MPH During MD or Preventive Med Residency

[shaunaiam]

First, if this has been answered I'm sorry. I did a quick search of the forums and couldn't find an answer.
I'm currently a first year medical student "planning" on doing the dual MD/MPH (MPH between 2nd and 3rd year, minimal extra during yr. 1 and 2). I was wondering if anyone knows much about the pros/cons of just doing it now, or doing it as the academic year part of a preventive medicine residency. I know that during a prev. med residency either the MPH tuition is paid, or you get a PGY2 salary, or both, depending on the particular program. I may do the IM/Prev Med residency. I guess what I am asking is:
1) Is it worth the extra cash to do it now rather than later?
2) How competitive are these programs? I know there are more positions available in prev. med programs post-MPH than pre. Am I going to screw myself by thinking it will be no problem to do it later, and take the chance of not getting into one of the prev. med residencies I want because they have less spots for the MPH-included track? (Specifically, I really like Dartmouth's program, does anyone know specifically how competitive theirs is (the IM/Prev. Med residency)?)
If anyone can provide some guidance on this issue that would be great.

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[fantasty]

Hiya,

I hope some of the current SDNers who have done (or are doing) these can answer your questions (I've seen users post in favor of each route). But, I just wanted to mention a few quick points.

First, you might check out ACPM (http://www.acpm.org/medstudents.htm) and join. (The medical student section is only $25 for your med school career - my friend is the current president and has tried to make a lot of improvements this year).

Overall, I don't think PM residencies are very competitive. Even Dartmouth, which I've heard excellent things about, should be within reach for most medical students (my hunch - I have no data to support this).

Another factor to consider is simple logistics. If you're at a school whose MPH program is strong, you might be better off taking advantage of the current opportunity rather than going through the hassle of applying somewhere else later. The net timing should be roughly equivalent. A combined IM/PM residency should be 4 years with an MPH and 5 without it. The money factor may be important for you, as you mention you may be paying an extra year now, or getting paid for the year later. However, your school's tuition may be different for public health compared to your med school tuition. Another factor that my combined degree friends have considered is timing for graduation (specifically, it may help or hurt if you are married or in a relationship).

Another broad consideration is about applying your skills and decided why you want the MPH. As there are probably dozens of scenarios about this interplay, I'll just mention a few But, if you want to learn more about health behavior and health education, doing your MPH before your clinical years may make you a better clinician. Heck, you might even be better talking to your patients than your attending! Similarly, if you really want to do infectious disease epidemiology or international health, you might learn things and make connections that would allow for you to do some cool stuff during your elective time at med school (assuming that your curriculum allows you some flexibility - but I've seen some folks to international away electives, or you might find some other interesting things like AMSA's HEART elective, or something at a health dept, the CDC, or even something in health policy if that's your thing). ... On the other hand, if you are getting your MPH to ready yourself for an academic career and research, you might be better off doing your MPH later so that you have the clinical expertise to guide your investigations.

Ok - I'm not even sure if I answered any of your questions now but hopefully you get more responses

 

[marsupial]

I would do it after. You make a lot of connections for possible employment in mph school that you would waste during the following 2 years in med school. plus if they can pay for it, awesome!

 

[Adcadet]

Dante makes some good points. There's no one right answer, but my thoughts on your situation are:

- getting into all but the most competitive prev med residency should be a cake walk from what I've heard (no firsthand experience)

- all else being equal, it's better to get paid than to pay. So if you can, do an MPH in residency/fellowship when you're getting paid vs. paying tuition and sitting on med school loans.

- getting into all but the most competitive MPH programs should be a cake walk (only a little first hand experience), especially with an MD or MD in progress

-an MPH during med school will help inform your clinical rotations and residency; doing med school first and part or all of residency will help inform your MPH. If you don't know what you want to do for residency, an MPH earlier might make more sense; if you know exactly what you want to do in residency +/- fellowship it makes sense to do an MPH then within that area OR now to boost your application if it's a very competitive field. Doing an MPH in med school in a specific area that you don't want to go into makes little sense unless you're learning great techniques/methodology.

- if you're doing an MPH and you don't know the exact sub-specialty field you're going into (and even if you do), consider a "general" or "liberal arts" style program that lets you get a broad based degree. Don't get bogged down in picky details that you'll forget in a year. Instead focus on learning the basic really well. I had MPH classmates who focused as much as they could on a small area and then went into that area, and did great. But for most people, you don't know what area you'll be in within a few years. During my MPH I wasn't into regression at all, but then two years later had a project that required some sophisticated regression. Even if I had learned as much regression as I could have, I still would have had to go back and brush up.