People ask me about getting both degrees, or worse, going to a program that will give you both degrees at the end of your coursework. I shudder at those prospects: It's a waste of time. If you're called to the practice of law, go to law school. If you're called to the practice of medicine, go to medical school. 

So you want to practice medical law. Lawyers - - - good lawyers - - - can learn enough medicine to understand what they are seeing, and can hire experts (doctors) to explain what they don't yet understand. Remember that a lawyer's job in court is to hire an expert to explain medical matters to a jury of lay people and then personally to sell them on his/her client's case. Notice that the real medical explaining comes from a doctor, not a lawyer. MD-JD's do not make more money than JD's.

OK, so you want to practice forensic medicine. A JD helps, right? Wrong. As an expert, you are hired to give your opinion on medical matters. A doctor can learn enough law that she/he can function in a courtroom situation very well, and at bottom, you have more credibility from your medical expertise than you have from your legal expertise: they want you to explain medical things, not legal things. MD-JD's do not make more money than MD's.

Now you want to be a medical administrator. A JD helps, right? Yes - - - a little. Is it worth burning up three years of your time? No. Could you get the same expertise simply attending courses at a local law school? Yes. A JD is overkill for helping an administrator understand the legal system. An MBA - - - of business courses - - - would be far more helpful for a medical administrator. BTW - - - I took an accounting course at the business school while I was in law school so I could understand what was driving some otherwise incomprehensible business practices; but I didn't get a CPA. MD-JD's do not make more money than MD's.

But you still - - - foolishly - - - want both degrees. Isn't acombined degree more efficient? Perhaps. But is that combined program the best medical school you could have gotten into? Is that combined program the best law school you could have gotten into? I can tell you from experience that working part time as an MD is a good way to pay your way through law school. I went to the best med school I could get into, and the quality of that medical education has helped me over and over across the years. I went to a fine law school in a city where I wanted to be, in an environment I enjoyed (e.g.--no "Paper Chase" BS, had a future senator for a classmate, etc.) and had a good time. I got the best of both experiences, so I was able to enjoy the intellectual expansion that came with going to law school after medical school. An expensive enjoyment.

When I pursued the law, I was unmarried and without children. If you have a spouse and kids, spend time with them, not with law books. If you do not yet, buckle down, make yourself the best doctor or lawyer you can be. If you want to dabble, make each hour you spend count for something - - - either it goes directly to a specific need, or you're going to enjoy something. Don't go overboard and waste your time.

2000/07/15. Updated 2000/08/17

Dear Dr. Hume,

We haven’t met, but I was doing a bit of research on the net and happened to come across your website.  I am a . . . resident in internal medicine at a large university based program and have been trying to decide for the longest time what direction to take with my career.  At first, I was attracted to [one subspecialty, then another], but the recent changes in the healthcare marketplace have changed my idea of what it will be like to practice medicine during our time.  The amount of hours that these [sub]specialties demand, the workload, the paperwork (insurance, billing, coding, etc etc), HMO’s and what not, have made me come to the preliminary conclusion that the amount of time and energy spent completing my education will not be rewarded by the patient care or reimbursement.  I simply think that at the end of each day, instead of sitting back and reflecting on the quality time (the 5-10 minutes in reality) that I spent with my patients, I will instead be preoccupied with the ridiculous amount of administrative responsibilities.

To make a long story short, a colleague of mine recently suggested that I look into getting a law degree after completing residency and working on patent law & intellectual property within the realm of the biotechnology, pharmaceutical and genetics.  industries.  My initial reaction was very positive and the field sounds interesting as well.  The whole biotech and genetic industries are growing at a phenomenal rate and this is sure to continue for some time.  It seems like MD, JD’s will be in short supply and uniquely positioned to capitalize on the growth on this sector.  I also think that it would be interesting to deal with new ideas and concepts on the cutting edge of the bio-medical field and the reimbursement would not be bad either.  I was thinking all these things until I came across your section entitled “MD,JD: don’t do it!”  You mentioned that not only is it an extra three years of education, but that MD, JD’s don’t even earn more than only MD’s.  In addition, I’m also married and have a baby girl.

Now, I’m completely confused.  Do you feel that my idea of patent law is a reasonable one, and what do you recommend as the best course for me to take?

Sincerely,

A confused and tired resident

My answer:

I looked into patent law as well, and decided against it. A friend in law school wanted me to practice patent law, but I am not “called” to practice patent law.

You want quality time with patients. Instead of changing professions, consider that artificial intelligence engines will be able to help us with our paperwork. As for passively sitting back while managed care beats us into the ground, stay tuned: a backlash is building.

In any case, if your talent is for medicine, go that way. Finish your residency. The need in this burgeoning biotech world is not for MD-JD’s but for MD’s who can do clinical research to try out these new therapies on patients. If you practice for a while and hate it, then go back to school.

Good luck.

Hi, I’m a 4^th yr medical student about to go to law school after my MD.  I found your article on the internet really interesting.  I was hoping for your advice, being an MD/JD yourself.

My goal in getting a JD is to teach health law at a law school. I am graduating in the top 10% of my class, and did really well on the LSAT so I think I have a good chance of getting into Yale/Stanford/Harvard Law school.  Then I want to teach health law.  Is it difficult to get a job as a professor with an MD and a JD?  What is your advice?  Thanks!

My answer:

Lordy. Teaching health law. For that you want to give up medicine? Re-read my little essay [above]. Its title? “Don’t do it.”

Re-read Betty Lehan Harragan’s advice in Games Mother Never Taught You: don’t go getting over-educated.

OK, you could probably get into an ivy league law school, but you could probably get into a very good history graduate school, too. Or a crackerjack MBA program.  Just because you can get in doesn’t mean you have to go.

The only man I ever met who was truly happy that he had gotten a JD after an MD was a man who did not feel like practicing medicine after graduating medical school. After law school he practiced law, his true calling.

Only go to law school if you want to give up medicine. Otherwise, don’t waste your time. 

Dear Dr. Hume,

      I am practically done with the undergraduate portion of my education and have been accepted to [a high-powered university]'s M.D/J.D program, yet I still have time to reconsider.  I read your essay "Don't do it" and found it interesting, but it doesn't pertain to my career objectives.  I am interested in Psychiatry but in relation to Law, I am interested in working with the criminally insane and participating in the legal process.  I am very interested in legal competency issues, why would an MD/JD be such a bad idea for me?

Thanks for your attention,

My Answer:

Because you can learn those legal competency issues quickly. Most psychiatrists who do forensic psychiatry have never been to law school. Remember, what they--the patients as well as the courts--need you for is your psychiatric expertise, not your legal expertise. Besides--what if you go to medical school and decide to stick to clinical matters because medicine "calls" you? Go be a doctor (or lawyer) first. Plenty of time later to spiff up on the other side of the fence.

Dear Dr. Hume:

Though I agree that an MD/JD is not for everyone, or even most, neither is an MD or JD alone.

I practiced Neurology for 20 years, and loved the emotional gratification of patient care.  But I also thought like a lawyer.  That thing they teach most law students was, for me, a birth defect.  In my mid-40's, with my son in college and my wife working, I went to law school.

Now I practice medicine 2 days per week and law 3 days per week.  Every day allows me to exercise different parts of my brain and satisfy different parts of my soul.  Medicine is emotionally gratifying, while law encourages detailed thought and creativity.  If one values both attributes, the combination is ideal.  And each makes me better at the other.

I agree that MD/JD programs have an inherent weakness, in that they require the young to make too many life decisions and commitments before they know themselves adequately.  That does not, however, mean that adults cannot make a rational decision to combine professions.

I am sorry you found your combined education valueless, but you should not extrapolate your worldview quite so broadly.  It is possible to enjoy both professions concurrently.

Sincerely,

David B.  Ketroser, M.D., J.D. Neurology

I wrote him back:

And you, in essence, make my point.  As a fully-grown and fully-experienced professional, you were ready to embark on a second career, and you did so.

You practice medicine.  You practice law.  You don't work as a hybrid doctor-lawyer somewhere.  Each thing you do exercises a different part of your talent set, but you didn't plunge into law with stars in your eyes.

Someone like you doesn't need my advice.  Someone like you--rightly--would reject my advice as not relevant to your aspirations.  But you ain't no virgin.  They are.

As the results from the human genome project allow biotech to conquer old age, people will naturally embark on second, third, tenth and hundredth careers as they pass through their millennia of life.  But they won't be virgins, either.

For the virgins, the new kids on the block, I hope that my opinions will prove helpful.  It seems like someone is always trying to sell something, and they need to know what they are buying.

I am happy you are enjoying your careers.

BTW--I would like to post our exchange, with your permission.

And he wrote me back:

Dr. Hume:

Feel free to post my reply.  And it sounds like we do agree entirely.

The MD/JD itself is not wrong, but to truly be an MD/JD, you must first learn to be one and then the other.  As we both know, that does not happen in medical school or law school.  There is so much more than medical school to being a doctor.  It probably takes at least 10 years of life and practicing, regardless of intelligence.

Law is the same, with the additional point that being a good lawyer requires human experiences that only come with time.

If you can aid a few intelligent but star-struck youngsters, you have performed a great service.

Sent:Sunday, January 27, 2002 9:19 PM

Subject:One quick question

I get that you are quite tainted about having both a MD and a JD degree.I am a doctor and think about entering into politics in the future, in that case would both degrees be of benefit?Yes I know I can go into politics without a high school diploma, but it seems that a majority of politicians have JDs, only about a dozen Representitives have an MD.

K R

[my reply]

The only real problem I have with MD-JD combinations is getting them both at the same time.You are already a doctor.You're thinking of going to law school for a particular reason.

It's not a terribly bad reason, but I keep Betty Lehan Harrigan's advice (Games Mother Never Taught You) firmly in mind: don't get over-educated.Spend the time and money you would have thrown at law school to get hands-on political experience.Now THAT is a school worth attending ...for a future politician.

And you'll have to attend that school anyway if you want to go into politics.

And, I believe, people don't elect representatives because they are good legal technicians--politicians hire plenty of those.People elect representatives because the politician convinces them that he/she will represent the people the way they want to be represented.Again, a turn at law school would be unnecessary.

Would a JD be nice to have?Certainly!Do you need it?Is it worth three years or more of your time?Hmmm.But at least you already have a profession.That's the point I want the young folks to get.

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