Fellows in Training: Degrees, Degrees Everywhere!

I recently ran into a colleague of mine at the American Heart Association’s Quality of Care and Outcomes Research Scientific Sessions in May in Atlanta, Georgia. Having been a classmate of mine since college, I knew this person (let’s call him “John”) for more than 10 years. John, a second-year cardiology fellow at a very prominent institution, started telling me about how he was getting excited to finally have some relief from clinical time so that he could start pursuing his interests in outcomes research. Our talk then turned to advanced degrees. He was going to pursue additional degrees to reach his goals, but couldn’t decide between the Masters of Public Health and the Masters of Clinical Epidemiology. “Why not get both?” I joked.

However, as I left the poster session, I began to wonder. Are we getting additional education and more degrees to acquire “the skills” needed to achieve our life goals? Are we merely pursuing the “labels” these degrees afford, hoping that they will open doors? Don’t get me wrong, I’m into labels as much as the next girl (Gucci, Prada, Louis Vuitton—they all do it for me!), but does a person who has excelled at M.I.T and Harvard really need to take a math class in statistics in order to learn how to conduct outcomes research? Or rather, it is just that it has become necessary in the current research environment to have an “MPH” or an “MS” behind our “MD” in order for people to take us and our research interests more seriously? Do we need these “labels” to get funded? Do we need them to get jobs?

Current research shows that more individuals are pursuing multiple graduate degrees than ever before. This is not surprising at all. After all, the degree menu is quite appealing and most places even have a special: for only 5 years of your time (and the price of 4 years of tuition), you can receive an MD, with your choice of a side of MBA or MPH. If you add an extra year, you can substitute these sides for a “super-sized” JD. It’s a wonder more people aren’t ordering the special off the menu and there isn’t more alphabet soup out there behind people’s names.

The same is true for our clinical training. When our mentors trained, there was a 3-year cardiology fellowship. Period. It has now become 4 years at most academic programs, along with several additional years of sub-specialty fellowship training. Interventional cardiology used to be 1 additional year—now it’s 2! As we move towards becoming hyper-specialized, the length of our training keeps growing longer and longer. Add that to the extra degrees we are now pursuing and we will all be fully trained just in time for our retirements! Seriously, though, does it ever end?

Falling Into the Education Trap

Over time, I have come to appreciate that the value these additional letters add is not only in the skills that are acquired from taking these classes, but also in the exposure to those around us and the contacts we establish through our education. For some, they truly offer a unique perspective and open up new opportunities. But regardless of these advantages, after a certain point of training—enough is enough—we need to “grow up,” start working, and stop the never-ending quest to amass more and more degrees to hang on our walls. Additional education or fellowship training should become about really helping us reach the goals we have been working towards all these years, not just about legitimizing ourselves to our colleagues or our fear of finally joining the work force.

I can still remember studying like a maniac for the SATs at the age of 15. It actually doesn’t really seem all that long ago. And I know why... not much has changed since then! It was only a few months ago that I found myself in similar circumstances: my nose buried in my books, sitting with my giant-sized Diet Coke in a cubicle at the library, studying for my internal medicine boards. And now, perched at the cusp of the next step, my cardiology fellowship, the buzz about cardiology board review courses has already started invading my life and my inbox. Even our mentors, I realize, are in the same boat—they all have to study for their recertification boards!

Perhaps we have all chosen a field in which we are in some ways destined to remain students forever. I suppose the ongoing lifelong learning and knowledge is what keeps our fields interesting. But, as much as we can avoid it, we should refrain from falling into the education trap by acquiring titles that don’t help us achieve our objectives but instead distract us from them.

Payal Kohli, MD, graduated from MIT and received her MD from Harvard Medical School. She completed her internal medicine residency at Brigham and Women’s Hospital in Boston and is currently a research fellow at the TIMI Study Group. Dr. Kohli will begin her clinical fellowship in June 2012 at the University of California, San Francisco.

Clinical Topics: Prevention, Diet

Keywords: Outcome Assessment (Health Care), Books, Boston, Fellowships and Scholarships, Internship and Residency, Fear, Public Health, Mentors, Diet, Retirement, Internal Medicine, United States, Research

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