Ask the Experts: Exploring Medical Careers

Maria Soto-Greene

I would recommend that you find an opportunity in which you can experience firsthand whether helping others is what you enjoy doing. I am one of those individuals who enjoyed science.

However, it was not until I took a course called "Black Community Health," in which minority physicians provided me with their road to medicine and the great impact one can have on another life, that I began to explore medicine. I can say that I am still in love with the career and enjoy mentoring and guiding others.

George Richard

Ask yourself some questions:

• Do I care deeply about other people, their problems, and their pain?
• Do I enjoy helping people?
• Do I enjoy learning, gaining new understanding?
• Do I often dig deeper into a subject than my teacher requires? Do I understand the value of learning beyond just making good grades?
• Am I interested in how the human body functions?
• Am I intrigued by the ways medicine can be used to improve life?

If you answered "Yes" to most of these questions, chances are you have the right kind of personality for a medical career. 

Denice Cora-Bramble

You need to follow your heart and passion. Medicine is an immensely rewarding career, but it requires hard work and sacrifice. Consider shadowing a practicing physician, researcher, and/or academician to help visualize yourself in one of these roles.

Maria Soto-Greene

Increasingly, students entering medical school are nontraditional in many ways. In reviewing the ages of our current first-year class at the New Jersey Medical School, 29 out of 181 were between the ages of 25-34, and three were over 35. In fact, we have had from three to nine students in any given class who are over the age of 35 in the past four years. If you really want a career in medicine, age should not be a factor. Some of our best students are older.

George Richard

Only you can truly answer that question, but you would not be alone in starting a career in medicine as a "nontraditional" student. Many people enter medical school after completing another degree, or after having been in the workforce for a number of years.

Dual degree programs, such as the MD-PhD and MD-MPH, are not unusual in the medical field. These programs are usually combined so that students can complete them in a slightly shorter period of time than if you were to complete the programs separately. Nevertheless, you do have a "leg up" with a doctorate in public health, which can increase your appeal in the job market.

Public health focuses on community-based approaches, whereas a career in medicine often maintains an individual focus. If you have an interest in helping patients in a one-to-one situation, then perhaps the medical school option is worth considering. Of course, with your public health training, there will be many opportunities to apply your expertise in the international and public policy/public health arena.

If you decide to go to medical school you should plan to commit at least seven years (four years of medical school, plus at least three years of residency). 

Howard Dickler

If you feel a calling to medicine, then by all means respond to it. More and more medical students these days are older than the prototypic student fresh out of college, so you will definitely not be out of place.

But as you point out, it involves four more years of school plus postgraduate (residency) training. So, you should carefully consider what you wish to do when you are finished. If the answer is research, then you will have to consider what kind, because your doctorate in public health will equip you to participate in many types of research including clinical, translational, and health services research. Bear in mind that research today is becoming more multidisciplinary and increasingly involves teams of investigators with complimentary areas of expertise.

Maria Soto-Greene

A physician can opt to pursue research without completing a PhD degree. Typically, a medical student becomes involved in summer research. However, you can also apply for a joint MD-PhD degree, which typically takes about seven years. You complete the first two years of medical school, do three to four years of research, and then return to your third and fourth years of medical school. We do have a paucity of physician-scientists and, in particular, those who are underrepresented in medicine.

George Richard

Students with these interests enter medical school and follow a combined MD-PhD program, during which a period of time (usually between the second and third years of medical school) is spent pursuing a research degree. This can be in any of a number of scientific areas, including biochemistry, cell biology, biomedical engineering, genetics, epidemiology, molecular biology, neuroscience, and others. MD-PhD programs can take seven to eight years to complete and are the most popular route to becoming a physician-scientist. Another route to a research career is through the completion of a research fellowship following receipt of the M.D.

Most MD-PhD graduates are employed as faculty members in academic medical centers, conducting either basic science or clinical research. Other employment opportunities exist in both government (e.g., the National Institutes of Health and the Centers for Disease Control and Prevention) and industry (e.g., pharmaceutical research and biotech).

The field is small (only about 5 percent of the physician workforce), but demand is strong due to the aging of the physician-scientist population and the unbelievable growth of medical research, discovery, and innovation. This is an exciting time to go into the medical research field.

Howard Dickler

There are many different pathways a physician can become engaged in research. For example, I became an investigator more by chance than by plan. During my residency training in medicine, I had the opportunity to spend six months working with an eminent scientist and the experience changed my life and my direction.

But if you are an undergraduate and seriously wish to pursue both medicine and research, you should definitely think about MD-PhD programs. These are generally seven-year programs that involve three years of thesis work conducted between the second and third years of the medical school curriculum. This provides a very strong background for doing biomedical research. In fact, if one compares success in obtaining NIH funding, MD-PhDs are consistently more successful than are either MDs or PhDs. In addition, most programs provide your tuition, fees, and a stipend to live on for the duration of the program. Those MD-PhD programs that are supported by a National Institutes of Health Medical Science Training Program grant are the most highly regarded. You can get details on these programs at the website of each medical school.

The opportunities for research are almost endless. There are many different kinds: laboratory research, clinical research, translational research, health services research, public health research, international health research, etc. The majority of positions are in academia or industry or with a federal agency like the National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC), or the Food and Drug Administration (FDA).

If you have an inquisitive mind and like to solve problems, a career in research is richly rewarding.

Maria Soto-Greene

Don't worry. Even when you think you know, it is not until you enter the clinical years (third and fourth years of medical school) that you really experience the various specialties and go for the one you love.

You will need to decide no later than the beginning of your fourth year since you will need to begin to apply for residency training programs. In terms of other careers for MDs, there are many opportunities in the field of medicine.

George Richard

For most people, the choice of specialty is made during the last two years of medical school. Prior to that time, students are engaged in a variety of educational opportunities that expose them to the many career options and specialties available in medicine.

Your school may offer career planning services to help you select a specialty that fits your interests, values, and personality. Most schools will offer access to Careers in Medicine, which offers a variety of resources and exercises to help you choose your specialty.

While most physicians are employed in clinical practice, there are many other ways to use your medical degree, including teaching and research; working in federal, state, and local governments; and working in private industry.

Your direction will be based on your interests and passion for the field. Keep your mind open to the many opportunities that will be presented to you.

Maria Soto-Greene

There are many options. For example, you can work for a medical school, which offers a combination of teaching and clinical practice.

We are in need of diversity in academic medicine. This may become your calling.

George Richard

Most physicians work in either a private practice (as a solo practitioner or member of a group practice or clinic) or in a hospital. Others work in federal, state, and local governments or in colleges and universities.

Depending on your interests, other opportunities exist in business and industry and involve research and development, broadcasting, even serving as expert witnesses in the forensics field.

There are also some nontraditional work environments to consider, such as aerospace medicine, undersea and hyperbaric medicine, and international medicine focusing on health needs of special populations and other parts of the world.

Maria Soto-Greene

Increasingly, we have had students who have families or pursue them while in medical school. In selecting a school, you may want to see what is available. For example, do they have a decelerated option in which you can complete the first two years in three years?

George Richard

While it is not impossible to go to medical school and maintain family commitments, medical school is a very demanding responsibility, and the ability to continue to maintain the balance that you had before will be difficult. Organization, planning, flexibility, and family support are important to your success, as is communication with your spouse and with medical school personnel.

The number of women entering medical school is increasing and is now at around 50 percent of the student body. The increasing number of women entering the profession as practicing physicians is likely to impact the nature of the profession and its view of work-life balance, both during training and in practice. Changes are already beginning to take place, but there's still a long way to go.

Denice Cora-Bramble

It is possible to become a good physician without neglecting the roles of wife and mother, but you need a good support network and an understanding spouse. The field of medicine is much more receptive now to women, and there are multiple part-time options during training that are particularly attractive to parents of young children.

Maria Soto-Greene

It can be done — in medical school and residency. Once accepted to medical school or during interviews, ask questions of the students or staff. They will be honest about what works.

George Richard

Yes, it's possible. But the demands of a medical education will make for a difficult balance.

For many students, the best time to start a family is during the fourth year of medical school, when there is a little more flexibility in the curriculum. But it will still have a significant impact on such things as financial aid deferment and the start of residency training.

Some students choose to take a leave of absence to start their family, but this also will have an impact on the process of medical education and USMLE exams, which are taken at different stages of the medical school curriculum. 

Denice Cora-Bramble

Clearly the easiest way to complete medical school and residency is without young children. The last few months of residency or the year between residency and your first job are probably the ideal times to start a family.

I would not recommend pregnancy and childbirth during medical school. As long as you are focused, it is not difficult to go back to training after maternity leave, but you need to have good childcare and family support. In my opinion, colleagues and residency program directors are usually supportive of individuals taking maternity leave.

Maria Soto-Greene

There are no defined hours. You will need to pursue the type of career or practice setting that provides you with the balance you are seeking.

For example, you may want to work in a clinic with defined hours or become an emergency medicine physician with defined shifts. However, it is important that you choose a specialty/subspecialty that you enjoy.

George Richard

In general, fulltime practicing physicians work approximately 55-60 hours per week, and to some extent, the number of hours worked tends to vary by specialty.

Sometimes the work day can be extremely long, and many physicians are expected to be on call at various times during the week. In larger practices, where the on-call responsibility is shared with a larger number of physicians, there may be more flexibility. But the commitment to a medical career is significant and encompasses all aspects of your life.

Still, most physicians find time to be with family and friends and to get involved in a number of outside interests and activities. A fulfilling life as a physician is always possible.

Maria Soto-Greene

You will need to complete four years of medical school and four years of residency training in general psychiatry. You can also choose specialty training, such as in child psychiatry.

George Richard

Following medical school, residency training for psychiatry can be completed in four years. Some psychiatrists opt to continue fellowship training in a number of areas, including addiction psychiatry, child and adolescent psychiatry, pain medicine, forensic psychiatry, and geriatric psychiatry. These fellowship training experiences require an additional one to two years.

Maria Soto-Greene

In terms of what steps to take, you will need to pursue medical school, three years of an internal medicine residency training program, and two to three years of infectious disease fellowship training.

George Richard

Once you complete medical school, the path to an infectious disease career is through completion of a three-year residency in internal medicine, followed by a two-year fellowship in infectious disease.

Another route involves obtaining a pediatric infectious disease fellowship, which focuses on the diagnosis, treatment, and prevention of infectious disease in children. Training involves three years of a pediatric residency followed by a three-year fellowship in pediatric infectious disease.

Maria Soto-Greene

As long as there is cancer, there is a great need for oncologists. In fact, as the population ages, the need will continue to grow. You can become a medical oncologist, a radiation oncologist, a surgical oncologist, or an orthopedic oncologist to name a few types of specialties.

George Richard

Specialization exists in hematology and oncology, oncology, gynecologic oncology, musculoskeletal oncology, pediatric hematology/oncology, and radiation oncology, each of which contains different training requirements and focuses on slightly different areas of specialization.

A study conducted by the AAMC for the American Society of Clinical Oncology projects a shortage of oncologists by the year 2020. Projections also indicate that demand for oncologists will far outweigh supply in years to come.