A PhD can be a game-changer for your career, especially at a research institute or international organisation. But not for everyone. Paul Caldron, one of our recent GPAC2 graduates, is a medical doctor approaching the end of his career – and in many ways he valued personal over professional development.
Paul, why exactly did you join our part-time PhD programme?
As you would expect, my answer will be non-traditional. When my kids had all left home, and my practice efficiency had improved to the point where I had more discretionary time on evenings and weekends, I pondered what elective use of my time and what experiences had brought me the most joy. I concluded that travel, mixing in other cultures, and learning – especially about political economy and how the world works – were what did it for me.
So, I was vulnerable to the advert in The Economist about the GPAC2 programme. It covered my desired dimensions and gave me the chance to contribute something meaningful in the way of new knowledge, under expert supervision. That’s why publishing the dissertation papers was important to me; perhaps even more important than the degree itself. Nonetheless, I may pursue new life adventures in which the PhD will convey an increased level of credibility. I’ll let you know. I don’t think I’m done yet!
Your study – on the costs and value of individual medical missions by doctors – reviews why medical doctors want to go abroad, how often they do so in their career, and what they are willing to invest in those missions. Often, doctors completely self-finance such missions, and spend a significant amount of time in less-developed regions to assist people who need their services. Why do some doctors do this and what is the value of those missions?
That is a central question of the work. In a nutshell, my research suggests that the answer lies in self-actualisation. The key rewards that those physicians seek through this activity are the satisfaction of helping in challenging circumstances, from teaching and their own learning experiences, a sense of renewal that comes from a more simplified, less contractual patient encounter, and that difficult-to-describe joy evoked by connecting with a fellow human being who lives in a very different environment. There appears to be a subset of the US physician population that is susceptible to this attraction, and they are somewhat identifiable by a set of demographic characteristics and a personality trait profile that does not include the whole population. In my opinion, the value of these rewards could be monetised in terms of the opportunity costs, since higher earners appear less likely to go on Short-Term Medical Missions (STMMs).
With so much crisis and conflict in Africa and the Middle East, there is a need to invest in support institutions such as Médecins Sans Frontières (MSF), the Red Cross and so on. These institutions could certainly use medical assistance, and supporting them would be easier than arranging a ‘personal’ mission. Does this connection exist, and if not, why do doctors prefer to go their own way?
My answer here dovetails from the second response above. The Realpolitik is that many quite rational physicians (with the above characteristics and traits) choose these limited venues, apparently because of the rewards system outlined above. (They may also give money to these organisations, of course.) In any case, it may be counter-intuitive and other researchers have recently published on this phenomenon, but it is what it is! I doubt that one could convince these physicians to stop doing this just because it may be economically more rational to give all their discretionary funds to existing NGOs.
Having completed your PhD in November 2016, you will have plenty of time in 2017. What are your plans? Will you be doing any more research?
My plans for the next year are to catch up on practice and home matters that have been neglected! Already, I have started a collaboration with interested academic and non-profit organisers to study the global health outreach phenomenon further and develop guidelines, and it is likely that I will be involved in further research in that direction. I hope to publish an essay soon contrasting physicians participating in MSF and STMMs. I’ll be engaging in STMMs again on my own. Lastly, I’ll be exploring my options for later career activities.
UNU / H.Pijpers
The opinions expressed here are the author’s own; they do not necessarily reflect the views of UNU.