Specialty Profiles

What it’s like to specialize in public health: Shadowing Dr. Carlo

As a medical student, do you ever wonder what it’s like to specialize in public health? Meet AMA member John Carlo, MD, a public health physician and a featured doctor in the AMA’s “Shadow Me” Specialty Series, which offers advice directly from physicians about life in their specialties. Check out his insights to help determine whether a career in public health might be a good fit for you.

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The AMA’s Specialty Guide simplifies medical students’ specialty selection process, highlights major specialties, details training information, and provides access to related association information. It is produced by FREIDA™, the AMA Residency & Fellowship Database®.

“Shadowing” Dr. Carlo (@jtcarlo)

Specialty: Public health/administration focused on HIV prevention and treatment.

Practice setting: Nonprofit community health center.

Employment type: Employed physician.

Years in practice: 15.

A typical day and week in my practice: I do not have a typical day, and this is something I prefer, honestly. Some days I have early morning meetings before the clinics open, and other days I have evening fundraising events or community meetings—there is no typical day.

I don’t really have a typical workweek either. I usually work about 50–60 hours a week, although this can vary because of travel schedules and meetings. We have a number of special events, and I do a number of speaking engagements both locally and nationally. Most of my day is filled with meetings and talking to the various people who are working to ensure patients receive the very best medical care at our health centers.

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John Carlo, MD
John Carlo, MD

The most challenging and rewarding aspects of being a public health physician: Most of our patients are lower income and often have significant challenges with making ends meet, especially around housing, food and transportation. Over two-thirds of our patients discontinue care at some point, which is a huge challenge given the impact of our patients’ health when their HIV is not controlled. This also increases the risk of other infections.

Today, because of the great HIV treatment we have, we often see an amazing turnaround from their first visit to when they become virally suppressed. There are incredible physical improvements when someone’s HIV becomes controlled. Often, we do not recognize someone on his or her next visit because of the incredible improvement in health that can be accomplished today.

Three adjectives to describe the typical public health physician: Empathetic, intelligent and strong.

How my lifestyle matches, or differs from, what I had envisioned: My lifestyle today is very different from what I envisioned, as I currently have a 100% administrative role. I do not have call, and I frequently have most weekends completely free.

Skills every doctor in training should have for life as a public health physician but that won’t be tested for on the board exam: Working at a community health center takes a great deal of patience and emotional maturity. Physicians have to work closely with various members of the care team, often from very different backgrounds and experiences. The most important way to be successful in this environment is knowing how to work well with others: peers, case managers, nurses and other specialists.

One question doctors in training should ask themselves before becoming a public health physician: Are you interested in looking at the big picture of health and public health, and would this motivation be strong enough to lower your direct patient care responsibilities?

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What your peers are researching about medical specialty choice

Books every medical student interested in public health should be reading:

  • Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, A Man Who Would Cure the World, by Tracy Kidder.
  • My Own Country: A Doctor’s Story, by Abraham Verghese, MD.
  • When Breath Becomes Air, by Paul Kalanithi, MD.

The online resource students interested in public health should follow: Centers for Disease Control and Prevention.

Quick insights I would give students who are considering public health: Spend the necessary time to become familiar with all areas of medicine during your training. Practitioners of public health tend to need to know a little about all of the different areas, especially if deciding to work internationally.

Mantra or song to describe life in public health: Ted Nugent, “Cat Scratch Fever.”