Advanced Degrees

Obviously the main degree that you need to practice medicine is either an MD (doctor of medicine) or a DO (doctor of osteopathy or osteopathic medicine). However, for many different kinds of careers in medicine, an advanced degree in a related field can enhance your medical-school experience and clinical training, and improve your skills and job satisfaction. These degrees include a variety of master programs at schools of public health such as a Master of Public Health (MPH), a Master of Science (MSc), or a Master in Health Science (MHS). Other advanced degrees that may be useful for physicians include a Master of Education, a Master of Business Administration (MBA), a Master of Medical Management (MMM), or a Master in Public Policy (MPP). Some future physicians, especially those interested in pursuing academic research, enroll in joint MD/PhD programs from the beginning of medical school. Others pursue PhD training separately at a later time.

In a survey of 568 physician members of the American College of Physician Executives (ACPE), most of whom had advanced management degrees (MPH, MBA, MMM), approximately 90% of respondents reported that their investment in the additional education was “worth it” (Weeks, 2008). The return on investment was independent of the quality of the academic institution, although primary care physicians stood to gain more money and satisfaction relative to specialists.

When evaluating a specific degree program, remember that the skills obtained from an advanced degree are more important than the degree itself. For example, students pursuing a Master of Public Health take courses in a wide variety of health care fields, while students pursuing a Master of Science might take courses only in epidemiology and biostatistics. Therefore, an MPH may be a better choice for a physician interested in a career in medical education but an MSc would be more useful for a physician seeking research skills. Most academic institutions are now expecting that competitive physician applicants for junior faculty positions already have an advanced degree. So, if you are considering a career in academic medicine, the question may not be should you get an advanced degree but when and how. For women in medicine who have decided to pursue additional education, the main family issues to consider are timing and finances.

Some students attend public health school during their premedical years to help them decide if they want to pursue a career in medicine. Others who are already sure of their plans enhance their medical school applications with an advanced degree. A growing number of medical students take time off during medical school to participate in one of these degree programs, either full- or part-time, at their own institution or at a different one. Medical students may be able to take advantage of specific affiliations between their own medical school and programs at other universities.

Many physicians who pursue advanced degrees do so during their fellowship training. If an advanced degree is part of a fellowship program, it is usually structured as a part-time endeavor to accommodate other fellowship responsibilities. Therefore the degree itself takes longer to complete than it does for full-time students. Finally, there are some physicians who complete their residency training, enter directly into clinical practice or a faculty position, and later return to fellowship and/or school. For doctors who pursue this last option, they must negotiate whether to stay in their current position, to scale back, or to leave their current job entirely when they return to school.

If you pursue additional education outside of a formal fellowship, it is likely that you will pay your own tuition, which can be expensive. For example, full-time tuition and fees at the Harvard University School of Public Health for 2008-2009 are $35,403 per year for one-year master’s degree students and $33,320 per year for two-year master’s degree students (http://www.hsph.harvard.edu/administrative-offices/registrar/tuition-and-fees/).   Your salary as a fellow will be slightly higher than your salary as a resident but still significantly lower than what you will earn as an attending physician. If you consider the cost of an advanced degree as a “benefit” of fellowship, then your salary becomes more reasonable.

Finally, it is very important for women in medicine to consider the timing and financial issues of advanced degrees in the context of planning, bearing, and raising a family. There are real advantages to being pregnant and on maternity leave while you are in school. As a physician-student, you typically have fewer clinical responsibilities and more flexibility in your schedule. The major disadvantage of having children while in school is related to the timing of your pregnancy and maternity leave relative to your course requirements. If your timing is inopportune, having a child could cost extra tuition and fees as well as additional time needed to finish your degree. If you go on leave from your degree program, you may need to procure interim health insurance.

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