Do you need to go to medical school?

I met a couple of kids who are in high school right now and are interested in a career in public health. They couldn’t be more different from each other in so many ways. Student A is White, lives in a big city, and goes to a public school. Student B is Asian, lives in the suburbs of that big city, and goes to a private school. Student A’s parents work at a local hospital. His mother is a nurse and his father is a radiology technician. Student B’s parents are both physicians at another hospital. I didn’t ask them, but I think they’re not poor, but it is clear that Student B’s lifestyle is a little more privileged.

Where these two differ is in their plan to get to a career in public health. Student A wants to go to a respectable college, get an undergrad in public health, then apply and go to medical school. Student B wants to go to a similar college, get an undergrad in microbiology, then a master’s in biomedical sciences, and then a PhD in public health. Student B wants to be more involved in research. Student A wants to be a physician so he can “be the boss” in a public health agency. It was that last part that gave me a chuckle.

So let’s look at Student A. He wants to go to medical school because he believes that it will give hem a position of authority within a public health agency. This is true. If you are an MD or DO, and you have gone through epidemiology training, you’ll have a solid position. You might even get to be a boss. But those degrees neither guarantee you the position nor are they cheap. I have two friends right now who got out of medical school before finishing and are now in a ton of debt. I have another friend who is also in a ton of debt — approaching half a million dollars — and she hates being a physician. But she went through the school and the training and now she’s going to stick with it because, dammit, both her parents are physicians.

Student B, on the other hand, has a more low-key approach to his future career in public health. He doesn’t really like person-to-person interactions, so he likes the idea of being submerged in a laboratory setting. Yes, there are a ton of laboratory people involved in public health, and we rely on them a lot to get things done. If there is an outbreak of disease, the first step is to confirm the outbreak. How do we confirm it if not by some lab test? (Yeah, okay, there are some diseases that don’t require a lab test, per se, like diarrhea.) Public health labs are becoming more prominent in a lot of the work that we do, and the technology they have is advancing by leaps and bounds.

Physicians are portrayed as the heroes in stories about epidemics. It’s always “doctor” this and “doctor” that. Those of us with the MPH degrees who are in the trenches are rarely acknowledged. Worse yet for any of us in academia. They never acknowledge the people who taught the epidemiologists how to do what they do. Do they?

So my money’s on Student B to make a bigger impact in public health, compared to Student A. Then again, I’ve been wrong before. Student A could finish at the top of his class at each level of his education and become a world-renowned medical epidemiologist. But, if I were a betting man, I’d bet on B.

Always bet on B.

4 thoughts on “Do you need to go to medical school?

  1. About student A…If he thinks he will be “the boss” in the public health agency, where I worked, he’s wrong. The Commissioner of the health department was not protected by the civil service system and was appointed by the County Supervisor and confirmed by a vote of the legislative body. When a new Supervisor was elected, the Commissioner and his/her deputy were history.

    We had a number of supervising physicians who were department heads (Division of Communicable Disease Control, STD unit and HIV unit, Director of medical services at our public health clinics and our public health laboratory he was an M.D./PhD, who were covered by our union contract.

    Student A. might think he will have a spectacular career trajectory, but to achieve that status, you have to have experience as an epidemiologist in the field and a reputation for implementing innovative programs…

    I had the best of both worlds; working as nurse-epidemiologist and seeing patients in public health clinics.

  2. I’d bet on B as well. Things rarely work out well for someone whose primary goal is “to be the boss”, even before beginning training.

    As for those with MPH degrees “in the trenches”, I always think of them. But then, I’ve interacted with and assisted those people while deployed and responding to epidemics.
    A more dedicated and skilled bunch, one cannot find and because of their efforts, physicians get to take credit for eliminating an outbreak.

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