We read with interest “Getting an Advanced Degree—Why Bother?” in the April issue of The Hospitalist. We appreciate the discussion given LS’s background in hospital medicine and now 31+ years of administrative medicine, as well as MS’s unique perspective. We are father and son. Several points were not made:
Timing of the master’s in a clinical career. Many of the hospitalists mentioned in the article pursued the degree early in their career. LS presented a peer-reviewed poster at the April 2012 American College of Physician Executives (now American Association for Physician Leadership) annual meeting in San Francisco titled “Master’s vs Non-Master’s, What Is a Physician Executive to Do?” The data, drawn from the ACPE annual compensation committee on which LS served, showed that the most advantageous time to acquire a master’s was after five years of clinical experience upon completion of residency. This timing of getting a master’s with an administrative focus resulted in a promotion (in-house or elsewhere) within two years of completion, along with an average salary increase of 17%. The type of administrative master’s degree acquired did not make a difference. For a clinical or administrative career, completing a master’s degree early (with the MD or DO), or late (end of career), did not produce a similar advantage.
Timing of a master’s in a non-clinical pathway. If you’re not entering a clinical career, acquiring a master’s degree before, along with, or soon after the MD or DO, appears to be the best option (MS). Careers in pharmaceuticals, consulting, and venture capital frequently treat the advanced degree as an entry-level requirement, rather than a differentiator. The early-career physician moving into these spaces is competing against master’s in business administration (MBAs) from top programs, and the MD alone, however clinically prestigious, does not signal the business fluency these employers screen for. Firms like Boston Consulting Group and McKinsey hire MD candidates into structured consulting tracks at the same base salaries as their MBA hires. Pure MDs without an advanced degree often do make it into consulting, but consulting firms often recruit the pipeline they know: MD or MBA candidates from top medical or business schools. The five-year clinical practice benefit mentioned above, which holds for hospital and hospitalist clinical administrative tracks, does not generally apply to the non-clinical world. If anything, the opposite is true. Delay in completion of the master’s degree risks pricing the physician out of entry-level roles where the advanced degree is an assumed prerequisite.
Program prestige is judged differently in different circles. Per LS’s poster data referenced above, the type of master’s did not appear to make a difference in the clinical aggregate, and the general recommendation was to pursue the master’s that fit the physician’s cost, location, timing, and family circumstances. That guidance still holds, but with important caveats 14 years on. The MBA and master’s in health administration (MHA) rankings do not map onto each other, and prestige is judged differently depending on the audience and the preferred job (hospital administration or clinical positions versus consulting versus pharma). The right answer in degree and program selection depends on what the physician is trying to accomplish. The “Pursue Learning, Not Letters” article on page 9 of the same issue hints at this, though the choice is more deliberate than that framing suggests.
The aforementioned points add context and color to the recent Commentary from the January 2026 issue titled “Being a Hospitalist in Your 60s and 70s,” focusing on the benefits of more senior hospitalists, the value of advanced degrees, and the impact of both on career trajectories.
By the way, both of us agree that getting a master’s worked well for our careers!
Dr. L. Scarpinato
Dr. M. Scarpinato
Dr. Len Scarpinato’s 40-year medical career includes 30+ years in physician executive positions. He was an original member of the National Association of Inpatient Physicians (a precursor to SHM), started one of the first hospitalist programs in Wisconsin, and has been an associate chief medical officer at a major hospital and chief medical officer at the largest privately held hospitalist company and a major national primary care physician group specializing in managed care of elderly Medicare HMO patients. Dr. Mark Scarpinato is a principal in the Healthcare and Life Sciences practice at Publicis Sapient in Denver, where he leads large-scale digital transformations for payers and providers. His prior experience includes strategy consulting at Boston Consulting Group and Deloitte and an internal medicine residency at the University of Colorado in Anschutz, Colo. He completed his MD at the Medical College of Wisconsin in Milwaukee and his MHA at the University of Pittsburgh in Pittsburgh.
I fully agree with the recommendation for timing of a MBA or MHA for a clinical leadership career to be more than 5 years after completion of training. Establishing a reputation for clinical excellence is a prerequisite for moving into leadership, followed by pursing an advanced degree.
Many years ago I was part of an MBA cohort, and one of my department’s physicians asked if I would seek out some career advice about his son who was pursuing a combined MD-MBA at a prestigious university. I asked our most esteemed MBA professor for his advice, and he didn’t hesitate to state that the first thing this physician’s son needed to do was to practice medicine full time for 5 years, then begin to move into leadership, assuming his interest was clinical leadership.
I do find it interesting for non-clinical careers, getting the MBA early on is essential, as that appears to be the key that unlocks the non-clinical leadership door.
I guess another way of saying it is that for clinical leadership, practicing excellent medicine for 5 years, establishing your clinical credibility and reputation, is the key that unlocks the clinical leadership door. Fortunately, we have moved far beyond the bad old days when a physician who couldn’t cut it in clinical medicine would default to administrative roles.