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dual degrees

Baljot Chahal

As an adolescent in Edmonton, Baljot Chahal noticed a shortcoming in Canadian medicine when its practitioners treated his family members.

"I sensed [the doctors] felt like they were handcuffed by the system at large and there were so many barriers in providing the best care to their patients," says Mr. Chahal. "That made me think about what I wanted to do with my career."

The 23-year-old is now in medical school at the University of Alberta in Edmonton, but to help combat the challenges Mr. Chahal saw as a child, he decided to add three more letters – MBA – after his name.

Mr. Chahal is among a new wave of students who are combining their medical and graduate health-care studies with MBAs, with the aim of some day navigating and helping to streamline Canada's health-care system. Educators say the combination produces independent, nimble thinkers, while recruiters see this as a turning point for hospital administrative candidates in the next decade.

When Mr. Chahal applied for medical school he made sure the university he attended had a combined MBA and MD option. "I realized that if I wanted a medical career I wasn't just interested in being a clinician for the rest of my career because I didn't want to feel handcuffed the way other clinicians did."

There are just a handful of these programs in Canada at the moment and most have emerged in the past decade. The majority are completed in five years, which shaves a year off doing the degrees separately and lowers the cost that an MBA would traditionally add to health-care training.

The combined degree's demands are gruelling at times for its participants, who are trying to balance the requirements from these two schools and shift between the often very different cultures. That's why the business-school element is slotted between the second and third year of medical school, and not simply tacked on the end.

"It is a little bit of an adjustment coming over from medical school because there's a risk that you'll lose some very important information heading into your clinical years," explains Mr. Chahal.

But he emphasizes that, for him, it's worth it because he sees the advantages of having a wide perspective on the health-care system going back into medical school and his first years in practice.

According to Christopher Lynch, director of recruitment for the MBA program at the University of Alberta, the MD/MBA program can put its graduates on a fast track into health-care administrative roles, but it's more than that. "What it gives students going through [medicine] is a different way of looking at the administration within a hospital," says Prof. Lynch. "It's different ways of looking at problems and understanding the business or the administrative, financial mindset that goes into some of the decisions before they've gone out and had five years within the health-care setting itself."

Traditionally, hospital administrators were the business-minded MBA holders, while health-care providers, such as doctors, were left to tackle middle management.

Lisa Kershaw, a health-care recruiter and partner at Boyden Global Executive Search, says she sees the edge these joint program graduates may have over other future administrative candidates.

When hospitals and boards are looking for their executive decision makers, they are looking for candidates that "understand clinical enough and they understand business enough," explains Ms. Kershaw. In her more than 20 years of experience, Ms. Kershaw has seen hospitals and health-care organizations headed by medical professionals and business people alike, and she says the combined graduate level training in these categories would satisfy both camps.

"There's nothing better as a marker of your ability to understand than education," she says. "If you have an MBA then that would check the box for business, and if you have an MD then that would check the box for clinical."

These combined degrees include other members of the health-care system, including several schools in North America that combine the MBA with graduate-level nursing and pharmaceutical studies.

After his pharmaceutical degree training in 1988, Zubin Austin, who helped pilot the PharmD/MBA combined degree currently in its first year at the University of Toronto, worked at the city's Mount Sinai hospital in a clinical position. But as his career progressed, he explains, "I recognized that being a clinical pharmacist wouldn't give me the administrative and managerial background necessary for departmental or hospital administration."

He didn't have the option to do his degrees concurrently, so Prof. Austin enrolled part-time at U of T's Rotman School of Business in 1991 and completed his MBA in 1994. But he speculates that with these combined programs there are more ideal options for graduates who want to pursue an administrative career.

"For many students there's a sense that while they're in motion and have the momentum of being in school, it's easier to just stay in school rather than finish one degree, work for a little while and then go back to school," he says.

Students, like Mr. Chahal in Alberta, are part of a unique breed because they are thinking about both their administrative and clinical careers right from the start. For him, it's about unifying practitioners and administrators.

"I think there's a culture of pessimism and a feeling of being disenfranchised with some of the decisions that are made and I think that's something that really needs to be rectified," he explains.

But he says he still needs years of experience as a clinician to be able to benefit the system.

"It would be naive to think I could come out of this MBA and be put straight into an administrative role."