MD/MPH – DO/MPH Guide

This guide is a compilation of experiences and opinions of many and the result is that there is no single way to do your MPH. It will not tell you the perfect path to take. It may, however, raise questions you haven’t asked yourself yet and expose you to different paths you didn’t know existed.

Keep in mind that these opinions are those of medical students and recent medical graduates, so there is of course a bias there. This guide is intended for those planning to work in public health and become a physician or surgeon and for those who have already decided to undertake an MPH, and are now deciding when and how to do it. If you’re still learning about public health, try these resources:

Schools of Public Health

Some words of wisdom before you start reading…

Get various opinions from different people (including this guide). Eventually someone will present an idea or be in the process of a plan that’s perfect for you.
People often look at the degree now as something that can help you get into medical school or residency. All that may be true, but I’d recommend having a bigger goal in mind than that. I think you get out what you put in, so if you go in with specific things you’d like to come out with, that’s probably better.
You don’t need to wait to do your MPH because you’re worried about better USMLE numbers or that you’ll be less competitive – if you want to work in public health, you’ll be more competitive with the kinds of programs that appreciate public health.
Explore public health concentrations in undergrad, so that when you start, you know where you want to go with the MPH in the future.
Don’t forget there are other degrees which may suit your interests/goals more – Masters in Public Policy, PhD in Public Health or Public Policy, MBA, and more (see sidebar for additional opportunities).
Pursue the MPH if you ever considered working in an NGO, government or international health organization, etc. Pursue it if you’d like to gain skills in non-clinical medicine/health… It’s amazing the doors that will open because of the background you’ll obtain from your studies as a master’s student in public health.

WHAT YOU’LL FIND IN THIS GUIDE:

Why should you do an MPH…ever?
Why should you do an MPH…before medical school?
Why should you do an MPH…during medical school?
MD/MPH and DO/MPH Combined Programs Adding a year during medical school
Why should you do an MPH…during residency?
Why should you do an MPH…during a Preventive Medicine residency?
Why should you do an MPH…after residency?
Do You Need an MPH at all?
Things to think about…
…when researching an MPH program and/or a School of Public Health
…when researching a combined program
…while you’re doing your MPH.

Why should you do an MPH…ever?

To approach health as a population-based issue rather than an individual one
To contextualize health: social, economic, cultural, religious, etc.
To gain research skills (e.g. epidemiology and biostatistics) that build the foundation of public health
To develop and implement health programs in limited resource settings that are tailored to the specific needs of the community and in partnership with that community.
A broader range of career options
Increase networking potential – access to key people in the public health world in your community
Opportunity to travel or experience health from a different perspective
It gives you credibility in public health circles and trying to advocate for change in your community (or outside of it) on a policy level
Access to an institution with resources that can be used for the communities with which you work
“One of the best things about any MPH program is the group of people that you’re surrounded by. Everyone has different goals, experiences, focuses, but we’re still like-minded in many respects. Most of us want to make a change, or to become part of change that’s already taking place. We push each other to think through conversations within and outside of class. We recommend books to one another, and we let each other know about lectures that are taking place nearby. We force each other to look at things differently. This environment – in addition to the classes, obviously – is extremely conducive to learning and thinking about public health issues, as well as for making friends and connections that will likely remain for years… The classes are extremely engaging and truly help me to see how medicine is practiced on many levels.”

Why should you do an MPH…before medical school?

“I did my MPH between undergraduate school and medical school. I was really interested in international health and environmental health, and also health policy. I was interested in medical school but I felt that I needed to explore public health in a structured way first (as my interest in medicine was very much based in what I could do in public health in the future). I think I actually would have quit medical school with all its frustrations and myopic view of health if I didn’t have the base of public health to go on.”
“The full public health experience” – a full year (or two) devoted to public health, and an MPH’s perspective while attending medical school
Don’t have to juggle medical school and public health school classes
Many people who earn an MPH before medical school do so as deferment of entry (either for academic or personal reasons). Those who do it mindfully have a very broad perspective that usually is grounded in personal experience (peace corps, family history, etc.).
Great suggestion for pre-meds that didn’t get into med school right away and are looking for experience, a degree, and an extra “umf” to their resume.

Why should you do an MPH…during medical school?

Be involved in public health issues and tie them into practical medicine while still in school
Some schools allow for an academic year in which students may pursue an alternate degree (such as MPH) or other academic research.
May give you a better sense of how you’d like to plan your career (life?)
More competitive/unique during residency application process
Real life experience after MPH may give you the mental structure to understand and process what you are doing and seeing.
Gives you time to step back from the day to day of medical school to see the bigger picture and what role you play in the broader medical system.

Why should you do an MD/MPH or DO/MPH combined program?

Taking MPH classes while taking MD/DO classes may allow you to observe medical care from the institutional level as well as the individual level.
Allows you to integrate the information you are learning from each program at the same time and to see how medicine and public health are integrated.
Able to access public health and medicine faculty to facilitate collaborative study
Often no extra tuition or decreased tuition for additional degree!
Greater access to scholarships
Con: Additional stress and time that coursework imposes on an already not-so-easy MD/DO schedule. (primarily 4 year programs)
Con: Sometimes, MPH classes may get a little short-changed in terms of effort and time put in. Possibility of resentment engendered among public health students and faculty who may believe that you are giving public health work short shrift (primarily 4 year programs)
Con: May take time away from hobbies such as writing, art, etc. that might be totally different from academic interests
Con: Forced to accept the programs available at your school, which may be limited

Why should you take a year off during medical school to concentrate on your MPH?

One year to focus only on MPH
Extensive opportunities to gain field experience
Ability to choose a school depending on your academic aims and interests
Expands access to resources beyond your medical school institution
A good option if the medical school you want to attend does not offer a combined MD/MPH or DO/MPH program, and schools that you’d like to attend for residency/fellowship do not offer MPH.
Delaying residency/entry into the real world can be a pro or a con!
Consider doing before 3rd and 4th year so that you have some clinical experience beforehand.
Con: Can be very, very expensive. Tuition plus living expenses.
Con: Limited number of scholarships
Con: Pausing financial aid when you take a sabbatical from your home institution may cause problems – scholarship and loan repayment programs (e.g. National Health Service Corps) may not have established policies to govern sabbaticals – need to research this when deciding

Why should you do your MPH during residency?

Be in a class with current and future academic/community leaders in the medical community in which you are most likely to practice
Creating your own path and program allows you to tailor course projects to your specific practice of medicine rather than “clinical practice in general”
Those who can enter or create a dual residency track have a foot in the two fields during a highly generative time of unique growth and crossover potential.
Con: Creating your own path may leave you taking call and courses at the same time.

Why should you do a Preventive Medicine residency that incorporates an MPH into your training?

MPH work is usually funded with a stipend (be sure to determine how stable this funding source may be!)
The reasons that you would like to pursue an MPH align with an interest in preventive medicine.
More clinical experience prior to MPH.
More information

Why should you do your MPH after residency?

During 2-year preventive med residency following other residency or family medicine research fellowship – can get paid for it, will know better what research you want to do
More clinical experience
Not a bad time to have kids – during MPH classes
International health fellowship after emergency medicine residency
Have a better idea of how to apply everything learned doing MPH
Tailor MPH to fit career plan
A break in clinical work

Do you need an MPH at all?

It is nice, but not a necessity if you want to work as a physician in clinical medicine, teaching, or research.
It helps if you are interested in pursuing a public health policy or administrative positions – as noted above, good connections and more background in these issues than a “regular” MD/DO
AN MPH allows you to acquire a skill set(s) you may not get in med school, but you may also be able to develop similar skills through experience in the field and through personal study.
To be successful in public health, an MPH is not a necessity. All you need is passion, endless amounts of energy, creativity, ability to work with all types of people and across cultures, and flexibility.
Work experience in public health may be even more helpful or just as important as sitting through an academic program in public health.

THINGS TO THINK ABOUT…

… when researching an MPH program and/or a School of Public Health

“Consider the quality of the MPH program as carefully as you considered medical schools…perhaps more so, since the quality of the MPH program depends somewhat on the quality of the courses, whereas in medical school, it’s more about what you put into it. My personal bias is that you’ll get more from an MPH program at a free-standing school of public health that offers lots of resources and choices, rather than an unaccredited program at a medical school. If you can, really consider taking a year off from medical school and going to a good public health school rather than just blindly taking whatever your medical school offers you.”
Accreditation – most of those who offered their opinions and experience recommended attending an accredited school of public health or graduate public health program. For a full list of programs and more information about accreditation, visit theCouncil on Education for Public Health and/or the Association of Schools of Public Health
US public health schools are often very biostats/policy based. Try applying to international schools of public health too. (often less expensive as well)
Research what opportunities the program has for specializing/focusing in one area of public health and ensure that they offer a focus in the type of public health you are interested in.
Think about how important completing a research project is to you and find out how research-oriented different programs are.
Look carefully at the faculty for the program and evaluate how much diversity (in terms of work experiences/expertise) is represented.

… when researching a combined program

Do you have to coordinate what classes to take on your own?
Is the program through two different schools?
Is the program through an accredited school of public health or graduate health program?
How flexible is the schedule?
What is the workload? What are the credit requirements?
Is there a practicum?
What level of support do you receive for the thesis, independent study opportunities, etc.?
Is additional time required to complete a combined program? That may be a pro or a con for you.
How long is the program? Do you want a program that is one year long for ALL MPH students or one that is meant to be two years long but condensed into one year for medical students?
What opportunities for experiential learning does the school provide?
How much time do you have for elective courses?
Does the school have classes and focus on what you want to do? (e.g. global health, epidemiology)
Is there funding for international experiences during the MPH year?
How good is the Career Center?
Consider taking more classes during the summer, so that you don’t have to take classes during med school semester. (“MPH exams and papers have an uncanny way of always colliding with the med school exam schedule.”) Some schools may allow you to take classes the summer before first year.
Find a full-time summer experience between 1st and 2nd year that you can use for your Master’s thesis – it could save you some time.

… while you’re doing your MPH

Get experience doing something in your area of study – e.g., work in a free clinic, go abroad with a program you respect, do some environmental or policy work; there are many different options. Don’t wait till your mph capstone or internship to do it; do it the whole time so that you have a concrete way to apply what you’re learning.
Stay connected to the communities you’re working in. It can keep you conscious of the importance of being humble and respectful in doing this work.
“Don’t let public health education become a barrier between you and your patients/clients. Because of the academic nature in which public health education tends to approach public health issues, this can become a problem. There’s something about being able to communicate with people on a real level that public health education doesn’t give you, that only real experience and genuine respect can give you. In my estimation, that needs to be there in order to get a real understanding of situations and the actual people they affect, so that change may be effected by building power in communities so that they don’t have to rely on academics that aren’t invested in their communities to solve their problems.”