Public Health

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Tue Jan 20 12:25:42 EST 1998

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Karen Lona Allendoerfer wrote in message
<199801182308.SAA21286 at>...
>Hi, I hope everyone's back from Christmas and having a good new year!
>        I wanted to bring up a topic I haven't seen discussed yet on this
>group; it's a big factor in a career decision for me, but the way it's been
>handled so far in my education isn't making sense to me (yet).  I was
>wondering whether others who might have similar interests could share their
>thoughts or experiences.
>        I have been interested in public health for a long time.  I read
>the "personal health" columns in magazines and newspapers religiously, and
>always have an opinion on health matters (sometimes to the annoyance of
>friends and acquaintances).  Along with Marie Curie, other heroes I had
>when I was growing up were Elizabeth Blackwell and Dr. McCoy from Star
>Trek.  Oh, and Quincy.
>        I wanted to do "medical research," and was pre-med for a while, and
>that's where this whole "problem" started.  I was dissuaded, rather
>strongly (it seemed, anyway) from going into medicine by the pre-med office
>of my undergraduate institution.  They said things like "if you really want
>to do research, the time spent doing actual research, rather than getting
>an M.D., would be better for your career."  The culture surrounding
>"pre-med" was really rather appalling, in any case.  It seemed as if no one
>liked pre-meds (sometimes for good reason).
>        And when I was applying, back in 1987, for medical school, they did
>ask me a lot of questions about topics that I had little to no interest in,
> questions about HMO's and managed care, and my lack of interest in these
>sorts of topics did make me think twice about becoming a physician.  And
>when one interviewer asked me why I wanted to be a doctor, and I told him I
>wanted to do medical research, the look on his face was sort of as if he
>had stepped in something unpleasantly aromatic.  Another interviewer kept
>trying to get me to get in touch with my feelings during the interview.  He
>wanted to know how it "felt" to give a violin lessons to a 50-year-old
>beginner (something I had mentioned in passing in an essay on
>extracurricular activities), and told me I came across as too "in my head"
>in the essays.  I've since wondered, in my head as opposed to where?  In
>his head?
>        When I talked to a few people who'd gone through MD-PhD programs, I
>became convinced that such a program wasn't for me, mainly for physical
>reasons.  I need too much sleep.  In fact, I've never been able to stay
>awake for 36 hours straight, and the one all-nighter I pulled in college
>made me physically ill.  When one interviewer in an MD-PhD program
>described the "exhilaration" of being pulled awake in the middle of the
>night in the on-call room to get a patient's heart started for the third
>time that night, I thought I was talking to an alien.  I felt vicarious
>pain and sympathy for the patient, and only a bit less for my imagined self
>as a resident unable to get any sleep.  But exhilaration was the furthest
>thing from my mind upon hearing that story.
>        So, for reasons like that, I decided against the MD-PhD, and went
>on to get a PhD.  I thought that I could still pursue "clinical" interests
>and "medical research" through getting a research job at a medical school.
>But here too the culture was alien.  Few in the PhD culture I was immersed
>in seemed to have much respect for having clincal interests.  There was the
>attitude of "we have to make our work relevant to a disease so it can get
>funded," but if one was actually sincerely interested in the clinical
>implications of one's work, then one wasn't a serious scientist.
>        Basic scientists did science because they were "curious about how
>the world works," and "liked to solve problems."  Not because they wanted
>to "help people."  I was involved for a while in a debate against animal
>rights activists.  Many of the scientists cautioned that we shouldn't make
>too much of how biomedical research using animals has cured diseases,
>because most scientists didn't do research with this in mind.  They were
>right.  And if I had a dollar for every time I have heard, in the past 10
>years, from PhD's, that "M.D.'s don't do good research" or "MD-PhD's often
>get a second-rate PhD," I'd be rich by now.  How much of this is true, and
>how much is it jealousy of M.D.s' higher prestige and pay for the same
>work?  I've never really been able to evaluate that.
>        So now I find myself again in a strange position.  I am applying
>for a position where "clinical interests" should be a plus, and finding all
>of the sudden, again, that I might not seem "clinical" enough.  I am always
>feeling like a fish out of water, that I don't fit into the clinical world,
>nor the basic science world, and that my dual interests are considered more
>of a liability than an asset in either place.  Either I'm a cold
>intellectual, too in my head for the MD's, or a naive dreamer without the
>proper drive and intellectual curiosity in the eyes of the PhD's.  And I
>still would like, somehow, to use my scientific talents and education to
>"help people."  The public, by and large, supports medical research very
>strongly.  The NIH has done well even in the budget-cutting years, and may
>do even better if the government actually balances the budget or has a
>surplus.  It seems like it ought to be a no-brainer to figure out how to do
>something that there's so much support for, but I'm having a lot of
>        I've come up with a few thoughts, from less to more adventurous.
>One of the more extreme thoughts was to engage in a complete career change
>and get an M.P.H.  Another was to try to get a research job in a medical
>school in something like an Alzheimer's Disease center.  Another was to get
>a job in the biotech industry working on drug design.
>        I applied for a AAAS fellowship to work with Congress a couple of
>years ago, but was turned down, and that made me realize how unprepared I
>am for making this decision and carrying out the necessary steps to achieve
>my goal of doing medical research with benefits to the public health.  I'm
>sure the selection committee received applications from much
>better-prepared, more thoughtful, and more well-directed applicants than I
>was--and I would like to become better prepared, more thoughtful, and more
>directed myself.  But I am having real trouble knowing even where to start.
> Does anyone have any ideas or thoughts?
>Karen L. Allendoerfer, Ph.D.
>Dept. of Physiology, Columbia University P&S
>630 W. 168th St.
>New York, NY 10032
>(212) 305-3691 (phone)
>ka143 at

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