Wednesday, February 22, 2012

Uncertain Crossroads

Last week my application for re-admission to complete my MPH (Master's in Public Health) was approved. Initially I was ecstatic because I had been talking about this moment for over a year, about how I loved/valued the program, etc. Now for the past week or so, I'm not so sure - I've been getting some cold feet and doubting whether I will actually go back and finish what I started. The conviction which I had held for the past 1-2 years is gone. And it all hinges on "uncertainty."

I am uncertain that:
1. I will get funding to finish my MPH (I do NOT want to tack on any more to my growing student loan debt).
2. I really need to finish my MPH to do what I want to do.
3. I still want to do what I had originally set out to do when I began med school.

Here's how those primary uncertainties are being addressed at the moment. 1.) I stand a fairly decent chance of getting funding via teaching undergrad courses as a grad student. It was reassuring that the professor I taught for was very willing to write me a letter of recommendation and remembers me so well. 2.) I do not need to finish my MPH to do what I want to do. Would it be useful? Perhaps, but it depends on what I end up doing. Which brings me to, 3.) Without even realizing, I've changed. I had set out to be the so-called "triple threat," that is the doctor who sees patients, does research, and teaches students. Now I'm not so keen on the research bit, haha. Also I had set out to do ID (infectious diseases), and while that's still on my career list, I've begun to shift away towards primary care or another specialty like rheumatology.

My MPH degree is very specific towards a particularly ID-oriented skill set. With my degree I would be better equipped to understand infectious diseases, conduct laboratory "bench" research, and create surveillance programs relating to infectious diseases and the agents to treat them. And prior to med school, that was one aspect I had wanted out of my career. Now I don't know.

Now a few things are certain and have remained certain (if not strengthened) over the past several years: 1.) I want my career to be clinically focused on treating patients. 2.) I want my career to have a public health/community engagement component. 3.) I want to teach students (doesn't have to be med students). 4.) I want a good work-life balance. None of those require an MPH - or more specifically, my focused MPH program.

So I'm in a bind. Will I regret later down the road for not having finished my MPH? If I get my MPH and never end up going into an ID field, will I feel like I "wasted" a year? I can see myself going either way, and neither road is superior to the other (not really, anyway). I can convince myself to go either way and I've been changing my mind on almost a daily basis for the past week. Ugh.

Talking to one attending physician who basically does what my MPH would prep me to do, he asked me, "What do you want to do?" And I said either peds or something within peds, like peds ID. And he emphatically said that I did not need an MPH to do peds or peds ID, and it wouldn't necessarily help me that much. What matters most is not how many letters I had after my name (so long as I had letters at all); what matters most is talent, hard work, and good networking. That said, if there's something I wanted to do within medicine that requires an MPH (or practically requires it), then I should definitely get it.

Anyway, what do you all think? I've talked to so many friends and several faculty, and I keep ping-ponging between the two options. I can't delay my commitment too much longer, have to make a final decision soon!


Uncutplus said...

It may depend on whether you want to do research and be in academia. Does your MPH have to be in ID or can it be more generalized? Once, I worked with a pulmonary care physician with an MPH in pulmonary medicine, and I think it helped him in research and publishing articles.

Anonymous said...

Just my opinion, but an MPH is mostly soft science, and will not add much to your abilities. It's kind of like an MBA, it might help you in academic medicine with climbing the admin ladder.
Think about all the rigid hurdles in getting an MD, if some tragedy happens in your life while getting the MPH it might prevent finishing your MD. Clearly understand the requirements for obtaining a license in your state or the state where you want to live. For example, once you pass step 1 you have a fixed number of years to pass step 3 in many if not all states.
I have heard of a number of residents taking time off during their residency. I knew of a pathology resident that left residency unfinished to start a fellowship at another institution, and then completed his residency at yet another institution.
So, I would say get your MD and license first, because that is such a huge life changing event. Then explore your options.

Mike said...

I'm inclined to think that the sooner you are in the workforce and making money. You can always go back and do it - but the chances dwindle when you are working.

R said...

at least you know you've got a way out once you're done with study? good luck in whatever you decide to do, MPH or not.

. said...

I'm not sure what is best for you Aek...I second the comment above. MPH or not...good luck in what you decide to do!! I know you will do well in either case!!