MPH During or After Med School?

[Catalyst]

I'm definitely going to do an MPH (health promotion track?)sometime in the future and am currently applying to medical school. For those of you who have gotten (or are working on obtaining) an MPH already, would you recommend getting it during or after medical school? For a while I was thinking that it would be efficient time-wise to get the MPH while in medical school, but I'm concerned about how valuable the training really would be without prior experience in the public health field. It seems that the training involved with an MPH would be more valuable after having public health experience as a physician. Anyone have any comments on this?

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[DW]

This is strictly my personal opinion, but I'm not a huge fan of the MD/MPH program the way many schools have them set up. What effectively happens at some of these programs is that you basically take a year off (between M2 and 3 or M3 and 4) and do an "accelerated" or "condensed" version of the MPH. While you'll finish all the coursework and ostensibly have a MPH degree, I feel the greatest value in public health studies is not so much the classes themselves but the accompanying thesis/praticum/public health work experience that you get in tandem with the coursework, and seeing my own project go from start to finish over two years during my MPH program was invaluable to me. Now I'm sure there are some rockstars out there can maximize that year off, but I really feel a MPH program should allow ample time for field experience, and shouldn't be done under the time crunch of a set 12 month window. I did it before med school, but many people do it after as well, and in some residency/fellowship programs (like columbia's FP program and Emory's infectious disease fellowship for example) you can actually incorporate your MPH studies into your post med school training.

just my 2% of a dollar

 

[DrMom]

I agree with DW.

From what I've seen, it is either like DW described with taking a year off to cram in an MPH or (if it isn't an integrated program) med students taking some MPH classes on the side. Either way, I think the public health courses get the short end of the stick. You're either trying to get all of the coursework into a year or you're trying to find time to complete the MPH work while feeling more pressure to study pharm and path. Either way, people can get it done...I just think it gets watered down.

 

[Catalyst]

Wow, thanks for the info... I think I'm definitely going to just get my MPH after medical school.

I had another question: if I want to go into public health with an MPH, is it absolutely necessary that I enter a primary care field? I've been thinking about the possibility that I'd do a field like Preventive Cardiology and then integrate that into my public health work.. how common is this?

 

[Daiphon]

I'm currently doing the MPH at the same time as my med school responsibilities... and I don't feel that either are getting the short end of the stick... however, at least half of my courses are online, which is nice because it frees up my medical schedule.

That might be something to look into - the proportion of "in person" hours vis-a-vis "virtual" hours; if the MPH program is really flexible (like mine is), then I don't think it would be a problem or detrimental to do them concurrently... I am and am doing well at both... also, there are a lot of things I understand more fully b/c of my side-by-side MPH work, and being able to argue about clinical studies can be a good way to look good to your attendings.

Just my $.02,
-Daiph

 

[DW]

Originally posted by SachinG
I had another question: if I want to go into public health with an MPH, is it absolutely necessary that I enter a primary care field? I've been thinking about the possibility that I'd do a field like Preventive Cardiology and then integrate that into my public health work.. how common is this?

You absolutely dont have to do a primary care field to get involved in public health, in fact your scenario of preventive cardiology is what I'm interested in doing. For example when I used to work at CDC, while there seemed to be a decent number of general internists, you'd meet docs from all over the gamut, from ER, immunologists, ID, nephrologists, pathologists, even some people with surgical training who work in hospital infections control, et cetera.....

 

[Zweihander]

I'm currently working on both, and neither program is being compromised. This might be because my school doesn't coordinate the two -- I'm essentially enrolled in two schools simultaneously, and will be doing coursework for both over a period of four years.

Personally, I find the MPH training I'm getting to be an asset to my med classes, because I feel that I am getting a social perspective on the medicine I'm studying, and it does add something to the coursework. Managing both courseloads can be rather trying at times, but I do enjoy it.

I reckon it doesn't truly matter when you get your MPH, but I do think that if you are in a good program, having the background before or during your MD will add a dimension to your medical education that you could otherwise miss.

 

[edfig99]

i'm working on my mph now, after residency and am loving it. personally, i think everyone in medicine should get the training in public health school (and do away with the pretty bogus undergrad training system...i'm not convinced the time and money was worth it)

there are all types of tracks and majors in public health school and i think that there are some tracks and personality types that will do just fine with a condensed mph since they're probably after the degree just to use it to open up some career path and not REALLY do public health....

then you have those socially conscious, change the world types...those people are probably best served by getting some experience first, and then getting the mph later....

i would have to agree with DW and DrMom's comments...i think getting through med school and maybe even residency, and then getting the MPH is probably the better route -- it's better to have at least a little experience when you sit in those classrooms. (or work a few years, get the mph and then go to med school) i would agree with the poster who said that the mph work does seem to complement the med school work, and MAYBE you'll do better in the classes, but the reality is that with med school there is already so much to learn that the mph will end up taking second fiddle.

Besides the coursework and practicum/internship experiences, the people i get the most out of are my classmates -- i am in class with people who run managed care companies, lawyers, case managers, former peace corps people, med students...everyone brings so much to the table...if you've got no or limited experience ya got nothing to offer for the educational exchange...

and you definitely don't have to be a primary care person to go into public health. i've met the entire spectrum of physicians, as well as social and behavioral scientists.

-ed

 

[Samoa]

At my school they're done concurrently, and at least in my track there are numerous opportunities to go see and do public health-related stuff. The MD/MPH students have fewer credits to take to get the MPH than the regular MPH students, but then again, some of the classes over there are just MPH versions of stuff we already take.

As for the primary care issue...well, I'm getting my MPH in International Health, and my current career goal is surgery. I have no idea how those are going to fit together--I'm just interested in them both, so why not?

 

[DrLady]

Originally posted by Samoa
.well, I'm getting my MPH in International Health

Samoa that is so FANTASTIC!!

I am INCREDIBLY interested in International Health. How do you find this division versus what you heard about epidemiology and biostatics, etc.?

I dont know anyone who is doing international health, most of my friends have done or are doing epidemiology, so i really have no one to ask questions or talk with. Can you tell me how is it?

Thanks so much!

 

[Samoa]

I don't know yet, DrLady--I start taking classes next semester. There are several specializations within the track, like reproductive health and population, public nutrition and food security, emergencies, infectious disease, mental health, international health-systems management, etc. I'll probably go either with emergency response or international health-systems management.

We have to take core courses in epidemiology and biostats, although I'm hoping to get an exemption from biostats based on previous coursework. I didn't apply to biostats because I don't want to be a statistician, although I wouldn't mind taking some advanced classes in that area. As for epidemiology, it wasn't so much a lack of interest in that, as it was a greater interest in the other options available. So for me it came down to International Health vs. Health-systems Management, and I decided on International Health because I wanted my focus to be international first and management (whether of health systems or emergencies) second.

 

[Adcadet]

gotta agree with DW. Plus, I think for many people it takes a while to start thinking in public helath terms. I know for me it took me about a year to really have a clue about population health, not to mention just to go over the nuances of study design and analysis. I think for people coming from an MD curriculum it is especially important to think of public health as a distinct field of study with it's own ways of thinking. Not saying you can do both, but you need to appreciate the character of both individually.

 

[Adcadet]

Originally posted by SachinG
Wow, thanks for the info... I think I'm definitely going to just get my MPH after medical school.

I had another question: if I want to go into public health with an MPH, is it absolutely necessary that I enter a primary care field? I've been thinking about the possibility that I'd do a field like Preventive Cardiology and then integrate that into my public health work.. how common is this?

Just to echo DW yet again: I've seen/worked with the following in my studies:

- attending dermatologist
- attending rheumatologist
- prev. med fellow
- nephrology fellow
- medical (heme?) oncology fellow
- infectious disease fellows
- internal medicine resident
- medical students

And then of course are many of my current medical school faculty who have MPH's - mostly family practice people, including one FP/gerontologist.

Personally I think I want to go into a medical sub-specialty and use my epi background to do clinical research or outcomes research.

 

[exmike]

Not to be sour or anything, but how can any of you doing dual degree programs know whether or not your public health experience is being watered down? Part of the great thing about a 2 year program is being able to explore many classes in public health outside your area of interest, an important thing in a field as diverse as public health. I don't see how people only taking one years worth of classes can possibly have the same experience as a traditional two year program. In addition, when you're at a school thats main focus is public health, its sure to be a different experience than at a school where the public health school is some annex to the school of medicine.

I would say that if you have time, take two years and immerse yourself in the experience. You wont regret it.

 

[Zweihander]

Originally posted by exmike
Not to be sour or anything, but how can any of you doing dual degree programs know whether or not your public health experience is being watered down? Part of the great thing about a 2 year program is being able to explore many classes in public health outside your area of interest, an important thing in a field as diverse as public health. I don't see how people only taking one years worth of classes can possibly have the same experience as a traditional two year program. In addition, when you're at a school thats main focus is public health, its sure to be a different experience than at a school where the public health school is some annex to the school of medicine.

I would say that if you have time, take two years and immerse yourself in the experience. You wont regret it.

Are all the dual programs really one year? I knew definitely of a couple that were, but mine is a full masters program, 45 credits including thesis.

 

[exmike]

Originally posted by Zweihander
Are all the dual programs really one year? I knew definitely of a couple that were, but mine is a full masters program, 45 credits including thesis.

Sorry, I was referring to 1yr programs.

 

[DrLady]

Hey Samoa,
Thanks for your reply!

 

[flaming_gypsy]

If you're interested in International Health, you might want to consider looking into some Peace Corps Masters International programs. I was considering this a year ago, and I'm thinking about it again, but the basic setup of the program is that you train at a school for a year (maybe 2 at some schools) then go to a country and work on a public health project there, which provides the basis for your thesis. I would guess it's mostly hands-on preventative public health work, but there's probably a fair amount of policy in some locations. Anyway, it seems like a really neat program, but is only offered at a few schools (Emory, Boston University, and a couple others).

Here's a link to the MI program: http://www.peacecorps.gov/index.cfm?shell=learn.whyvol.eduben.mastersint

If anyone has actually done one of these programs let me know how it was.
The only problem is figuring out where to fit the whole two years away thing in our endless training...

 

[Samoa]

There's one here at Tulane. It's called the Master's Internationalist program, and it requires two years in the Peace Corps as part of the degree (after coursework).

Living in primitive conditions for extended periods is not a viable option for me, for reasons I won't go into here. Plus three and a half years, full-time, seems an inordinate amount of time to dedicate to a Masters degree. But to each his own.

 

[Heal&Teach]

Sorry so late to this conversation (I've been consumed by the pre-med forum)...

I'm actually surprised that no one mentioned the financial aspect of this. I'm quite glad that I took the two years to complete my MPH, but at the same time, I'm in $40K more debt than I would've been had I done a dual degree program.

If money is not an issue, then either way, I think that you can still get what you need. I can see how a person in a one year program could feel like they're getting the watered-down version of the degree, but at the same time, is it more classes that you're looking for, or more practical experience? As long as you're getting the practical application, I see the combined degree as beneficial to learning the basic principles of public health and seeing it in action. If you're looking to buy yourself some time and the possibility of exploring public health as a career, then a two-year program may be the way to go.

H&T

 

[exmike]

Oh yeah, the tuition at Berkeley was about 8k for two years. not a bad deal!

 

[Heal&Teach]

Originally posted by exmike
Oh yeah, the tuition at Berkeley was about 8k for two years. not a bad deal!

I might have been so lucky... but I couldn't do another two years in Albany....

 

[BushBaby]

If I wanted to do my MPH after medical school when will I find the time to do it for 2yrs?
Once I finish MD wouldn't i be going straight into residency, or will I have to take two years off and return? How will it work?

 

[DrMom]

Originally posted by BushBaby
If I wanted to do my MPH after medical school when will I find the time to do it for 2yrs?
Once I finish MD wouldn't i be going straight into residency, or will I have to take two years off and return? How will it work?

There were quite a few physicians in my MPH program. We had classes in the evenings & on weekends, so they were able to work at the same time.