one has the greatest/realest potential for impact? Do you have to be a genius to make an impact in biomedical research?

Thanks Again! (Sorry for the novel)
 
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Cheenghee Koh

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Global health and health disparities within the US are different fields, and belong to different research communities. Which one are you talking about? In addition, you have to have some specific personalities in order to do well in global health. Are you willing to go to some places where you know nothing about their local languages, cultures, and politics? Are you willing to spend a week or more suffering from traveler's diarrhea or other local diseases that you may not have immunity? Are you willing to share the responsibility to work through some cultural differences which may at times break the communications or even the teams? Are you willing to spend many months in your field, far away from your family and friends? Also, are you willing to compromise and accept the imperfection, and even failure, as a result of your work?
 
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OneTwoThreeFour

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Most MD/PhDs end up working minimum 60/40 research/clinic. Would you be happy spending a majority of your time in the lab/doing research? Also-every researcher thinks they are working on "impactful/cutting edge stuff". My two cents-the way you're writing shows someone who is excited about the outcomes of research but not in love with the process of research. This tells me you should not do an MD/PhD.
 
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faerie62

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Hmm, but which do *you* enjoy more...? Both careers have the potential to broadly impact people, and both will absolutely impact people in some way, but I don't think that is the best metric for your decision right now. Most likely you will not be the next Francis Collins or Paul Farmer. Would you be mostly happy on a day to day basis with either career, if you ended up being, well, average or meh in terms of success?
 
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Lucca

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Hmm, but which do *you* enjoy more...? Both careers have the potential to broadly impact people, and both will absolutely impact people in some way, but I don't think that is the best metric for your decision right now. Most likely you will not be the next Francis Collins or Paul Farmer. Would you be mostly happy on a day to day basis with either career, if you ended up being, well, average or meh in terms of success?

This is the most important thing to consider. I feel very strongly about global health as well and considered going all in on that but the truth is I like the lab /basic science too much. There are some ways to combine the two. For example, many Infectious Disease physician scientists also run clinical trials abroad
 
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LizzyM

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Question one of my kids was asked when applying for a lab job: When you cook, do you use recipes carefully or do you improvise?

Take a guess which is better for molecular biology. On the other hand, I suspect that being flexible, creative and innovative might be useful in global health policy.
 
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