Breaking Into – and Surviving In – the Global NGO Sector: Part 2

From alum Roice Fulton (GLEPI, 2014)

Observe, Infer, and Engage 

I’m an almost willfully naïve person, for reasons better explained over pints somewhere within a few tube stops of CEPI’s London office. What matters for this post is how that naivete seems to underpin my career strategy: at every turn, it forces me to ask the most basic of questions, and think critically about how the answers affect my understanding of my own place in the public health world.

Case in point: I’d long held this picture of the global NGO community as some distant, impenetrable entity. What do they all actually do? How do they work together? I’m totally new to this scene – how do I fit in?

For years, the barrier to entry seemed prohibitive. Entry-level posts at places like Gavi were sparse, incredibly competitive, seemed only loosely matched to my new epi skillset, and took months of screening and interviews to get through. And at 30, I wasn’t keen on taking up an internship somewhere to try and get a foot in the door.

~~~

A few factors would change the whole equation. One was my introduction to the world of independent consulting, which began with a short-term remote contract to conduct a systematic review for the WHO post-graduation. Another was learning that global NGOs sometimes use independent consultants to cover line work when they can’t hire full staff (which happens more often than they’re willing to admit).

A third factor was understanding just how quickly NGOs’ needs can change – and figuring out how to identify and seize work opportunities as new needs arose. In my case, that naivete I mentioned required me to build a picture of the immunization NGO scene from the ground up in order to understand my potential role in it.

I’d love to lay out everything I’ve learned, including the full history of the global immunization NGOs and their evolution toward the current landscape. But it’s not appropriate here, and it’s less than useful for those of you not interested in vaccines. Suffice to say that organizations such as Gavi and CEPI are mission-driven, highly impactful, and brimming with brilliant people whom I am incredibly lucky to count as colleagues.

What I will do is try to distill my experiences into a set of guidelines, to help you bridge the divide between your skills and the emergent needs of the global NGO community – or really, any employer. As it turns out, it’s an extension of an approach I took in grad school: observe, infer, and engage.

Observe

Find an organization doing something interesting and meaningful to you, and research the hell out of them. Look at all their job postings and RfPs, not just the ones that have an epi slant.

Ask fundamental questions about their mission, vision, and strategy – why does this organization exist? – then anchor your mindset to the world they work in. If you can, ask those questions to current employees – you’re bound to get some insightful answers informed by their personal experiences.

Infer

Apply inductive reasoning to what you learn about the organization. Your observations about what the NGO is doing, where, with whom, and why, will create a mental picture from which you can quickly infer organizational needs that may map to your skills.

Now, allow yourself to think big for a moment. Without targeting a specific job posting or title, think about what your ideal job in this organization would look like, both now and in five years. Be honest with yourself about what you can and can’t do now – but consider your full range of skills and experiences, not only those associated directly with epi. Make a list of the skills you lack but want to develop. This exercise helps shape your career trajectory into a practical narrative to share in an interview.

Finally, the hard part: identify opportunities to slot in. This is where you channel your big-picture ambition into a concrete career progression, with your target NGO as the first major step.

Unfortunately, most job postings won’t often immediately suggest a role for you; there wasn’t a single mention of epi skills in the first contract I took at Gavi. But if you parse job descriptions with an open mind, and think laterally about how to translate your epi background into adjacent fields or in unorthodox ways, you might suddenly find yourself screaming at the monitor: “I can do this!”

It’s all about context – which is why all the observational legwork is essential. If you know innately where an organization is, and where they’re headed and why, you’re already thinking along the lines of what they need and where you fit in.

Engage

Whether by traditional job application, introduction via a colleague, or a cold email – or, better yet, all three – put your best foot forward to the organization, and jam it in their door. Your objective is to familiarize your name and reputation for good work with them, one way or another (but always politely!).

Clearing the familiarity hurdle is harder with distant global NGOs than with, say, a state or local organization. But it remains a function of networking, timing, and yes, luck.

Be patient – job hunting is the ultimate test of patience – but utilize all the resources you have. Utilize your mentors; utilize your PIs; utilize your friends; utilize me. Be clear about your availability and adaptability to the needs of the work, and broadcast that to everyone who might help you get noticed.

If you score an interview, get the name of the hiring manager (not just the HR intermediary), and send a direct follow-up email. If you can’t find their address, maybe do what I did and email every permutation of their name you can think of until one gets through.

In the end, it was my thesis advisor who got me in the door at Gavi; a department head was his classmate at Hopkins, and had forwarded him the posting. From there, it was the usual CV/cover letter, then an interview, then that shot-in-the-dark follow-up email – then ten days later, I was packing my bags for Switzerland.

~~~

Once you land your first global NGO gig, be it a contract or a full-time job, the process has only begun. Continue to observe, infer, and engage, taking full advantage of your insider knowledge. For short-term contracts, the first thing to find out is whether your role was really intended to be temporary, or if there’s a long-term gap they’re trying to fill (they may not even realize the gap until you point it out).

Act accordingly with what you learn and with what you want from the organization, whether that’s the flexibility of continued short-term consultancies or the security of a full-time position with benefits – or a move to a different organization working in a similar space. Either way, congratulations – you’ve broken through!

In case you missed it, check out Breaking Into – and Surviving In – the Global NGO Sector: Part 1, where I shared my path from GLEPI student graduating at the height of the 2014 Ebola outbreak in West Africa, to a full-blown career at an unexpected employer.

In Breaking Into – and Surviving In – the Global NGO Sector: Part 3, we’ll look at how cultivating strong leadership and teamwork skills can help you manage the dynamism of life and work at a global NGO, particularly in this time of emergent threats to public health – including, yes, COVID.

Roice Fulton, MPH (GLEPI, 2014) is currently an independent consultant for the London- and Oslo-based Coalition for Epidemic Preparedness Innovations (CEPI), where he manages projects in CEPI’s epidemiology portfolio. Roice currently lives and works near Geneva, Switzerland.

Tell an Influential Story

I recently submitted a grant application that proposed to develop a molecular profile to predict which breast cancers have high risk of recurring ten or more years after diagnosis. Here is the first paragraph of the application:

Imagine a 45 year-old premenopausal woman diagnosed with stage I, estrogen-receptor positive breast cancer. She, along with her partner and children, will face a year of surgery, radiation therapy, chemotherapy, fear, and disruption of their day-to-day life. She completes her treatments and endocrine therapy, and recovers. She and her family are immensely grateful, and although those years remain a part of the family fabric, the fears diminish with time. Now imagine this same woman 20 years later. She is excited about life following retirement, especially the prospect of spending time with grandchildren, but her breast cancer recurs and these things will never come to pass. Her physicians tell her she did everything right, that there was no way to know that the tumor might recur so long after diagnosis, that it was just bad luck, and that even in 2020, no one can predict which breast cancers have this malevolent potential and which do not.

I am an epidemiologist proposing an epidemiology research project, so why did I start with a story about a single person?

Because it works.

I want the grant reviewers to feel empathy and sympathy for this woman and her family, and to read the grant in the frame of mind of wanting to help. To be influential, one must change minds. To change minds, those minds must be open to change. Data and evidence do not open minds; emotions open minds. Telling a poignant story about one person that illustrates the nature of the problem will open minds, and then these open minds might be receptive to the data and statistics.

We see this strategy of opening minds used frequently in public spaces. Politicians tell stories about people they meet on the campaign trail, and then they tell us the statistics that demonstrate the broader need and their policies for how to address them. News stories highlight the plight of a single person as a vehicle to convey the story. Presidents bring people to their State of the Union addresses and ask them to be recognized before launching into the statistics that describe the bigger problem and how the administration will address them. Religious texts are full of parables that faith leaders use to introduce a larger message. Why does everyone use this technique? Because it works. Once you recognize the method, you will see it used wherever you look.

And now that your mind may be open to the idea, here’s some science to back it up. In her book “The Influential Mind,” neuroscientist Tali Sharot says that evidence tends to be persuasive when it fits your world view. But if you are trying to change minds, then you are inevitably communicating with others who have a different world view. On average, when we encounter evidence that is inconsistent with our world view, we interpret that evidence as wrong. The further away the new evidence is from preexisting beliefs, the less likely it is to alter them. To be influential, you must first address and influence the emotional state of the audience (which can be one or many people). Helping them to get into the right frame of mind will improve your chances of changing their mind with evidence.

Our students are adept at collecting, analyzing, and interpreting data, with the goal of changing policies in ways that will improve public health. To be truly influential, though, we must all be prepared for resistance. Inherent in the idea of changing policies is the idea that we will have to change minds that are resistant. Using tools like the ones above to open those minds is as important a skill as the research skills.

Breaking Into – and Surviving In – the Global NGO Industry: Part 1

This is the first of a three part #PROspective series from alum Roice Fulton (GLEPI, 2014) on career paths with global NGOs and the creative application of epidemiology skills for public health practice. In Part 1, Roice shares his path from GLEPI student graduating at the height of the 2014 Ebola outbreak in West Africa, to a full-blown career at an unexpected employer. In Part 2, the focus turns toward the nuts and bolts of the global NGO industry and how to navigate your own entry post-graduation. Finally, Part 3 will cover the role of teamwork and leadership in public health work. We hope this series will help stimulate a creative approach to the post-graduate job hunt and reiterate the broad applicability of your epidemiology skillset. Enjoy!

Part 1

So, full disclosure: I’m not what you might consider a practicing epidemiologist.

It wasn’t for lack of trying. The GLEPI program granted me a fantastic epi skillset, coupled with a few publications in vaccine research, all in two short years. With my 2014 cohort graduating amid the West African Ebola outbreak, there was ample opportunity to put those epi skills to work. Like many of my classmates, I’d planned on heading straight into the field, and had lined up as many interviews as I could to put myself into the mix.

Yet as Rollins’ newly minted epis went their separate ways, I quickly found myself at a crossroads. Gavi, the global vaccine alliance, had offered a short-term contract based at their Geneva headquarters to provide analytical support for their upcoming fundraising conference.

I’d done fundraising work in the past, but nowhere near the amount Gavi was targeting – a massive $7.5 billion to keep their programs going through 2020. But Gavi just needed someone who could conduct a variety of analyses to help their donors understand the impact of their investments in vaccines. Surely, I thought, between all the spreadsheet jockeying and SAS coding over my two years at Rollins, there was a toolset I could gin up to help Gavi get the resources they needed.

And so, instead of joining my friends in the field, I embarked on a journey as an independent consultant for Gavi. One contract led to another, and I found myself working on everything from fundraising analyses, to tech innovation initiatives, to program monitoring and evaluation.

In my three years at Gavi, I never so much as glanced at a 2×2 table or an epi curve. I’m working now with the epidemiology team at CEPI, Gavi’s new sister organization. And although I’m managing an epi study, I’m still not doing any hardcore epi work. So why in the world did I agree to write for an epi career advice blog?

I decided to write because I believe the lessons I learned in adapting my skills to the needs of my employers might help those of you looking to apply your own newly-acquired epi skills in unique ways. And in my experience, this sort of adaptability seems better suited to what organizations like Gavi and CEPI are looking for in their new employees – particularly as they leave much of the epidemiological heavy lifting to groups like WHO and academic partners.

Frankly, if I couldn’t find a way to channel my epi (and other) skills into a non-epi work product, my career at Gavi would’ve been over before it started. Surviving the first few months would have been much more difficult without the gifts of an analytical background and enough tenacity to spend hours buried in spreadsheets working against hard deadlines. Likewise, succeeding at CEPI meant quickly learning the contours of a complex and ambitious scientific study in a region fraught with difficulties from poor infrastructure to political instability. The work can be intimidating, but the payoff is tremendous – both in personal satisfaction and in human impact.

It’s been more than five years since I first set foot in Geneva. Since then, I’ve gradually developed an understanding of the global NGO community that suggests a wealth of opportunities exist for aspiring young epidemiologists and public health practitioners.

As I figure out my own place in this community, my hope is to identify – and create – such opportunities for you all, just as my mentors did for me. More than ever, we need talented, passionate young thinkers to shepherd the global health and development community into the next era. And more than ever, we need a diversity of perspectives to inform how we can build strong, evidence-based global health interventions. This is where you come in.

You’ve already got a leg up on the competition. Each of you will leave Rollins with an analytical and lateral mindset holding immense potential value to the global NGO ecosystem. But the complex and changing needs of these organizations will rarely perfectly match up with your classwork – so we need to dig deeper to learn how to unlock that potential.

As we’ll explore in Part 2, standing out from the sea of candidates will depend both on how well you understand the global NGO you’d like to work for – and how you can demonstrate adaptability in, and compatibility with, a dynamic work environment.

Roice Fulton, MPH (GLEPI, 2014) is currently an independent consultant for the London- and Oslo-based Coalition for Epidemic Preparedness Innovations (CEPI), where he manages projects in CEPI’s epidemiology portfolio. Roice currently lives and works near Geneva, Switzerland.

Internships: Not just about fulfilling the APE requirement

The second semester is already off to a strong start – 2^nd year students are diligently working on their Thesis and Capstone projects (and maybe wrapping up those core course requirements!), and 1^st year students are immersed in causal inference, more advanced statistics, and designing & implementing epidemiologic studies. Now that we’ve finally settled into the routine of the new semester, we wanted to shed more light on one of the next milestones that our 1^st year students are approaching: identifying an Applied Practice Experience. To our seasoned 2^nd year students: we’d love to hear what you’d add to this conversation! Keep an eye out for this topic to surface on Twitter, and feel free to add the ways you made the most of your Applied Practice Experiences! 

There are so many things that I love about Rollins (please don’t make me pick!) – but one thing that nears the top of my list is our Applied Practice Experience (APE) and the vast network of organizations that welcome our students each year. You may have heard this from me before, but my motivation for pursuing a career in public health was driven by wanting to make a difference. The reason why I love the APE so much is that it affords our students the opportunity to make their mark on public health even before graduation.

While some 1^st year students are well on their way to identifying an APE, most are in the early phases of thinking about how their APE might take shape. As you begin researching opportunities, I urge you to think big so that you can use this opportunity as more than a way to proverbially “check the box” on this degree requirement.

Q: Did your personal statement outline your passion for studying inequities in birth outcomes, but now you can’t learn enough about the novel coronavirus?

First – you must know that this is very typical in the life of a Rollins student! One of my favorite moments from a recruitment event was hearing a GLEPI student say that his “research interests were aligned with whatever [he] learned about during the last seminar [he] attended.” There is so much great work happening in and around Rollins, and there is no shortage of important public health topics to tackle! Take advantage of your APE as a low-stakes way to test the waters in a new topic area.

Q: Did you come to Rollins because you wanted to soak in all that our neighbors at the CDC have to offer, with the hope of landing a job there after graduation?

Many students are drawn to the Rollins School of Public Health due to our proximity to the CDC, and lots of students complete their APE with a wide range of teams across the agency. The APE affords students an inside look at the work environment of their chosen organization. You might find out that your dream job really is at the CDC, or you might find that the work environment isn’t the fit that you thought it would be. Learning what doesn’t suit your strengths and interests can be just as informative as learning what does.   

Q: It’s all about the Epi, right?

Well, not quite! While you will hopefully get a chance to apply your classroom knowledge and skillset during this experience – don’t forget that your APE is also going to test your soft skills and ability to navigate new workplace politics and dynamics. Maybe this means you will have your first opportunity to ask your manager for feedback, test new time-management techniques, navigate generational differences in the workplace, or find ways to translate the stress into focus. These techniques are just as valuable to an early career epidemiologist as experience with methods and their practical application and I encourage you to keep these ideas close at hand during your APE. 

Q: Are you nervous about navigating the job market after graduation?

Thinking about next steps after graduate studies can be daunting, but it doesn’t have to be! You can use the entire Applied Practice Experience process – from start to finish – as a way to prepare for your next steps. The interview process will afford you greater confidence when you are ready to apply for fulltime positions after graduation [NOTE: you may wish to revisit Dr. Lash’s PROspective piece on making a good first impression]. Some students are able to continue working with their APE organization upon completion of the degree requirement, and are even hired full-time upon graduation. If you’d like to pivot to a different area (see above!), your APE supervisor may be willing to serve as a reference for you during your job search.

No matter what APE you choose, I urge you to seize every opportunity that you can to learn from these practicing public health professionals. Keep an eye out for ways in which you are gaining and applying those professional skills and foster good relationships with those you encounter along the way. This will set you apart in the applicant pool as you demonstrate that you have what it takes to be an influential public health professional. We cannot wait to hear how you choose to use the Applied Practice Experience to make your mark on public health!

Interested in more ways that the Applied Practice Experience can expand your horizons? Check out this short article for some additional thoughts!

The EPI-Curious Society

This PROspective is a love story about books, fascinating people and topics that matter.  Have you ever had the chance to share one of your favorite activities with some of your favorite people and then have really interesting conversations on topics you are passionate about while you are doing it?  For me, this beautiful spot where these collide has a new name – The EPI-Curious Society.

“I am always thrilled to find a great read and love to talk about what I have read, particularly when it moves me or changes the way I think.“

I love to read and have for as long as I can remember. When I was in elementary school, my mom would tell me I had to go outside to play during the summer instead of sitting in my room reading. She was truly trying to limit my reading time!  So I packed my books and outside I went… to read. 

“There is no doubt that sharing books together and challenging the way we think has deepened my understanding of the stories of life.”

These days, I spend a lot of time reading papers but I still carve out time for books and have become quite enamored with audio books I can listen to in my car or while cooking. I am always thrilled to find a great read and love to talk about what I have read, particularly when it moves me or changes the way I think.  Some of my closest friends are my six book club buddies. We have been together reading, debating, traveling and supporting each other in life for 20 years. There is no doubt that sharing books together and challenging the way we think has deepened my understanding of the stories of life.

“Our students are passionate, good humans who are engaged and interested.”

Next we add in our Emory Epidemiology students. Wow. I really am inspired by them and the way they think, their experiences, and the questions they ask. Our students are passionate, good humans who are engaged and interested. It’s a gift to know them and I was truly getting a bit blue thinking of them moving on and out of EPI530. We had spent a semester talking about the vaping crisis or the latest NPR story all while learning and growing in knowledge about epidemiology and I was not ready to have our conversations end.

So here comes the leap. Would you be willing to give up your lunch time to join me to talk about books? The response was exciting and two wonderful student leaders came forward to help set this up. Being researchers, we quickly surveyed for interest, best day of the week, book suggestions, and a name for our new book club. With the blend of a couple name suggestions, The EPI-Curious Society was born, a book was picked, and the date was set for our first meeting. 

“Learning from our past and talking about our different perspectives is fundamental to doing good work.“

Our first book, ‘The Immortal Life of Henrietta Lacks’ by Rebecca Skloot has led to a fascinating discussion about research ethics,racial inequities, the individual people affected by research, and the strides made for public health. Learning from our past and talking about our different perspectives is fundamental to doing good work.       

The EPI-Curious Society now gets top billing as one of my favorite things. 

What do you get when you spend lunch discussing the ethics of human subjects research, social inequities & medical advancements with a dedicated group of @EmoryEPI superstars? The #Epicurioussociety bookclub! What a treat to be reunited with these students. ?#readingforfun pic.twitter.com/cP4XofBAgr

— Jodie L. Guest (@Jlguest) January 22, 2020

If you are a current EPI student and would like to join the EPI-Curious Society, please email sarah [dot] johnson2 [at] emory [dot] edu to be added to our listserv for information about meetings and books.

To build your list of interesting books, several faculty in the Department of Epidemiology have also created a list of their top reads from the past year, which are presented below:

Educated, A memoir

The Undoing Project: A Friendship That Changed Our Minds

The Book of Why

The Influential Mind: What the Brain Reveals About Our Power to Change Others

Thinking Fast, and Slow

How Not to Be Wrong: The Power of Mathematical Thinking

Just Mercy

The Theory That Would Not Die: How Bayes’ Rule Cracked the Enigma Code, Hunted Down Russian Submarines, and Emerged Triumphant from Two Centuries of Controversy

The Sun Does Shine

An American Sickness: How Healthcare Became Big Business

Dying of Whiteness

Even on your worst day, you can be a student’s best hope

What were your favorite books of 2019? Tell us in the comments below!

Didn’t see something here that caught your eye? Browse some of our favorite book lists from the last year:

• NYT 100 Notable books of 2019 
• NPR’s Book Concierge
• Bill Gates 2019 Book list

Keep Calm and …

The two most important things I learned as an undergraduate were: (a) I can do a lot in 24 hours, far more than I had realized and far more than many people ever realize, and (b) I can only do a lot in 24 hours if I keep calm while doing it. The ability to work well under pressure is critical to career success, and can be learned. Today’s PROspective article provides ten concrete suggestions for how to manage your emotions and remain calm under pressure, which has a direct link to your wellbeing and to the quality of your performance.

There are a few aspects of this reading that resonate most strongly with me. First is the idea that some stress is normative. As the article states: “Our brains are wired such that it’s difficult to take action until we feel at least some level of this emotional state.” Accepting the feelings that come with intermittent moderate stress as motivational is a first step in turning it to your advantage.

Second, it is important to develop a reliable and healthy coping strategy that you can turn to when stress rises. Knowing that you have a solution provides relief from the aspects of stress that might prevent you from performing, and allows you to channel the stress towards achievement.

For me, the advice to disconnect rings true. I do not work well in the evening, so very seldom even try. I look forward to that time at home with my family, or to play guitar, or to read and watch TV (music documentaries are my latest guilty pleasure). I always have work I could be doing; not doing it reminds me that I am in control, and feeling in control is an important defense against stress.

Learning to use stress to your advantage is healthy and will give you a competitive edge. Like many career skills, it requires introspection and a commitment to being intentional about the goal. This week’s reading will give you some foundational knowledge as a place to start.

Year In Review

2019 was the inaugural year for PROspective – one that has been full of wisdom and insights from both faculty and alumni. This week we take a walk down memory lane to review our top 5 most-read articles from 2019 (in no particular order):

#EpiTwitter: Professional engagement in the 21st century

In our very first article (ever!), Dr. Cecile Janssens introduced us to #EpiTwitter and the wealth of value that comes from having access to an online community of students, teachers, and professionals at your fingertips. 

The quote:

“Over time, I connected with many people who have similar interests but who I would never have met in person because we attend different conferences. Physicians, statisticians, policy experts, patient advocates, and journalists. Slowly but steadily, I expanded my network across disciplines. Twitter is now my favorite ‘annual’ conference, every day.”  

Public Speaking

Science is hard for a lot of reasons, but at the top of that list is that science involves a lot of scrutiny – of data, of methods, and… of presentation. In one of our favorite articles of 2019, Dr. Jodie Guest told us about her experience grappling with the challenges of public speaking. 

The quote:

“”Tell me the facts and I’ll learn. Tell me the truth and I’ll believe. But tell me a story and it will live in my heart forever.” The best speakers are really storytellers even if they are talking about science or a mathematical model.  This is what connects to people and will help them remember what you have presented.”

Get to ‘Yes’

In sports, it has been said (maybe a few too many times) that “you miss 100% of the shots you don’t take”. In the professional world, things aren’t so different. In Get to ‘Yes’, Dr. Timothy Lash gave us a strategy for nailing that shot – making use of our innate human tendencies, like the desire for reciprocity.

The quote:

“Ask in person, and offer something in return. These two principles rest on fundamentals of human interactions. People are more likely to agree to help when asked in person, not by text, email, or telephone. In addition, offering something in return shows respect for the other person’s time and effort.”

Setbacks (not Failures)

Did I mention that science is hard? Let me reiterate: it’s hard – and that means that consistent success is never guaranteed. In Setbacks (not Failures), Dr. Lauren Christiansen-Lindquist helps us reframe the personal and professional challenges inherent in our work, taking a larger view of our journey as scientists. 

The quote:

“The word “failure” sounds so final and evokes imagery of a dead end, where there’s little hope to move forward. It helps me to think of these setbacks as speed bumps, rather than closed roads. Sure, they’ve slowed me down, but they have not, and will not, halt my progress.”

Professional Feedback

While the days of primary school report cards are long gone, evaluation and feedback are still a crucial part of our personal and professional development. Nowadays, that probably comes in the form of monthly check-ins or formal bi-annual reviews. Last, but certainly not least, we heard from Elizabeth Hannapel, MPH (Alum, 2012) about the value of professional feedback and how to incorporate both the good and the bad with tact and grace.

The quote:

“On-the-job training, and the corresponding evaluation processes, should reflect not only job-specific tasks but also the interpersonal skills that enable staff to navigate complex professional environments. “

From all of us at the Confounder – thanks for reading, and we hope to share a lot more insight and PROspective in the new year!

New Year’s Resolutions

A new decade. A new year. A new you. 

This year, countless people will set their resolutions for the year.^1,2 Motivated and fueled with the energy a new year brings, they will rely on their willpower and determination to actualize these goals. Yet, the majority of these best intentions will have flickered by February.³

So how can this year be different for you?

The refrain of countless self-help professionals has been that it takes “21 days to make a change.” By this, they mean that by following a given practice for 21 days, say to set the alarm every morning for a two-mile morning run, that by day 22 you will automatically wake up in the morning ready to run. This prescription for a new you, however, has been widely misinterpreted.⁴

In the 1950s, the surgeon Maxwell Maltz observed it would take a minimum of 21 days for his patients to mentally accept their new appendage, that is, to form and accept a new mental image of themselves. In his book, Psycho-Cybernetics, he delved deeper into his own period of adjustment to new behaviors and concluded that it took a minimum of 21 days before he would adapt to change. However, the “minimum” that Dr. Maltz recorded was lost as pundits hung on to the “21-day change” mantra. 

Now, just how long does it actually take for a new habit to form?

It turns out, it takes an average of 66 days⁵ for new habits to become automatic.

“We are what we repeatedly do. Excellence, then, is not an act, but a habit.”

– Will Durant

You are your habits. Habits are cognitive associations that are formed when we repeat an action in a given scenario and are then rewarded for having done so.⁶ According to researchers at Duke, habits account for about 40% of our behaviors on any given day.⁷

Knowing this, how do we make this year be the one that allows us to make habits not daily decisions?

1) See yourself the way you want to be:

Maltz also observed that change begins within. The most powerful tool you can employ is your own imagination. Picture yourself the way you want to be and change your mental picture. See yourself as the researcher, community activist, fitness buff, you aspire to be. The internal picture you carry of yourself is a powerful tool. Use it. Your current behavior is a reflection of your current identity. Change your identity and begin the change process in yourself.

2) Form Associations:

Add the new behavior to a habit you have already established. Brushing your teeth is a no brainer… so add 10 pushups, a 30 second plank, or drink a glass of water, each time you brush to create association, and link the behaviors. Determine a specific time and space for your desired behavior to live in your world.^8,9

3) Use Physics:

Reduce the amount of friction to achieve the habit and set yourself up for success. Make the action as effortless as possible – sleep in your running gear, or have it laid out by your bed, surround yourself with healthy foods, block out time to write every morning before the day gets away from you. Eliminate as much of the decision making as possible, to make the behavior automatic.

Add friction to dismantle the behavior. According to Wendy Wood, “if you add thought to the behavior, you make people attend to it, and more likely stop”. Place the bowl of fruit on your desk and put the bag of chips on the top shelf of the pantry. Find ways to add friction to the behaviors you no longer want to engage in.

4) Rebound:

You are going to miss a day, skip a run, not follow-through – the key here is to get back on track as quickly as possible. Do not fall for an all or nothing mindset. Put your scientific training to work and treat your “failures” as data points; opportunities to learn what works and how to change your course to achieve your goals.

5) Be patient:

Remember the tortoise and hare fable? This is a key step in the process. “Slow and steady wins the race.” Remain steadfast in your resolve and pacing. Change is difficult. Some behaviors will take longer than others to become habits, but if you are persistent (and are kind with yourself) – you can manifest your inner vision of yourself.¹⁰

So, set your intent. Decide on the person you want to be, and the characteristics you aspire to embody.

Happy New Year!

1. https://www.sciencedirect.com/science/article/pii/S0899328988800166?via%3Dihub

2. https://health.usnews.com/health-news/blogs/eat-run/articles/2015-12-29/why-80-percent-of-new-years-resolutions-fail

3. https://www.businessinsider.com/new-years-resolutions-courses-2016-12

4. https://www.forbes.com/sites/jasonselk/2013/04/15/habit-formation-the-21-day-myth/#e37c81ddebc4

5. https://onlinelibrary.wiley.com/doi/abs/10.1002/ejsp.674

6. https://www.ncbi.nlm.nih.gov/pubmed/26361052/

7.  Neal, T. D., Wood, W., Quinn M. J. (2006). Habits- A Repeat Performance. Association for Psychological Science, 15, 198-202

8. Milne, S., Orbell, S., Paschal Sheeran, P., (2002). Combining Motivational and Volitional Interventions to Promote Exercise Participation: Protection Motivation Theory and Implementation Intentions, British Journal of Health Psychology, 7 163–184.

9. Gollwitzer, P., Sheeran, P., (2006). Implementation Intentions and Goal Achievement: A Meta‐Analysis of Effects and Processes, Advances in Experimental Social Psychology ,38, 69–119

10. Duckworth, A. L., Peterson, C., Matthews, M. D., & Kelly, D. R. (2007). Grit: Perseverance and passion for long-term goals. Journal of Personality and Social Psychology, 92, 1087-1101.

“No, those are dermatologists…”

“We use math and critical thinking to figure out who gets sick and why”

“No matter what we study, there are always individuals who are sick, suffering, or dying – and we’re all trying to do our part to reduce the frequency of those negative outcomes”

“The work that we do can take its toll on us, and it’s important that we don’t forget to take care of ourselves when we’re off trying to save the world”

Compassion & Community

This week has been tough for the Department of Epidemiology. We are mourning the loss of a student and friend of ours. Some knew he was sick and some did not; all of us are shocked and saddened by his passing.

I have seen faculty, staff, and student colleagues struggling to understand, wondering how best to remember him. I have seen loss and sorrow and hurt. And I have also seen compassion and grace.

This week I have witnessed some beautiful moments in between tears and questions. I have listened to a faculty member care for a student who was particularly close with the one we lost. This conversation was filled with moments allowing for grief and offerings of comfort.

I have seen the leaders of our department quickly provide space and support for our students to process and grieve together. They have publicly shared their emotions allowing others to feel safe to share theirs. I watched our Dean hug a student overcome with emotion and was deeply touched when a former faculty advisor spoke of rereading a letter of recommendation written for the student we have lost.

The loss of a young and talented person is hard to process. And while there is nothing about this loss that feels right, these moments have been another reminder for me that I am surrounded by really good people. I believe people are drawn to public health because they are deeply compassionate and have a desire to make the lives and experiences of everyone better. We have bold visions of a world filled with justice, equality, and health. Ambition is a core value of our department—we are used to thinking big. This week, the Epidemiology Department has paused to remember and to band together while we take extra moments to care for our own.

Instead of offering my PROspective on some aspect of your future career, I offer a hope instead. I hope that in the places you will work, you will find this level of commitment to both the big challenges in our world and the connection to those who travel our days with us. It is a special combination indeed.