Reflections of an MD-MBA student
By: Derek Banyard, M.D., M.B.A.
The number one question I have been asked over the past two years is, “So why the MBA?” The immediate response that always pops into my head is “Why not?”
This contrived, yet sincere response best sums up my feelings about the cost-benefit of having pursued the joint degree of M.D., M.B.A. during my time in Nashville. Unfortunately, this answer is never sufficient and requires a more detailed explanation; and just like any other potential residency interview question, one must always be prepared. But I digress…
When I arrived at Meharry in 2003, the only aspect of my future career of which I was certain was a desire to become a surgeon. I began searching for an extracurricular activity that would diversify my educational experience. Coincidentally, a novel form of collaboration was being forged between the two major health science centers in Nashville, which if successful, would become the first organization of its kind in the country. This seemed like an ideal opportunity, and in its inaugural year, I had the honor of serving on the executive board as the social co-chair for the Meharry-Vanderbilt Student Alliance alongside Airron Richardson, an MD-MBA student from Vanderbilt.
Airron’s joint-degree program intrigued me, and as our organizational relationship and friendship developed, so did his encouragement for me to pursue the same joint degree that he was. Despite the fact that a joint MD-MBA had never been attempted by a Meharrian via Vanderbilt’s Owen Graduate School of Management, Susanne Brinkley, Director of Medical Education reassured me that it was this kind of opportunity that the MVSA and Meharry-Vanderbilt Alliance were created for.
In preparation for business school I took the required Graduate Management Admission Test or GMAT the summer after my first year of medical school. This was the most ideal time for me to take the test as it was my only summer off as a medical student. Though nothing compared to the rigor of the MCAT, the GMAT did require me to study for two solid weeks including the use of practice exams. I took the test at a Prometric center among medical students sitting for their Step exams, finishing in roughly half the time and receiving my test results immediately.
While a typical MBA program takes two years to complete, the MBA portion of the MD-MBA degree is achieved in 18 months. Similarly, the traditional medical school curriculum is truncated from four years to 3.5 years so that the joint degree can be achieved in five years. I structured my educational curriculum as did most Vanderbilt MD-MBAs, taking a year off between my 3rd and 4th years of medical school to attend business school fulltime. The 5th year is typically split between both schools, spending 6 months performing clinical electives, and the final 6 months finishing out the MBA. Unlike most Vanderbilt MD-MBAs however, I decided to take my Step 2 exam before I started business school as opposed to during my fifth year so that my clinical knowledge was still fresh.
So now that you have some background, let me address the question: “So why the MBA?”
After the attending or practicing physician hears my response to this question, he or she usually follows by commenting that they’ve considered acquiring an MBA and then proceed to ask ancillary questions like how difficult I found the GMAT. I believe the reason for this curiosity is this: regardless of how fantastic the medical education is in this country, medical school does not prepare future physicians for the administrative or business side of healthcare.
Vanderbilt’s business school is structured so that all students must take what are called the core concentrations of business. These include accounting, finance, strategy, marketing, operations, and human & organizational performance or HOP. First year students are also required to take important courses such as public speaking, statistics, economics and ethics. After the core business fundamentals are laid, students are then able to focus on the aspect of business in which they are most interested. For instance, some of my friends concentrated on finance and accounting, and focused on real estate. I, like most other MD-MBA students who preceded me, concentrated on general management with a focus in healthcare.
Though the core business classes were challenging and required significant amount of study time, the most difficult aspect of my first semester was learning how to use a different part of my brain. Once I got into my business school academic groove, my anxiety turned into an excitement driven by the diversity of knowledge I was acquiring.
My first healthcare course was taught by Paul Keckley, Ph.D. who is the former director for Center for Evidence-Based Medicine at Vanderbilt University Medical Center and is now the Executive Director of the Deloitte Center for Health Solutions in Washington, D.C. acting as a key advisor to such companies as Intel as well as U.S. Senators. His course broke down the landscape of what is now known as modern healthcare. From the Hill-Burton Act of 1946 which required every state to have 5 hospital beds for every 1,000 citizens to certificate of need laws which limits the expansion of a new healthcare facility in a community, I finally began to understand the drivers that effect the demand and supply of healthcare in our country.
I have always had an interest in health policy, so it was very exciting to have our health policy & legislation class taught by the U.S. House of Representatives Congressman Jim Cooper. Beyond an intense analysis of Medicare and Medicaid, the systems upon which all physician reimbursement levels are based, we were required to analyze Washington health policy in real-time as Congressman Cooper reported it back to us on a weekly basis.
The summer after my fulltime MBA year, I decided to enrich my health policy knowledge by participating in a summer internship. I was able to secure a position working with Dr. Keckley at the Deloitte Center for Health Solutions. We began the tedious but necessary process of examining and outlining health reform on the state-by-state level so that we could characterize which forms of health policy work best and what might serve as a basis for universal healthcare.
I could go much further into my healthcare MBA training than recalling key concepts learned like when we examined the philosophy and structure of the payment engines, DRGs and ICDs, in our Business Fundamentals of Healthcare class, or learned the optimal staffing levels needed to run a medium sized clinic in Service Operations, for example. But there’s simply not enough room for me to convey to you all that is available to learn.
I can say, however, that my most meaningful experience at Owen was during my Healthcare Marketing class with Bob Stevens. I was required to produce a marketing plan for an existing healthcare company and present my findings to the class. I decided to do a project with Nashville General Hospital at Meharry where I worked with Dr. Reginald Coopwood, among others, to construct not only a marketing plan, but also a sustainable business model for NGH’s lifestyle modification center which was funded by federal grant that was soon to run out. Not only were my findings well received by the CEO and CFO of Nashville Health Authority, I received real-world experience that I can implement in different settings down the road.
Business school, and specifically the Vanderbilt Healthcare MBA was an experience that I would never trade. Though my graduate education was extended by one year, I made life-long friends and learned from the experiences of business-minded people, as well as a registered nurse, a couple Ph.D.s and a fellow medical student seeking to augment and diversify their educational acumen. I only wish more Meharrians, whether dental, public health or PH.D., would continue through the pipeline that has been laid.
When people ask me, “So why business school?” I would prefer to respond “Why not!” But rather have a relatively formulated response that covers all the bases; but as you can tell by my account, I could go on forever in response to this question. So I implore you, if you are even the least bit interested in getting your MBA, do it now, because it will be much more difficult to motivate under such an endeavor once you have started practicing and making money, likely entrusting your business affairs to an office manager. Oh, and the one year away from the sciences is a nice break… not to mention that there’s no class on Fridays.
Derek Banyard served as Social Co-Chair of the MVSA from 2003 – 2005 and was co-founder of the MVSA Student Newsletter. He graduated in 2008 with an M.D. from Meharry Medical College and an M.B.A. from Vanderbilt University Graduate School of Management with a concentration in general management and a healthcare focus. His interests lie in healthcare policy and reform as well as facial plastic surgery. He is currently a postdoctoral research fellow in the department of otorhinolaryngology at the University of Maryland and plans to start an ENT residency in 2009 or 2010.