[Editor's Note: This is a guest post from a doc and regular reader who comments under the name “Arthur” but wishes to remain anonymous. “Arthur” is an MD/MBA who offered to write up his experiences obtaining the degree after a discussion in the comments section on an older post. Since that time this site has run another article (with another discussion) on MD/MBAs, but it was not written by an actual MD, so I thought this post would offer a much better perspective on the subject. I hope you enjoy it as much as I did. It is a little lengthy, but it was so well-written, high-yield, and comprehensive that I couldn't stand to cut any of it out. We have no financial relationship.]

Some time ago, a discussion of physician MBAs cropped up in the comment section of a WCI post and there was interest in a guest post on the subject by somebody who had actually done it.  I am now at the tail end of my MBA program and wanted to share my experience and what I learned from colleagues about pursuing advanced business education.  I spent quite a bit of time talking to other physicians in different fields and practice environments who had done an MBA program before committing to my own. I wanted to make sure I understood my options and that the experience would be worthwhile.  Much of this post is a consolidation of those conversations and the perspectives offered by my current classmates.  By way of disclaimer, I would like to point out that I have been extremely satisfied with the mid-career, physician-oriented MBA program I am in, so this post will have a favorable bias toward this pathway.

Why do it?

If there is no “why” then there is no point in considering the other issues.  Surprisingly, several of my classmates struggle to answer the question “what are you going to do with your MBA?”  From my exposure to like-minded physicians at various meetings and conferences (statistically suitable for publication in the Journal of Anecdotal Medicine), I would suggest the following major categories as reasons for going down this path:

# 1 Finding an Entrepreneurial Pursuit or “Company Job” to Exit Clinical Practice

med school scholarship sponsor

This is probably the most common scenario I see bandied about, particularly by those who haven’t “taken the plunge” and are still just dipping a toe in the water of low-commitment management conferences.  This is probably something a fair number of physician MBAs do, but it is not something that the degree will supply to you on its own.  The entrepreneurial path will require considerable investment of both time and money, even if you have a great idea. Just ask WCI how many hours of uncompensated work he did the first year of his blog.  Likewise, the company job will require proving yourself in a leadership role just to get hired and a probable pay cut in the initial change, particularly if you are in a higher paying specialty.  An unknown and unproven manager with an MBA is not going to be offered a $400,000 per year job just because they also have an MD.  If you want to get out of clinical medicine through this path, you’re going to need to have a specific plan or be prepared to wait a while to identify an opportunity.  An alternative would be to ease into it by developing consultancy work on the side, but don’t underestimate the amount of travel away from your family that this will require and consider whether this really serves to give you the lifestyle change you wanted in the first place.

# 2 Maintaining an Independent Practice

In this era of corporate medicine and hospital-owned practices, some physicians still want the freedom of running their own shop and recognize that they need some heavy-duty managerial training to compete. I recall speaking to one doctor who said that his group of hospital-based physician had been whittled down from five facilities of coverage to one and he saw his MBA program as a necessary (but perhaps too late) effort to turn the tide. Interestingly, if you are already in a management position in your group or run your own business, an MBA program could potentially be partially or fully paid for through your company or deducted on Schedule C. The requirement here is that it “maintains or improves skills needed in your present work” (IRS publication 970, Chapter 12), so you’re probably out of luck if you’re not already in a clearly defined managerial role prior to starting. There are some fine lines on this which should be discussed with an accountant or tax attorney prior to proceeding – this article from the Journal of Accountancy will help start the conversation.

# 3 Advancing Inside Corporate Medicine

Say you’ve given up on independent practice but realize that employed physicians don’t have the same income, control, or job security.  Why not move up the ladder to management? If you’re a standout low-level manager/medical director, an MBA will give you the credibility with the higher-ups at Consolidated Megamed, Inc., to get that VP spot which will open the door to further promotion or lateral transfer to a competitor.

# 4 Love of Learning/New Challenge

For some, the attainment of new knowledge is an end unto itself.  If you’re already financially independent and want a better understanding of the business world, an MBA will certainly be enriching.  Probably best to delay though if you still lack significant financial freedom.

# 5 Enhancement of Personal Financial Management

This, in my opinion, is a really bad reason to go to business school. Some people are under the impression that an MBA will give you the tools to be a day trader or otherwise solve your personal financial issues. While financial analysis is certainly a part of the curriculum, it’s not terribly applicable to personal finance and degree programs that are will cover far more than you need for your personal financial situation. You are probably far better served spending a few weekends going through the WCI archives and recommended reading list.

When To Do It?

In the discussion that led to this post, several commenters remarked on the timing of the MBA with respect to the MD. I’ve met people who have done it at almost all life stages and will discuss the merits of each below, in chronological order. I’ve excluded a discussion of getting the MBA well before the MD since I’ve only known one person who left the business world for a “second act” in medicine (though I know several lawyers who have) and I don’t think it’s a situation that occurs deliberately from the outset. Aside from that, most readers of this blog have already made a commitment to medicine.

# 1 Both Degrees At The Same Time

Whether it is a formally concurrent MD/MBA program or merely two separate programs in immediate succession, this option lumps all of the school time together. Typically, it will tack an extra year onto medical school, sometimes two years if the programs are separate. The biggest advantages to this path are that you don’t have to go back to school later and when you’re in the program you can devote your full attention to it rather than juggling it with work. If paying for your education with loans, however, this will add to your debt burden before you really know if you’re going to use both degrees. Also, most business schools prefer that MBA candidates have at least some work experience so that they can appreciate the applied aspect of the coursework. If you plan on using your MBA within the healthcare industry, then healthcare work experience would be very useful prior to the program. For these reasons, I don’t think that the typical direct-from-college-to-med-school student will get the full benefit of a dual degree program. It may, however, be suited to a nontraditional student with healthcare experience, like a pharmacist or nurse, making the transition.

# 2 MBA During Residency

Some programs will allow students to pursue other graduate degree programs during residency, particularly at their affiliated university. In my admittedly biased opinion, this is probably the worst timing for an MBA. It has similar drawbacks to a dual degree program, but will also lengthen your residency and/or distract you from it. This is the time you should be laser focused on learning the skills of your specialty, much more so than medical school. Having completed another master’s during medical school, I feel I have some perspective on the subject and think that a sideline degree program during residency would have been far more detrimental to my training.

# 3 MBA in Mid-Career

If you’ve been paying attention, this is obviously the path that I recommend. Once you’ve been an attending for a while, you should have much more familiarity with the business issues and politics of medical practice and can thus understand the applicability of the coursework in far greater depth. The disadvantage is that it will be very difficult, if not impossible, for most doctors to leave practice and return to school, so juggling work with an executive or on-line MBA program will likely be the only viable option. It can be done – I’ve been doing it for 18 months now, as have my classmates. It will be particularly hard for your family though and that’s why I recommend discussing it with your spouse early in the planning stage so that there is a mutual understanding of the purpose for your family and of the commitment needed for the undertaking. I spoke to my wife about it before I ever brought it up with my partners and I strongly recommend that you do the same.

# 4 MBA in Late-Career

This is probably the easiest time to pursue an MBA, but it is also probably not very useful.  The late-career MBA student has often reached financial independence, has grown kids, and plateaued or even begun winding down their career.  They also have a tremendous depth of experience for conceptual application of the coursework.  While a few may use it to a limited extent to advance an agenda with a hospital board or start a new venture now that they are not financially dependent on their practice, I think most do it for personal enrichment and a desire to better understand the system they’ve been a part of for so long.

What Type of Program?

Once you decide to advance your education in business, there are a few options available to you.  First though, I’d like to take a moment to mention the non-MBA options like a Master’s in Healthcare Administration or a Master’s in Medical Management. For those interested in applying the coursework within a medical practice, these may be great options and are often available in the formats discussed below. In fact, I tend to see the MHA on hospital administrators’ walls more often than the MBA. Depending on proximity and cost, it may be quite advantageous to pursue an alternate degree. As you move further from healthcare or higher up the corporate ladder, however, I don’t think that these degrees always have the same gravitas as an MBA. It’s sort of like being a DO: they learn and do all of the same stuff as an MD, but they still get the occasional sideways glance from interviewers or patients due to the less familiar letters after their name. It may be unfair, but DO/MHA just doesn’t have the same ring to it as MD/MBA. By the way, most schools don’t specify the educational path you chose to get your degree, if you’re worried about that. Your transcript and diploma will just say “Master of Business Administration” regardless of how you got there.

# 1 Traditional MBA

You go to school (physically present) for two years (often less in a combined program) and come out with a degree. While these programs often allow and encourage work and internships in parallel with the classwork, it would be difficult for most doctors to keep up a reasonable practice during the school year. This is particularly true if their practice is not co-located with the school. The biggest advantage to the traditional program is the contact time with professors and classmates. Easy access to professors can make a huge difference in difficult courses, while strong class ties can really pay-off in terms of a leveragable network after graduation.

# 2 On-line MBA

This is just a traditional MBA program done through an online portal. Having had a purely on-line course during my own program, I don’t think these types of courses establish enough of a connection with the professor and among the classmates to get an interactive benefit from the more managerial courses. You also don’t get the same networking benefit as a program with an in-person component. That said, if your interest lies more with technical side of finance, doing a program like this through one of your state schools is probably the most cost-effective way to cover the material. I’ve calculated an in-state option for me that was just $13k. Usually, there is also considerable flexibility in the pace at which you complete the program.

# 3 Executive MBA

These programs combine short on-site sessions with on-line platforms to try to allow people the benefit of personal interaction with the convenience of on-line learning. The on-site component is varied and ranges from every Saturday to every other weekend to a week or so each semester.  Obviously, geography will play a role in which program’s schedule will work for you. These are generally more expensive programs than the previous two options and many state schools do not offer an in-state discount on the tuition. State programs I’ve looked at start at around $60,000 while Ivy League programs approach $200,000 (meals and lodging are usually included). Generally, I don’t think the Ivy-level programs are worth it unless you have a very specific goal, like being the biotech guy at a hedge fund or venture capital firm. In this case, accessing the school’s alumni network may be worth the price. These programs generally run a set amount of time (1-3 years) and have very little flexibility in their curricula.

# 4 Healthcare-Focused Executive MBA

I spoke to a physician from the bay-area who did an Executive MBA program with a very prestigious business school and hated it because his class was composed primarily of Silicon Valley types and much of the case discussion centered on venture capital funding and taking start-ups to acquisition or IPO. If you’re looking to move into that world, such a program may be appropriate. I will also say that some MD/MBAs I’ve spoken with tout the benefits of diverse business perspectives among their classmates in non-healthcare focused programs. For those wishing to stay in the broader healthcare industry, however, it may be better to enroll in a program with a healthcare concentration or at least a more diverse student body.

# 5 Physician Executive MBA

This is a special flavor of executive MBA program which is basically a healthcare focused program where admission is limited exclusively to physicians. There are only a couple of dozen programs out there like this and the benefits come primarily from the laser focus on physician-executive issues and the camaraderie of a being in a small class of like-minded doctors. The on-site component also tends to be more compatible with physician schedules. An ancillary benefit is that some of these programs will not require you to take the GMAT, since they know you’re probably already pretty good at standardized tests. The criticism of these programs is that you lack exposure to outside perspectives.

My Experience

I have avoided mentioning programs by name since most of my knowledge of these programs is second-hand, however I do feel it would be helpful for some people if I take a moment to discuss my own program, how I chose it, and what my experience has been. I am about ten years out from my residency and doing the Physician Executive MBA program at Auburn University in Alabama. It is a two-year program that has five on-site sessions and two field trips (a Washington trip as part of the health policy class and an international trip as part of the comparative healthcare systems class). In my particular practice, taking frequent long-weekends is not feasible, so being able to coordinate the residency sessions with a week off had huge appeal for me. The cost is in the $60k range, which includes lodging and most meals at Auburn, as well as a travel allowance for the field trips. I chose a physician program because I intend to stay in healthcare and wanted that to be the focus of the program. I also feel that interactions among my classmates have been much more frank and open due to our shared background in medicine. While geography made Auburn particularly appealing to me, I have classmates from as far away as Arizona, Wisconsin, and New Hampshire who have found the longer but less frequent in-person sessions very manageable from a travel standpoint. I pursued this path because I am part of an independent practice that I would like to keep independent.  Now 80% of the way through it, I think it was worth the investment to further that goal.

What do you think? Have you done an MBA? What type? Was it worth it? Have you considered doing one? Why or why not? Comment below!