Although the majority of medical students earn a traditional MD degree, students who graduate with dual degrees are uniquely poised to tackle some of healthcare’s most pressing challenges.
According to recent data from the Association of American Medical Colleges, 10 percent of MD grads earn a second graduate degree, most commonly a PhD (Doctor of Philosophy), an MPH (Master of Public Health) or an MBA (Master of Business Administration).
Such dual degrees give physicians multifaceted—and often, bigger-picture—insights. The MD-MPH examines issues such as health education, controversial public health reform, and disparities in access to healthcare. The MD-MBA trains students to manage issues such as staffing, finance, and communication at medical facilities. And the MD-PhD degree enables students to have dual careers as physicians and researchers, and to translate between these two worlds.
In order to understand the experience of earning these three most common dual MD degrees, as well as the career options they open up, I had in-depth conversations with three physicians who’d each chosen a different educational path. It’s my hope that their profiles, below, will help you guide prospective and current medical students toward a dual medical degree, should it suit their interests and ambitions.
Marie Csete, MD, PhD
Marie Csete always knew she wanted to go to medical school, but as an undergraduate at Princeton University majoring in music, “I really didn’t have the confidence to apply to MD-PhD programs, and I really didn’t know much about them,” she says. After medical school at Columbia University, from which she graduated in 1979, though, she had the opportunity to conduct both clinically based and laboratory research in a research fellowship and then as an assistant professor, and discovered she loved it. “Once I moved to UCLA, I was doing laboratory-based research without, really, any formal training,” she says. After she was promoted at UCLA, she was offered a sabbatical year, and approached the chair of biology at the California Institute of Technology. “I said, ‘I want to learn as much molecular biology as possible, and I’m a hard worker. Throw me in a lab.’” At that point, Csete was in her early 40s, and realized: “If I don’t stop and train, I’m not going to ever have the opportunity again.” So, it was in that lab at Caltech that Csete ultimately earned her PhD in 2000, while still working part-time providing anesthesia for patients undergoing liver transplantation at UCLA.
For students who earn a joint MD-PhD from the get-go, rather than sequentially, the process is a bit different: students often undertake part of their MD, jump out to earn their PhD, then resume and complete their medical degree. The problem with this approach, Csete says, is that, during their PhD years, these students haven’t yet accrued the substantial clinical knowledge that comes with residency training. In this sense, Csete’s approach—embarking on her PhD as an experienced clinician—was, unintentionally, a blessing, as it allowed her to approach her research from a distinctly clinical perspective.
Some MD-PhDs, Csete says, are successful researchers who do no clinical medicine; others are successful clinical researchers without a lab; and yet others are able to combine both. “That’s hard,” she says, primarily because grants that fund labs are highly competitive. Not many people with this training, in her view, can sustain productive careers in research and clinical medicine because most are essentially managing two very full-time jobs. As for Csete, at this point in her career, she is serving as the CEO of ConeSight Therapeutics, a startup company out of Harvard working to transplant cells that make cone photoreceptors to treat blindness due to inherited retinal diseases. “Ultimately, we’d also like to use these cone cells with other cell products to address blindness in the context of macular degeneration,” she says.
Having both an MD and a PhD, Csete says, has been vital. Csete says her dialogue with the professor of ophthalmology who conducted the foundational research is possible because of their similar PhD training. Her MD training and experience in clinical transplantation, on the other hand, informs her understanding of how to deliver these cells into patients safely and effectively. “PhD language and MD language are two completely different ways of looking at a problem,” she says. “The MD-PhDs are the critical translators of medical research.”
Peter Slavin, MD, MBA
Peter Slavin’s pursuit of a dual MD degree was, like Csete’s, a sequential one: he earned his MBA from Harvard Business School in 1990, six years after he’d earned his MD from Harvard Medical School. He’d spent the year after college working in Washington, DC, and started medical school thinking he’d eventually combine a career in medicine with public policy. His plan was, after he earned his MD, to enroll in a master’s program in either public health (an MPH degree) or public policy (an MPP). After medical school, though, his inside view of hospital management during his internal medicine residency at Massachusetts General Hospital (MGH) changed his mind. “I became more interested in management than in policy and thought it would be a more interesting and satisfying career,” he says. “In management, I found that people were working on many of the same issues, albeit on a smaller scale—not nationally, but within a particular organization—but it was easier to connect the dots between your work and a certain outcome.” So, when he’d finished his medical residency, Slavin spent a year doing a combination of clinical care, research, and management at MGH to make sure that management was something he enjoyed. It was, so he enrolled in business school the following year.
After business school, Slavin served as chief medical officer at MGH, then as president of Barnes-Jewish Hospital in St. Louis, Missouri, for three years. After that, he became chairman and chief executive officer of the Massachusetts General Physicians Organization for another three years before becoming the president of MGH, a role he held from 2003 through 2021. Most hospital leaders in the US, he says, are not physicians or clinicians; their graduate degrees are more often in business or public health. “Having a joint MD-MBA degree is far from a requirement to run a hospital in this country,” he says. There are also many careers beyond running a hospital that MD-MBAs go on to have, such as healthcare delivery, consulting, biotech, finance, and more. “The healthcare industry is vast,” he says.
Slavin feels that, especially early on in his career, having the dual degree opened doors for him. Beyond that, understanding physicians’ work in detail has helped him in his management role. “Knowing what it takes, on the ground, to deliver great healthcare to people is a very helpful knowledge base to have when you’re trying to lead one of these organizations,” he says. “Being a clinician is no guarantee to being good at healthcare management. But overall, it’s helpful.”
He also was able to see, via his training, important parallels between medicine and business. “In medicine, you’re primarily trained, when you’re confronted with a human being who’s not feeling well, how to systematically go about figuring out what’s wrong with them and then figuring out what treatment plan is the most safe and effective. And in business—at least, what I took away from business school—was learning how, when you’re faced with a business problem, to go about systematically understanding what the cause is and how to go about coming up with a safe and effective treatment plan,” he says. “In one case the unit of analysis is an individual and in one case an organization; and in one case the schools of thought are anatomy and physiology and the heart and the brain, whereas in the other you’re thinking about the organization, finances, strategy, operations. The domains are different, but the fundamental thinking is very similar.”
Yair Saperstein, MD, MPH
Before Yair Saperstein earned his MD from Albert Einstein College of Medicine in 2016, he figured that, if he earned a second degree, it would be a PhD. During medical school, though, he transformed START Science, a nonprofit he’d started in college that sends college volunteers into public schools to teach science, into a 501(c)(3), and it went international. He also started a second nonprofit, TEACH, which enriches the educational experience for pediatric patients in hospital playrooms. Beyond his nonprofit work, Saperstein became involved in global health research, and graduated from Albert Einstein with a distinction in research. But, he says, “Once I hit residency, it was like the world came to a stop. Everyone was only focused on clinical medicine.” Saperstein felt acutely the lack of interest in a holistic model, so he started to ask around about other opportunities. SUNY Downstate, where he was completing his residency, offered him a partial scholarship to earn an MPH. “I realized that this was the answer I was looking for,” he says. “I didn’t just want to be a robot doing the work. I wanted to understand what goes into it from a higher level.”
Three years later, he’d gained enough insight to start his third company, avoMD. As he progressed in his clinical career, he was elected as chief resident and inducted into Alpha Omega Alpha, the honor society for medicine, as a resident for his teaching. Yet, he says, “I felt like I didn’t have access to the information I needed, both from the hospital standpoint and from the clinical standpoint.” Different hospitals Saperstein worked in had completely different workflows for each diagnosis—workflows he was supposed to have memorized, even though they were not standardized and constantly changing. “How in the world do I keep all of this in my head for all of the different conditions?” he wondered. “And how do the hospitals expect to have this standardized from an administrative perspective?”
As a clinician, Saperstein started to create notecards he could carry with him with algorithms for each condition and hospital. When there were too many notecards, he took photographs of them; his friends asked for copies, and he started sending them around. “For years, I had been dreaming: is there some kind of solution that can help me be a better doctor?” He joined with a fellow physician who was a software engineer to create avoMD, which transforms clinical workflows and pathways into an app. “But,” says Saperstein, “it is the hospitals and clinics that need their physicians to be practicing standardized effective care.” He realized that the buyers of the software, the administrators of health systems, are different from the users, the clinicians, through his public health training.
People who hold both an MD and an MPH, Saperstein says, go on to have a wide range of careers. Some focus more on clinical medicine, others more on the administrative aspects. “Overall, it makes for well-rounded people, because you have the perspectives from many sides,” he says. For Saperstein, having both an MD and an MPH has been crucial in paving the way for avoMD. “Being involved in clinical medicine”—Saperstein is affiliated with Mount Sinai Hospital, and still practices every month—“helps me understand the problem,” he says. “There’s no way I can create a health tech innovation by coming from the outside without understanding the inside.” As for the MPH, “If I’m only inside, and I don’t have this outside perspective, and I don’t understand the system, and I don’t understand the administrative aspect and policy and public health, then I’m just going to focus on the narrow clinical tasks. I’m not going to focus on the broader impact,” he says. “So, the two of them together inform my process and allow me to communicate well with people who are involved.”
* * *
The three dual MD degrees I’ve outlined above are far from the only options available. Medical doctors also go on to earn JDs, MS (Master of Science) degrees, MPP (Master of Public Policy) degrees, and more. Plus, although the three people I’ve profiled earned their degrees sequentially, others—who know from the beginning which dual degree they want to pursue—earn both at the same time.
Pursuing a dual MD degree is time-consuming and can be expensive, but for students with specialized career goals, it might be the best option. Each person I spoke with felt strongly that the combination of two degrees not only enabled them to meet their ambitions, but also enriched their approach to addressing healthcare issues. As you advise prospective medical students, consider whether an additional avenue of study might enable them to more successfully meet their ambitions
By Julie Raynor Gross, Collegiate Gateway LLC, EdM, MBA, CEP, IECA (NY)