An increasing number of doctors, including hospitalists, are pursuing advanced degrees beyond their medical degrees, driven by intellectual curiosity, the belief that such a degree is necessary for leadership positions or other roles, and by the ability to pursue these degrees mostly in an online format, giving them the flexibility to keep working as they do the coursework.
A 2021 study found a 434% increase in dual MD-MPH degrees from 2010 to 2018, even though the number of MDs increased only 16%, and the number of MPH degrees increased only 65% over that period.1
In a JAMA publication, researchers reported that about 61% of medical schools in the U.S. offered an MD-MBA dual degree program, up from about 26% in 2002, reflecting an increase in physicians getting such degrees.2
Hospitalists who have completed advanced degrees—at an expense between $30,000 and $60,000, depending on the program—say they are happy with the decision, that the degree has been useful in their careers, and that they found the coursework manageable while continuing their usual work as a hospitalist.
Adding an MHSI
Dr. Reid
Leah Reid, MBBS, MHSI, a hospitalist at the Medical University of South Carolina (MUSC) in Charleston, S.C., had completed her medical degree in Barbados and worked as a general practitioner there before completing the medical licensing exam and then her residency in the U.S.
She began working as a hospitalist in rural Alabama in 2017, before moving to MUSC. Then she started to sense that she was still not fully prepared for what might lie ahead of her.
She thought she needed another degree. She was interested in the emerging importance of telemedicine and in making improvements to the electronic health record (EHR). So, she decided to get a Master of Science and Health Informatics (MHSI) through an online program at the University of Pittsburgh, while she continued working as a hospitalist at MUSC.
“For myself, I just saw a person who had time and a love of learning, and I just knew it was going to be the right decision for me,” Dr. Reid said.
Dr. Reid said that, while working in Alabama, hospitalists were dependent on telemedicine to get access to specialists because they were two hours away from the main campus in Birmingham. This piqued her interest in telemedicine and how to optimize its use.
Also, while there, she said, hospitalists found the EHR system to be cumbersome, and she was able to make modifications to it to make it faster to order COVID-19 panels and gastrointestinal-bleed panels. She also reduced the number of clicks needed to order morning labs from five or six clicks to one click.
It was her interest in these areas that guided her decision to get the Master of Science and Health Informatics, Dr. Reid said.
Some logistics also influenced her timing and choice of the program. Soon, a fellowship was going to be required before she could be board certified in clinical informatics. And the University of Pittsburgh allowed her to begin her coursework earlier, in the summer, helping her beat that deadline.
“Even a few months later, I knew I would not be eligible to do that exam,” she said.
She took two or three courses at a time, with two or three hours of classes per week. She would bring her laptop and log in for class after work between 7 and 8 p.m., she said. With her schedule of seven days on and seven days off, she was able to get the majority of her coursework done on the days off, she said.
“Sometimes I’d have a group meeting online on the weeks when I was on service, but I did most of my studying during my time off,” she said. “I didn’t have to request any special time off during my clinical duties to do classes or anything like that.”
She said the degree has led to “a lot of good professional relationships.”
One of the valuable parts of the degree is a deeper understanding of artificial intelligence, she said. Large language models burst into prominence when she was about halfway through the program, she said.
“I had built machine learning models and knew why I was using it,” Dr. Reid said.
“As more AI tools become available, it helps me to understand, from the clinical and a bit of the technical side, why something works or why it would not work. Because I want something that’s very usable, not something that’s not validated and would not be accurate.” She said this understanding will help her assess models for bias. “We want a healthcare system that’s fair to all, to everyone,” she said. “Knowing how a model is validated, how it’s built, will help if I ever have to make those decisions.”
Also, she said, she is a certified Epic builder and a go-to person for working on wrinkles in the EHR system, such as the time a certain smart phrase no longer pulled in the information that it previously had.
Now, with the degree, she feels she is more prepared for opportunities that might come her way.
“I didn’t want the years to pass, and a leadership opportunity arose, and I did not have the full qualification,” she said.
Adding an MBA
Dr. Rankin
Alex Rankin, MD, MBA, associate chief medical officer at the University of New Mexico (UNM) in Albuquerque, N.M., finished his residency in 2010 and went to the University of New Mexico in 2014 as a teaching hospitalist and as a medical director for the hospital.
He decided that he wanted to boost his knowledge of the business side of healthcare, so he enrolled in an MBA program that focused on healthcare administration at the University of Colorado. The two-year program was mostly online, but there was on-campus coursework in Denver for one week each semester.
“I’ve always really enjoyed learning,” he said. “And moving from a small community hospital to a large academic medical center really piqued my curiosity around all of the nuts and bolts that go into making this large healthcare system run. And so, almost out of curiosity, I wanted the degree as well as the benefit of it advancing my career. I think I just wanted to learn.”
A year after he finished the MBA, he was hired as associate chief medical officer at UNM.
“I strongly feel that having completed my MBA degree helped me be a competitive applicant for that position,” he said.
He said that, even though he had two young children at the time, completing the MBA while he continued his work as a hospitalist was “doable.”
“It was a lot of nights and weekends,” and he was helped by a lot of support from his wife, he said.
He said he spent quite a bit of time working on projects with fellow students after the kids went to bed. And, on weekends when he finished rounding in the hospital, instead of leaving, “I would stay and work and continue to run problem sets or papers or group projects.”
As he was considering which advanced degree to pursue, one option was a Master of Health Administration. But he settled on the MBA.
“For me, it felt like the MBA would be the most general overarching knowledge that would help me in my career,” he said.
“I think an advanced business degree definitely helps physicians and AAPs who want to go into healthcare leadership,” Dr. Rankin said. “It’s a strong foundation of general knowledge around economics and finances.”
The University of Colorado program, with just one week per semester of in-person coursework, fit his schedule, which is a major consideration when choosing a program, he said. He did the on-campus week during the off-week of his work schedule. Getting an MBA at UNM, where he was working, was not particularly feasible because it involved regular in-class time, and “I was working almost every other weekend on service.”
He said that physicians who like a program with more in-class coursework can complete the degree even if they are continuing their hospitalist work at the same time. It just might take some cooperation from colleagues.
“Having a good work environment with colleagues who are going to schedule around your needs is important,” he said.
Even though it wasn’t his path, he said that a dual degree is something for future physicians to consider, since it will give them insight as they set out on their careers.
“The classical medical school curriculum does not create physicians who have good fundamental knowledge of the healthcare system as it relates to financial management or supply-chain management, the way that we operate in the world with insurance companies, and how the payment for healthcare works in this country.
“Going into a residency with an MBA will allow you to view everything through a different lens.”
Multiple Advanced Degrees
Dr. Rothberg
Bonnie Gould Rothberg, MD, PhD, MPH, MMM, assistant scientist at the Sylvester Comprehensive Cancer Center at the University of Miami, and adjunct assistant professor in the department of chronic disease epidemiology at the Yale School of Public Health, said her assemblage of advanced degrees evolved as her interests evolved, and as her career circumstances took shape.
She got her MD in 1994, but a family consideration meant she had to pause her internal medicine residency. She then spent five years working in the biotech industry and returned to academia, getting an MPH in 2005, where she said she “fell in love” with the quantitative aspects of epidemiology, which prompted her to continue on to a PhD in epidemiology at Yale.
After joining the Yale faculty, she went back to residency in 2013, after which she began working as an oncology hospitalist, which was a bit of a novelty at the time. Her research moved to a focus on healthcare quality and safety. It was the best way, she determined, for her clinical work and her research to mesh and feed off one another.
But she needed to bolster her education even more, she decided.
“I felt that the field of healthcare quality and safety had a lot more background to it than I knew,” Dr. Rothberg said, “and rather than try to blindly wind my way through it and stumble, that if I got some formal training by experts in the field, I would be able to hit the ground running and be a lot more efficient and a lot more effective with my science.”
She also had an interest in physician leadership.
So, after getting useful guidance from a mentor at Yale who was also pursuing a new advanced degree and after a lengthy phone conversation with a master’s program director, she has worked toward two additional degrees in quick succession. She finished her Master of Medical Management degree from Carnegie Mellon University in December of 2022 and started her Master of Science in Healthcare Quality and Safety (MS-HQS) from Thomas Jefferson University the next month. She is due to graduate in May 2026.
“These programs are very much catered toward people who want to pivot towards a leadership role in hospital medicine,” she said. “It doesn’t have to be somebody who wants to move to the C-suite, but somebody, for example, who wants to take a leadership role in ushering through healthcare quality projects.”
The MMM was a hybrid program with half of the courses administered in an online format and half administered in-person, with students traveling to Pittsburgh twice a year for a week of intensive, all-day classes. A group of her fellow students still has an active WhatsApp chat, a testament to the collegiality of the program, she said. The MS-HQS at Thomas Jefferson University involved no in-person coursework but a substantial amount of group work nonetheless, and she has formed friendships with classmates, she said. The work has involved many late nights and a lot of weekends, but it has been worth it, she said.
She has produced scholarship on dedicated cancer urgent care centers and oncology hospitalists’ impact on hospital length of stay, discharge time of day, and on the utilization of hospice, and her newly acquired advanced degrees will only help her research efforts going forward, she said. She is currently preparing a manuscript from her MS-HQS capstone project.
“Now, when I need to talk to leadership on the finance side about wanting to design healthcare quality and safety projects, if they want to understand the business impact, I can at least appreciate where they’re coming from and understand the business case for quality,” she said.
Dual Degrees
Dr. Harlodson
Kathryn Haroldson, MD, MPH, a hospitalist at Cooper University Health Care and assistant professor of medicine at Cooper Medical School of Rowan University, both in Camden, N.J., decided to get her secondary advanced degree early, enrolling in a dual MD-MPH program at Tulane. At the time, she had rough plans to go into global health, potentially working with Doctors Without Borders.
Doing the coursework for both at the same time could be “incredibly stressful” when there were tests in her MD coursework at the same time as MPH tests, but “day to day, it wasn’t horrible.”
Although she didn’t pursue the global health path, she said the MPH has been helpful in her career.
She said the knowledge of the broader issues patients face has helped her in quality improvement work, involving collaboration with infectious disease, outpatient antibiotics, and transitions of care.
She said the degree has been particularly useful in caring for patients from underserved communities who need to navigate around more insurance hurdles and struggle with issues related to social determinants of health.
“I think it’s helped me a lot with that. You don’t learn about that stuff in medical school,” she said.
Also, she said, “I feel like you kind of have to have some kind of secondary degree to start climbing the administrative ladder.”
She said that even though she did a dual degree, that might not necessarily be the best choice for everyone.
“I don’t think it’s ever too late to do it. I think if you don’t know what you want to do, then maybe it is safer to wait and then kind of figure out what it is you’re more interested in,” she said. “I think there are a million ways to do it, and I don’t think there’s a right or wrong time, depending on your circumstances.”
Tom Collins is a medical writer based in South Florida.
References
1. Reilly JM, et al. Dual MD-MPH degree students in the United States: moving the medical workforce toward population health. Public Health Rep. 2021;136(5):640-647. doi: 10.1177/0033354920978422.
2. Laditi F, et al. Characterization of the landscape of joint MD/MBA programs in the US, 2002 to 2022. JAMA Netw Open. 2023;6(6):e2321268. doi: 10.1001/jamanetworkopen.2023.21268.