The arduous track leading to the medical degree generally continues along a single path toward equally taxing residencies and fellowships. What usually follows is a lifetime of comforting and healing in private, public, or academic settings. Few professions can claim to be as admirable or noble.
Still, one cannot help wondering if consideration should be given to alternative paths. Is there more to a medical degree than meets the traditional eye? Is it all that it can be? Are current aspirations of those who attain it commensurate with present-day needs and opportunities? Are medical students exposed to the unconventional, let alone encouraged to explore it?
These and related questions first came calling during my tenure as a medical school dean, when students who were grappling with career decisions would come to me for advice. All too frequently, a guilt-filled confession would presage a conversation revolving around nonclinical professional interests. Would I approve of unorthodox career choices? Might I frown upon a road less traveled?
Their concerns couldn’t be further from the truth, because I have come to realize that the medical degree’s versatility is woefully undervalued. Other professions have long seen the light. For example, how many proud owners of the Juris Doctor degree argue cases in court as a matter of course? In all likelihood, precious few. Instead, lawyers put their talents to good use in numerous walks of life.
So I would encourage those with a medical degree who are drawn to an unconventional path to by all means “Go West, young medical man and woman!” and seek new kinds of opportunities. A medical education provides insights that are invaluable to diverse fields of human inquiry and pursuit that are complementary to comforting and healing—and are no less relevant.
In an economy in which health care expenditures account for close to one-fifth of the gross domestic product, opportunities abound. Furthermore, with globalization well under way, US-trained physicians are no longer confined to familiar shores as vast new needs and opportunities unfurl. Although precise numbers are hard to come by, there can be little doubt that growing numbers of them are being thrust into positions of leadership in parts of the globe where their expertise is highly valued. Leading the way will be physicians who attained additional training in fields as diverse as business, public health, public administration, and law.
Perhaps the most obvious outlets for physician leadership are health systems, free-standing hospitals, skilled nursing facilities, hospices, and other institutions of care. However, physician leadership is equally central to health plans, think tanks, professional associations, and of course the corridors of government.
Physician leadership need not be limited to government’s executive branch. Much could be said for increasing the ranks of physicians in the US Congress, which currently has 3 physician legislators (3%) in the Senate and 22 (5%) in the House. By comparison, 169 members of the House (38%) and 57 members of the Senate (57%) have law degrees.
Physician leadership also constitutes a key ingredient of a vibrant private sector. It is difficult to envision commercial success in the health care arena without physician leadership in the pharmaceutical industry and the universe of biotech startups, not to mention venture capital enterprises, hedge funds, consultancy shops, and private equity firms.
When I visit with medical students and residents in training, I inquire about alternative career paths, and I am generally left with the sense that interest in alternatives to the well-trodden track remains low. Such is the power of tradition and culture. Only the occasional student seems to resonate with the notion of expanded vistas and voices these thoughts in public or in private.
Still, such conversations about alternative career paths are occurring at a time when concepts about our health care system are evolving. In this time of change, I cannot help feeling that all enterprises that affect health and health care would do well to seek and embrace the input of medical professionals.
About the author: Eli Y. Adashi, MD, MS (Eli_Adashi@brown.edu) is Professor of Medical Science at the Warren Alpert Medical School of Brown University in Providence, RI. A member of the Institute of Medicine, the Council on Foreign Relations, the Association of American Physicians, and the American Association for the Advancement of Science, Dr Adashi has focused his writing on domestic and global health policy at the nexus of medicine, law, and ethics. A former Franklin fellow, Dr Adashi served as a senior advisor on Global Women’s Health to the Secretary of State office of Global Women’s Issues during the Obama Administration.
About The JAMA Forum: JAMA has assembled a team of leading scholars, including health economists, health policy experts, and legal scholars, to provide expert commentary and insight into news that involves the intersection of health policy and politics, economics, and the law. Each JAMA Forum entry expresses the opinions of the author but does not necessarily reflect the views or opinions of JAMA, the editorial staff, or the American Medical Association. More information is available here and here.