Students Pursue 2 Degrees, Help Underserved
By Catherine Duncan
While a medical school program may be difficult in itself, since 2007, 185 graduates have added earning a Master of Public Health to their pursuit of receiving their Doctor of Medicine.
The M.D./M.P.H. dual-degree program is the result of a partnership between the Joe R. and Teresa Lozano Long School of Medicine at UT Health San Antonio and The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in San Antonio, which offers and confers the M.P.H.
This innovative four- or five-year program prepares students to integrate medical and public health skills as practitioners and researchers. By combining M.D. training with an M.P.H. education, students have the opportunity to be better prepared to treat individuals and to address global health issues in communities. The program is ideal for students interested in global health, community health, clinical research, health promotion, public policy or administration, environmental medicine and preventative medicine.
Barbara Taylor, M.D., M.S., assistant dean for the M.D./M.P.H. Program, said students self-select to apply for the program. Each year, an average of 20 students participate in the program.
Students who receive admission to both the Long School of Medicine and UTHealth’s School of Public Health, enroll and complete coursework at the UTHealth School of Public Health in the summer prior to their first year of medical school.
“While most students complete the program in the four years, those who do a fifth year are doing public health work in addition to their M.P.H. coursework,” Dr. Taylor said. Students who apply to UTHealth School of Public Health after starting medical school can transition into the five-year program.
“In 12 years, 94 percent of students who began the dual-degree program completed it. That is an incredible success rate,” she said.
Melissa Valerio-Shewmaker, Ph.D., M.P.H., campus dean and associate professor for UTHealth School of Public Health, said the M.D./M.P.H. Program was the first in The University of Texas System. The partnership has been used as a model by fellow UT System schools and other universities.
The dual-degree program is offered across the UT System Health Institutions at UT Southwestern Medical Center, UT Rio Grande Valley and the McGovern Medical School, a part of UTHealth in Houston.
“Our partnership developed because of a mutual vision and interest in serving the San Antonio region. By collaborating, the schools can better address health taking into account the community setting and needs of our rural partners including federally qualified health centers (FQHCs). Both institutions are dedicated to addressing social determinants of health. This program allows us to contribute to the training of providers to serve our region and beyond,” said Dr. Valerio-Shewmaker.
By completing this program, students are given additional tools to be able to understand and serve their community and patient populations, she explained. “Students tell me they have a broader understanding of health and community, community resources in place to fill the health gaps, and other issues that exist affecting patients’ abilities to follow their doctors’ orders.”
Dr. Taylor said students gain greater understanding and compassion through their involvement in a UTHealth School of Public Health 180-hour program practicum, which requires students to engage in a practice-based experience and project that benefit a community. “This practicum can be done in San Antonio, South Texas or in another country,” she said.
Soraya Naqvi, a fourth-year medical student, said she chose to apply for the dual-degree program after taking classes on global health at Baylor University, where she earned her undergraduate degree.
“I learned the impact you can make on health in underserved communities,” she said. “I am interested in helping Spanish-speaking communities in Latin American countries and in South Texas.”
For her practicum, Naqvi went with the university’s Center for Medical Humanities and Ethics to sugar plantation communities in the Dominican Republic to assess their health needs.
“We worked with health promoters in those communities to figure out how we can best help those individuals on the next global health trip,” she said. “I interviewed the health promoters and analyzed the data to figure out what they truly needed regarding personal health issues and community health needs, all of which I included in my report.”
Naqvi later used the skills developed in the Dominican Republic to evaluate a Texas Department of State Health Services program on latent tuberculosis screening and treatment in a rural community. She was able to do this work as a Kleberg Scholar with funding from the Robert J. Kleberg, Jr. and Helen C. Kleberg Foundation.
Ricardo Pedraza, M.D., M.P.H, Class of 2018, completed the M.D./M.P.H. Program in four years and currently is completing his residency in internal medicine at University Hospital and the Audie L. Murphy Memorial Veterans’ Hospital.
Dr. Pedraza said he chose to work on his M.P.H. while earning his M.D. because he wanted to learn about the barriers that prevent people from getting health care. Growing up, he saw family members, including his grandparents, struggling with health care problems and access to care. After completing his residency, he plans on being a primary care physician and focusing on health promotion.
For his practicum, Dr. Pedraza worked to identify why patients seen at the emergency room at University Health System’s Robert B. Green Campus fail to show up for follow-up appointments.
“The no-show rate for the follow-up appointment two weeks later was 50 percent. When I interviewed those who showed up and contacted those who didn’t, I learned there were a number of contributing factors: anticipated cost of appointment, lack of transportation, and confusion about the need for the follow-up appointment,” he said.
Dr. Pedraza said the project helped him better understand medicine in general and social determinants of health in particular. “We must keep all of this in mind when we are talking to patients. I am now able to implement what I learned from this experience.”
Dr. Taylor said she enjoys watching the students begin the program and then grow. “Each student has a different path. Many start with a vague interest in public health. By their second year, they find one area they are very passionate about. By the end of the program, they each have a specific interest with a specific set of skills to perform this work,” she said.
“Seeing them develop into leaders in health and public health before our very eyes is exciting. I love working with students as they discover their identities as public health leaders. Our graduates are going out into communities and improving health and health care systems.”