The M.D.-M.P.H.

A NextGen Pathways in Medicine Article
By Jenna Lester

"The success or failure of any government in the final analysis must be measured by the well-being of its citizens. Nothing can be more important to a state than its public health; the state's paramount concern should be the health of its people"
- Franklin Delano Roosevelt

Introduction

Have you ever wondered who made the decision to add fluoride to water to reduce tooth decay or how bread began to be fortified with folate to prevent spina bifida? All of these decisions, that we now consider routine and don’t even pay attention to, help prevent disease and maintain the health of the people in the United States. The goal of public health is to identify any issue that impacts the health of a population, and enact policies to address these issues. An active focus on public health has played significant roles in improving the health and extending the life expectancy of Americans.  

An increasing number of people entering medical school are choosing a dual MD/MPH degree. This is an exciting combined degree program that allows medical students an opportunity to place an emphasis on prevention while studying for a medical degree. It offers a wider breadth of population-based study that will allow a focus on improving the health outcomes for large numbers of people of all ages. Most physicians develop care plans for individual patients, but an MPH allows a physician to develop policies that impact populations of people. These skills can be applied both in the United States as well as internationally, so it appeals to students who are interested in national and global health issues.

Why the combined degree?

A Masters in Public Health (MPH) would be of interest to those who are interested in making an impact on the health of a community on a large scale. Many policymakers and health care executives have public health backgrounds, often in the form of an MPH.  Even if you are not planning on running the healthcare system of a country, or having a major hand in implementing universal healthcare in America, this does not mean that an MPH is not for you. According to JiYeon Kim, an MD/MPH degree holder, an MPH is a good way to gain entrée into an established field of medicine or research. An MPH will give you the credentials needed to begin a career in research or focus your interest in special populations, such as women’s health, child health, immunizations, international health, or biostatistics, just to name a few. Individuals from varied academic backgrounds pursue this degree so that they can impact large scale public health care. However, there are also people who are interested in studying a specific area of health, and use the MPH to gain more knowledge and credentials to increase their ability to work effectively in that field.  

The Process

Several schools around the country offer combined MD/MPH programs, including UCLA, Columbia, Boston University, and Harvard. The sequence of completion of the MPH and MD degrees vary from program to program. At Columbia, for example, students in their MD/MPH program can finish both degrees in four years but many end up taking a fifth year to complete the program. There are a variety of opinions about whether an MPH should be completed during, before, or after an MD degree. Some say that in order to get the most from an MPH curriculum, it should be completed on its own so that it is not abbreviated in any way to accommodate an MD degree. Still others maintain that it is beneficial to be taking MD and MPH classes at the same time in order to fully see the integration of the two fields.

At Harvard Medical School. students can pursue a joint degree by enrolling in the MPH program at the Harvard School of Public Health (HSPH). Students in the MPH program at HSPH usually have several years of work experience and come from various backgrounds within the healthcare fields like dentistry, nursing or even veterinary medicine, but also from areas outside of the health sphere, such as law and business. Although the MPH can be obtained many years after your MD is finished, more medical students are enrolling in joint programs. At HSPH, medical students enrolled in the joint degree program take a leave of absence between their 3rd and 4th years to work on their MPH. Typically the MPH takes two years to complete, but this is reduced to one year when combined with medical school. JiYeon Kim finished her MPH after her fourth year of medical school at HMS and thought the combined degree program was ideal for her since she finished her degree in one year instead of the usual two years.

Future

Although the MD/MPH degree program enriches one’s perspective on medicine and allows for a focus on preventative medicine, it is similar to selecting a medical specialty after medical school.  At HSPH, there is a list of concentrations that matriculated students choose from including International Health, Clinical Effectiveness, and Family and Community Health. This level of specialization limits one’s area of focus while obtaining their MPH, and also narrows their field of expertise. A prospective MPH student should explore focusing on a particular area of public health that they are passionate about. As with any advanced degree, colleagues will expect you to retain and use the skills you gained through out your career.  Students who are genuinely interested in a specialized area, and have plans to incorporate that specialty into future career plans, should consider an MPH degree.

References

"Dual Degree Programs: MD/MPH." 2003, Columbia University College of Physicians and Surgeons. 19 April 2008.
        http://www.mailman.hs.columbia.edu/hpm/pdf/MDMPH.pdf

Kim, JiYeon. Personal Interview. 9 March 2008.

"MD/MPH-MPH/DO Guide." 2006, American Medical Students Association. 19 April 2008.
        http://www.amsa.org/cph/mdmphguide.cfm

"Mile Stones in Public Health." New York: Pfizer, Inc., 2006.

"MPH Program: Dual Degree & Summer Programs." 2008, Harvard School of Public Health. 19 April 2008.
        http://www.hsph.harvard.edu/academics/master-of-public-health-program/prospective-students/dual-degree-summer-programs/index.html

 
Jenna Lester is a writer for the Next Generation and a member of the Harvard class of 2010.

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