Med School Opportunity Cost When Compared to MPH etc. (Global Health Impact Potential)

[deleted826437]

Hello all,

I am currently trying to decide between an MD and a one or two year degree (MPP, MPH, MSc etc). Here are my interests:

Economics: health, development
Politics: International relations, policy
Global health: Outbreak response, health development, epidemiology, MicroBio
Medicine: Refugee care, infectious diseases/trop med (exclusively interested in international work)

Ultimately, I would like to have a high-impact career where I am able to make a difference and focus on shrinking the healthcare gap between underdeveloped countries and developed ones. Preferably one that involves international travel.

While I really like the idea of being a doctor, treating patients directly, and calling the shots, I am discouraged by the time commitment. I won't be able to begin long-term international work until I'm in my 30's probably. Still fairly young, but I can't help but wonder if that time could be better spent earning an MPH in a few years and starting earlier. The MD will no doubt open doors in terms of qualifications for jobs, but can do as much/more without it?

With those reservations, I have spent considerable time looking into alternative degree options. Most of them are 1-2 degrees and would be at schools in the US or London (LSHTM/LSE). The two year commitment seems much more appealing if I am going to be able to have a high-impact career afterwords and not be limited by my lack of MD. Policy, economic health development, outbreak response etc. don't seem like careers that would require an MD, but will I be limited regarding long term career advancement without it?

What do you guys think? What kinds of positions do you think need/don't need the MD? Who makes a bigger impact?

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[MarcusAureliusAntoninus]

Hi, I'd like to bump the OPs thread, as I have very similar goals in regards to career and hesitations when it comes to getting a MD (I actually find it sort of weird how similar the OPs thoughts are to mine haha). Is working in the fields the OP mentioned (And making a large impact) possible with only an MPH? It alway seems like any of the higher ups in these NGO/Gov/private public health agencies are always either MD/MPHs or PhDs.

 

[ed*26]

OP, it seems like you're most interested in the "big picture" stuff -- the policy/government side. Although some MDs do find their way there, it's a (very grueling, very expensive) degree designed to produce clinical practitioners that give care to individuals.

1. IMO, you should look into master's and PhD programs. A PhD can be very conducive to travel if you are interested in pursuing your own research abroad, while a master's may allow you to be hired by major organizations for their purposes. Master's and PhDs in global health (including global disease epidemiology and control), public policy, and health economics all exist -- look into such programs and see what their graduates are doing.

 

[deleted462159]

Don't go for an MD unless you have a clear vision of why you want to be a physician. Let's start there.

While many medical students and physicians do end up in administration or policy as another comment noted, it's a roundabout way that will make you hate your life while going through med school, residency, etc. (because you don't have that light to hold onto of why you're doing it).

Do you need an MD to do high-impact global health work? No. Do you need one if you want to become the top dog in it? Probably. Your call.

 

[She-Hulk]

Volunteer in a hospital setting to see if you like working with patients, I think it is something you love or are indifferent towards. Working with patients is one on one, and so doctors work for organizations like Doctors Without Borders, where they are posted in a hospital or temporary facility to treat people suffering from war injuries or infectious disease outbreaks like Ebola. That is probably great and satisfying work in itself, but it is at the personal level.

Most people who work on large public health projects aren't doctors, they have a Masters in Public Health, or Epidemiology or a related field, or just a lot of experience. They like to feel they are working on big issues that affect huge groups of people, like disparities in healthcare. Often times politicians have a bigger influence on who gets what type of healthcare, just look at Obamacare. Probably somebody with a PhD in economics or a Doctor of Public Health could do more to ensure healthcare for a large group of people.

Many physicians say they have a deep interest in public health issues, or even global health issues, but what they actually do about it is a different matter, beyond going to "Healthcare For Everybody" marches and occasional volutourism in the developing world.

Many organizations put an MD in charge because that looks good, and there are a lot of them interested in such a job, though a Doctor of Public Health person looks good too, though this is also an expensive degree.

 

[dextor2003]

I was in almost the opposite situation a few years ago, i.e. wondering if I needed an public health degree to do the type of global health work I'm interested in. I'm now a 4th year med student who took a year off to complete an MPH.

Having seen a bit through both lens, I don't think the MD is needed to do high impact international work. Yes, it can help in terms of qualifications, but experience also plays a huge role. In the 7+ years you train to be an MD, you could complete an MPH and acquire several years of practical field experience, by which time you will have already gone up the ladder in ranks and level of responsibility. From the faculty I interacted with at my MPH program, the handful of MD/MPHs I knew were a lot more renowned and published than the remaining PhDs and MPHs. However, this doesn't mean the former group's work was more "high impact" than the latter, except for a few cases like eradication of vaccine-preventable diseases. I would only pursue the MD if you truly want to be involved in patient care or at least use its lens to inform your work, though the latter is a much weaker reason to do so.

 

[Tots]

I was in almost the opposite situation a few years ago, i.e. wondering if I needed an public health degree to do the type of global health work I'm interested in. I'm now a 4th year med student who took a year off to complete an MPH.

Having seen a bit through both lens, I don't think the MD is needed to do high impact international work. Yes, it can help in terms of qualifications, but experience also plays a huge role. In the 7+ years you train to be an MD, you could complete an MPH and acquire several years of practical field experience, by which time you will have already gone up the ladder in ranks and level of responsibility. From the faculty I interacted with at my MPH program, the handful of MD/MPHs I knew were a lot more renowned and published than the remaining PhDs and MPHs. However, this doesn't mean the former group's work was more "high impact" than the latter, except for a few cases like eradication of vaccine-preventable diseases. I would only pursue the MD if you truly want to be involved in patient care or at least use its lens to inform your work, though the latter is a much weaker reason to do so.

Agree with this. Am also a 4th year medical student who took a year off to study at LSHTM. The majority of the amazing people doing impactful global health work are without an MD. LSHTM is an amazing place to study if you have the chance.