Choosing and getting into MPH programs: Part 1: Should you even get an MPH?

This is Part 1 in my series about choosing and getting into (and funded by!) MPH programs.

Let me start by saying something in general about master's programs. I have a fairly task-oriented view to master's programs, which is that they should serve a specific purpose in your life and you should feel fairly confident about what that purpose is.

It makes me nervous when someone talks about having found a master's program in "EXACTLY what I want to do". This is often preceded by someone explaining to me that they love swimming, and they are really into crafts, and they have just been wanting to take this interest farther, and come to find out they have just heard about a master's in underwater basket weaving (MUBW)!! Isn't that PERFECT?

And then I get a little bit cringe-y. Because yes, while you can have a fun 2-ish years doing exactly what you want to do, you then need to get a job. Do I love doing breastfeeding work? Yes, I made it a huge focus of my MPH degree. Would I rather have gotten a master's in lactation studies instead of an MPH? Honestly, no. I might have a super fun 2 years thinking and talking about my exact interests, but then I have to find a job. The breastfeeding promotion programs out there are probably going to be looking for an RN, RD, MPH, or MSW. And while they may be happy to hire someone with a master's in lactation studies, they're the only ones: that degree isn't going to have a lot of portability if the only jobs I can find are in HIV prevention or monitoring a heart disease reduction program. Those jobs may not be exactly what I want, but life doesn't always give you exactly what you want; it's good to spend the time and money on something that is adaptable.

This may be a cynical view, but schools need money and a master's program is a way to get it. They don’t have to worry about your long-term marketability. Just because you CAN get a degree in something, doesn't mean you SHOULD.

And that applies not just to the MUBW degrees of the world, but also to these more generalized degrees. Just because you're interested in public health doesn't mean an MPH is right for you. You may be happier and better suited to come at the public health issues you're interested in from a clinical approach, a legal background, or a social work degree (and all of those are also programs which often offer dual degrees with an MPH, for what it's worth). One of those may offer better fallback options for your interests and skills than the MPH, if your dream jobs aren't opening up.

While having a fairly accurate idea of what kind of job you want to do is of course not a prerequisite (thank god for those of us who are indecisive) it can be very helpful. I was talking with a friend the other day who talked about working backwards from the jobs he wanted to the kinds of degrees that people in those jobs held. While the MUBW might seem attractive at first, you may discover that all the underwater basket-weavers have degrees in hydroengineering, or that they all came up through an apprentice system. Jobs in public health are likewise filled with people from a huge range of backgrounds, including biology, engineering, economics, midwifery, nursing, medicine, etc. The jobs you’re interested in may be in public health, but need another type of degree, either instead or in addition to a public health degree.

You can also work forward from the degree and see what kinds of jobs the people who get it tend to do. Keep in mind that by no means are you limited to those fields, but that if you hate the sound of all of them, they are probably not going to be great as your “fallback” jobs if what you really want doesn’t pan out at first.

If you aren’t really sure what you want to do, I’d sit down and ask yourself again why you want to go to graduate school right now. Again, grad school = means to an end. If you have unlimited time and money, get all the degrees you want! But otherwise, know why you’re going to grad school and what you’re planning to get out of it.

All this is less about an MPH in particular, and more about advanced degree programs in general, but I know a few too many people who have done Perfect Degree X and then been shaken by the realization that there are a) no jobs in that field, b) no jobs in that field that they like, c) no jobs they like that they are newly qualified for, d) that they had no idea what the jobs in that field actually were like in the first place, or e) all of the above. (You’ll find doctors completing their residencies who confront (b) and/or (d), which with hundreds of thousands of dollars in debt truly sucks.) So before anyone runs out to get an MPH, I had to do a disclaimer post: just because you can get in doesn’t mean you should do it! Don’t e-mail me in three years wondering why you wasted your time on an MPH when you should have gotten an MUBW! Think hard about it first. All this self-reflection will help you pick the right MPH program if that's what you end up deciding that you want to do.

Edited, June 2011: Many doulas and other birth worker-type people ask me if they should get an MPH. The attraction is pretty strong for us types! We see the system issues, and where the research needs to happen, we are often committed to working with underserved populations, we want to be in a place to make changes on a big scale. But I also see the tension for those same people (myself included) once they enter the field and realize just how far removed most public health is from direct service. If you thrive on personal interaction with the population you serve, there are positions for MPH grads that can fulfill those needs, but they are not in the majority. I find many of those direct-service-oriented people (again, myself included!) contemplating after they graduate whether they need both an MPH and a clinical degree to really get the right mix for themselves. Considering an MPH plus some kind of clinical degree (e.g. RN, CNM, MD, MSW/LCSW) may be a good option and there are many schools that offer dual degree programs. I say this, again, not to discourage anyone from getting an MPH but to really think about what is worth the investment of your time and money.

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Next in the series, I promise to actually talk about masters in public health programs and how to get into them…