Is There Money to be Made in Public Health? Reflections from a Family Physician

Salary is important to consider

It’s a question students often think about when exploring career options but tend not to openly discuss with others. Consideration of income has become especially relevant given that affordability in many larger Canadian cities has decreased over the last few years. Recent articles highlight the difficulties of young professionals securing affordable rent relative to their income. This is troubling and anxiety-provoking for anyone, especially for young students, many with mountains of debt, or those seeking a career change.

Doing a quick Google search will reveal that public health salaries can vary quite a bit given the wide breadth of jobs. From careers as dietitians, nurses, health promoters to research coordinators or public health physicians, pursuing a degree in public health does not necessarily guarantee a certain salary. It is important to keep this in mind if repaying student loans is a priority.

Dr. Gregory Taylor, Chief Public Health Officer of Canada at the time, said in an interview that he “couldn’t recall his salary range, but stressed he isn’t in it for the money” (Ottawa Citizen, October 2014). He later suggested that he would’ve pursued a different medical specialty if money was his main priority.

To clarify, I am not a public health and preventive medicine specialist. In order to do this, one must complete both medical school and a five-year residency with a combination of academic, clinical and public health rotations. Many complete two years of clinical training through the Family Medicine Residency Program during this time, leading to eligibility for certification in family medicine, which I have.

My career path and how I ended up here

I often am asked why I decided to pursue an advanced degree in public health when I am already  a practicing family physician, given the cost of tuition on top of medical school debt. I’ve always had an interest in health care systems but also wanted to gain more experience in teaching and research. The Master’s degree at Dalla Lana School of Public Health, University of Toronto was able to give me the flexibility of studying part-time while working in my clinic, and enough breadth and depth to cover subjects relevant to both family medicine and public health.

While I was studying for my undergraduate degree at the University of British Columbia, I spent a summer in Copenhagen, Denmark studying health systems policy and was fascinated by the ways in which different countries approached health care. On top of that, I was awestruck by Copenhagen itself and the way people lived and travelled. This led me to explore how city design or infrastructure affected the health of populations. After I finished my undergraduate degree, I was accepted to a Master of Public Health program at Karolinska Institutet in Stockholm, Sweden. I decided to put public health on hold to pursue clinical training in medicine first, but the subject was never far off from my mind.

Once I started family medicine residency at St. Michael’s Hospital in inner city Toronto, I frequently observed how the social determinants of health impacted the well-being of my patients. In our primary care clinic, the majority of my patients were impoverished and often grappled with issues of violence and discrimination. They often had limited access to addictions and mental health services despite living in a resource-rich city such as Toronto. While completing a clinical rotation at Seaton House, a men’s homeless shelter in Toronto, I continued to observe the limits of using a purely biomedical lens in treating patients. I could see we needed a broader systematic approach to ensure inclusivity for groups that are often marginalized including new Canadians, LGBTQ+, intravenous drug users, sex workers, and indigenous populations to improve their health outcomes.

My hope with ongoing medical education is to increase my impact on communities at a macro level while I continue treating patients at a micro level.

Which leads me to the last point…

Don’t do it for the money

I’m sure it’s not the first time this has been said, but it deserves repeating. Do not pursue a career in medicine or public health for money. Sure, there may be some successful physicians who do fantastic work and make a lucrative income. However, there are top- paying salaries in almost every major sector or industry. It is absolutely a privilege to work as a physician, and we are rewarded for this career in more ways than one. I am lucky to be able to take time away from my job to pursue extra courses and training, because I recognize not everyone has that opportunity. That said, I do think if your goal is to make as much money as possible over your lifetime, consider finding a career outside the field of public health. There are abundant alternatives with fewer years of training. If you are fascinated by medicine, the broad career opportunities to help improve the lives of others and not afraid of a challenge, I would be happy to call you a colleague.

Source:

https://ottawacitizen.com/news/politics/canadas-top-doctor-paid-less-than-some-
provincial-equivalents

For more information on public health medicine as a career:

  1. The Association of Faculties of Medicine of Canada: https://chec-cesc.afmc.ca/en/public-health-education
  2. Public Health Physicians of Canada: https://www.phpc-mspc.ca/
  3. Canadian Public Health Association: https://www.cpha.ca

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