As medical students, we marvel at the endless combinations of letters often embroidered on white coats representing physicians’ degrees and association affiliations: MD, MBBS, DO, PhD, MSc, MBA, MPH, MPP, MS, MTR, JD, MSHP and so on. This “alphabet soup” represents the important diversity that exists in our profession. Medicine and health care at-large stand to benefit from physicians with a diverse array of experiences and backgrounds. MD/PhD programs create the framework for an expanding community of physician-scientists, while other contemporary training programs educate physician-lawyers, physician-policy experts, physician-public health practitioners. All of these programs have contributed to the overall diversity of the physician workforce. As two medical students who have sought dual-degrees, an MPH and MBA, we hope to relay our experiences to those considering such opportunities.
The health care ecosystem in the United States is wildly complicated with issues such as the opioid epidemic, integration of technology into health care, extensive access, cost and quality policy debates, rampant firearm violence and the social determinants of health. These are all salient issues in need of thoughtful consideration. Further, the impact of the health care system on the lives of Americans is evident both through the enormous spending on health care (nearly 18% of the U.S. GDP) and the importance that health care policy has had in recent elections. We believe physicians with diverse educational backgrounds, specifically those with dual-degrees, possess the unique ability to develop solutions for today’s trying issues.
The ecosystem’s key players — payers, providers and policy makers — strive to improve health through equitable, high quality and affordable care. Challenges to their efforts exist in the form of policy, finance and inequality, which require a wide range of knowledge, from public health and medicine to public policy and finance. Health care providers assume a unique role within the health care landscape and serve as agents of change in many ways. Physicians are particularly important players within the U.S. health care value chain. They act as advocates for patients, the health care organization they work for, their own profession and society at large. Physicians are also the most autonomous and influential actors in the health care ecosystem, privileged with many patient care and access decisions.
Despite this unique position, due to the depth and breadth of knowledge required for clinical medicine, physician training in medical school is almost completely patient-care and science-centric. From our experiences, few educational opportunities exist within medical education to explore the intricacies of the health care ecosystem. This lack of education prevents an understanding of payer/provider structures, health care policy, the business aspects of health care and the interplay between public health and medicine. However, opportunities are becoming increasingly available for medical students to pursue dual-degrees within a broad range of health care-related fields. Due to the mounting issues within the U.S. health care system, we believe leveraging such dual-degree opportunities is paramount for medical trainees who could provide innovative solutions to affect change.
For example, the opioid epidemic is as complex as it is widespread. More extensive epidemiologic research and public health outreach programs must be combined with treatment and prevention methodologies to adequately address this problem. We believe dual-degree holding physicians are uniquely situated to conduct research, advocate for change, and inform options of care for this challenging issue.
We recognize our good fortunes in receiving our medical education from institutions that encourage diverse academic experiences. As we have disintegrated from our MD programs in pursuit of our second degree, we appreciate the unique experiences and knowledge we obtained. Moreover, we believe that these experiences will continue to give us a unique understanding of different issues impacting the health care ecosystem.
Many dual-degree programs require applicants to declare their interest in degree combinations at the outset of their medical school application. However, due to the diversity of the health care landscape, not all students prospectively realize their interest in such academic endeavors. Thus, we believe medical schools should be flexible in allowing students to add unique educational experiences to their wealth of knowledge. As an example, one of the authors realized an interest in public health as a first-year medical student and was encouraged to pursue a Master of Public Health at an entirely different institution. Support for such opportunities is crucial in the education of the next generation of physicians and health care leaders. We have seen a growth in medical students pursuing dual-degrees at our own institutions, and we call students to continuously consider doing so throughout their training. Embracing alphabet soup will likely be an important means by which the medical community begins to address the hot button issues plaguing the U.S. health care system today.