Flexibility, Empathy, and Patience: A Year Later

A year ago, I wrote a PROspective column to welcome students to the Department of Epidemiology at the start an academic year that would be largely completed by virtual learning. This year, we are fortunate to anticipate an academic year that will be largely completed by in-person learning. It is a big and important step towards the lives and learning styles we remember from before the COVID-19 pandemic. But we are not all the way back to the before times. The column below contains many of the same messages from last year, with updates to reflect what we have learned in the last year and what we anticipate in the year ahead of us. We will all be learning, adapting, and improving as we go. That process will accrue benefits most rapidly if we recognize and practice flexibility, empathy, and patience in our endeavors and interactions. Humans are remarkably adaptable and resilient, much more so than we sometimes realize, especially when we can recognize common goals, reorient quickly when necessary, and maintain composure in the face of hardship. With that in mind, I want to take this opportunity to share a few suggestions that, in the past, have helped students to make the most of their Fall semester at Rollins.

Stronger Together

One of the great strengths of the science of epidemiology is that those who study it come from widely different personal and professional backgrounds. We embrace the diversity of perspectives as a strength. In our previous educational experiences, some of us studied public health, while others studied biology, mathematics, economics, psychology, languages, or arts, among others. What you already know will help you with your curriculum this semester, so let it shine through. Bring your unique perspectives to your classrooms and share it with others, and listen to the unique perspectives that others will share with you. Realize, also, that because of the differences in earlier education and experiences, some parts of the curriculum will come easier to you and some will be more difficult. This too will be an individualized experience.

There is no point in comparing your academic progress with your peers; you will only steal your own joy by making such comparisons.

Commit to growing your network

The ongoing social and physical distancing related to the pandemic response will make it more difficult to develop a professional network. We humans are pack animals and having six feet or a computer screen between us is an unnatural way to socialize. It is critical, though, that we adhere to these public health requirements during this pandemic – to protect our own health and the health of our entire community. Finding solutions and strategies for how to develop a social and professional network despite the barriers starts with realizing that it is a problem, and you will have to invest more than the normal effort to solve it. Get to know your peers in the program through the shared experience, even if less than optimal. Imagine how nice it will be to one day greet them with a smile not hidden behind a face covering. The department’s Canvas site provides guidance on how to network with faculty. The guidance suggests that your initial contact with faculty include a specific request. My friendly amendment is to keep the bar low for that ask. For example, many faculty members hold regular meetings with their research groups. Rather than asking to join their groups, ask to listen in on one of their research group meetings. That is not difficult to arrange and provides a point of entrée to the group’s network.

Don’t forget career skills

The department’s overriding educational goal is to prepare students to be influential public health practitioners. The knowledge, skills, and philosophies that you will learn in the classrooms will be instrumental in achieving this goal. Important, too, will be the career skills that, despite often being complex and nuanced, are seldom part of the classroom learning experience. This PROspective column has often addressed these skills, so I encourage you to read the archives and begin work on honing these professional competencies. Once again, the artificial social interactions related to pandemic response will make it more difficult to practice these skills. Recognize the problem, and plan to solve it. Realizing the importance of career skills and learning how to practice them will be instrumental in your success while at Rollins and for many years thereafter.

We can do it!

Welcome to the department and thank you for your faith in us to provide an excellent learning experience this semester. The faculty and staff have worked hard to prepare, and are ready to change and improve as the semester progresses. We look forward to working with you to make it a success.

Featured Image by Kelly Sikkema on Unsplash

4 Things I Wish I Knew Before Starting My MPH

By Tony Mufarreh, Class of 2021 RSGA Epidemiology Representative

As the class of 2023 arrives on campus for the first time, there are a few principles you should be living by to help maximize your experince in grad school. Graduate school is unlike any other kind of education. It’s difficult, eye opening, and most likely directly related to your desired career path. For me, it opened doors I didn’t even know existed and gave me a more complete understanding of the field of health. That being said, grad school requires a unique set of skills in order to be successful. As a recent graduate of the Rollins School of Public Health, these are the pieces of advice I wish I had on day one at Rollins.

1. Don’t compare

One thing that I was unprepared to encounter, but which became one of my favorite aspects of grad school, is that people come from all walks of life. Some, like me, were fresh out of an undergraduate program, some worked for a year in a related field, and others have had entire careers under their belts.

Each student is therefore here for a unique reason. For me, I wanted a larger breadth and understanding of the field of public health to integrate as a future healthcare provider, therefore I structured my schedule with a variety of topical courses such as nutritional and obesity epidemiology. Others may spend their time deep in practical learning experiences, working year-round with a local public health agency to advance their careers. Others still are looking towards advanced degrees such as PhD or DrPH, so they find themselves in focused methodology courses.

We are all at a different stage in our careers and headed different directions, so it is nearly impossible and, more importantly, unproductive to compare one student’s journey to another. Something I wish I had been told from day one is to focus on your goals, spend your time where you deem fit, and you will be successful in your area. Learning this lesson early made a world of difference in my experience at Rollins.

2. Network(ish)

Networking has a few different connotations, but it is most often focused on ones professional presentation and a set of calculated strategies to build complex webs of colleagues. However, the reality is that ‘networking’ is not that different from making casual friends. 

We’ve all probably heard how important networking is to finding a decent job or breaking into your field of interest. Starting graduate school, I was nervous about how to go about this. Something I didn’t realize is that networking isn’t that different from building any other relationship, and a friendship with a classmate can be just as valuable as a connection at a job. Your classmates can easily become co-authors on a research paper, partners on social justice and public health initiatives, or even just colleagues in the workforce. Many of my fellow graduates now work in the same divisions at companies — I’ve even collaborated with other students on my Applied Practice Experience (APE).

This also applies to professors and faculty. It won’t be long until you are working side-by-side in the real world, so it’s in your best interest to get to know them! Some of my favorite interactions with faculty were one-on-ones in their office (or virtually) chatting about their projects, their career paths, and even my aspirations in life.

The advice I would give to incoming first years who might be a little intimidated by networking at first is to treat networking as a synonym for making friends. Do this and you will find your network expanding exponentially with meaningful relationships. 

3. Not your “thing”? Do it anyway

The umbrella of public health covers a plethora of fields: epidemiology, behavioral sciences, health policy, and environmental health just to name a few. It’s common for people to have their niche field or interest even before starting school. For example, chronic disease was my forte and the beginning of the program, and at that time, I was uninterested in exploring other fields.

As it turns out, this was a limiting attitude. The universe works in strange ways and often the best opportunities come your way when you least expect them. Infectious disease was definitely not my first choice, but when the COVID-19 pandemic first struck in the middle of my second semester, all hands were called to assist in testing sites, research, and attacking misinformation. Mixing my interest with chronic disease, I found myself on a research study regarding Long-COVID and its risks — and this eventually became my practicum experience.

Going into graduate school, one of the best tips I can give you is to keep an open mind when it comes to work opportunities. They may not come from traditional means or even your initial field of interest but may open more doors for you that you never even knew existed.

4. Keep everything

Information you learn in graduate school is different than anything you’ve previously studied. The difficulty may be slightly higher, but its relevance to your career is, too.

For this reason, I highly suggest you keep (and organize!) everything. Your lecture notes, handouts, homework assignments, textbooks, recommended readings — basically anything you receive in a course or lunch seminar, you should maintain a copy of. Right before we graduated, our cohort created a shared drive of notes and key documents from our core courses, and some continue to reference these in their new jobs. Personally, I use these for various summer projects for easy review!

While it may feel early to be preparing for your eventual career in public health, thinking about these things now will save you later. Everything you learn fom day one on is going to be relevant. Keep everything you can to reference in the future; you never know when you’re going to need to review biostatistics 101 (and you will, trust me).

Those are my 4 tips for being successful at Rollins: Don’t compare, Network(ish), Not your thing? Do it anyway, and Keep everything. Grad school is an amazing experience, full of intellectually challenging coursework, relevant work opportunities, and friendships that will last a lifetime. You will learn so much while you’re here and look back on your time as, for most of you, the beginning of the rest of your life.

Best of luck, if you want to network (i.e. make friends), you can reach me at mufant15 [at] gmail [dot] com.

Anthony (Tony) Mufarreh, MPH (EPI 2021) is currently a first year MD student at Central Michigan School of Medicine. During his time at Rollins, Tony served as Rollins Student Government Association (RSGA) Epidemiology Representative.

Featured Image by Braden Collum on Unsplash

RETROspective

Once a year, we take the opportunity to look back on some of our favorite PROspective’s. This year, we invited authors from across the Department to contribute – including students – and the result has been a collection of thought-provoking and insightful articles on the experience of studying and practicing epidemiology in a time unlike any other. Below is a selection of must-read PROspective’s from this past year. We hope that these have helped you gain some clarity and perspective on our profession and how to navigate it. 

Sleep Can Be a Privilege

Last August we heard from Dr. Dayna A. Johnson in Sleep Epidemiology: Contributions of Social Determinants. In this article Dr. Johnson highlighted the ways social determinants can influence our health, specifically our sleep. The Quote: 

“Witnessing such injustices, which are the result of racism – a fundamental cause of health inequities, can cause a state of vigilance, which is particularly salient for racial minorities… These are vicarious experiences of racism or discrimination, which are known to affect health, and sleep.” 

Think in Chapters

In this thoughtful and straightforward guide, Dr. Lauren McCullough explains her simple approach Goal Setting, which can be summarized by three questions: Who are you? What do you want? and What is your plan? Without a doubt, you will find yourself coming back to this article again and again throughout your career during those times of transition and self-exploration. The Quote:

“Goal setting is a helpful way to establish a marker for success and measure your progress. Yet, your journey may be inefficient or ill-conceived if your goal setting strategy is missing some crucial steps.”

Should I pursue a PhD?

On the topic of making plans, in After the MPH, is a PhD Next? Dr. Shakira Suglia brought up points to consider for those students considering a PhD. Even if you aren’t considering further studies at this point in your career, its a good idea to understand what these programs offer because you never know how your goals or educational needs might change in the future. The Quote: 

“A PhD changes the types of jobs you are competitive for, you move into a lead role conceptualizing and leading research rather than carrying out the research.” 

Wait… where did I save that?

There is a lot we are expected to keep organized during a masters program – between coursework, REAL job, APE, and Thesis (just to name a few). This past February, Dr. Ashely Naimi taught us how to keep our research life organized, with a focus on practical solutions for file structures, naming conventions, and much more in his article entitled Taming the Chaos. The Quote: 

“Like your living or work space, your project space should be kept neat and tidy so that you know where things are when you need them.”

Epidemiology and Consulting

Cassie Kersten gave us a peak into the life of a Public Health Consultant when she talked about the journey to finding her job with Booz Allen Hamilton in Public Health Consulting. The quote:

“Even as the most junior member of my team and as one of the few without a military background, my input is valued and I have begun taking lead on some product development tasks.”

To Vax or Not to Vax

There is maybe no more prescient a topic today in epidemiology than this. Vaccine hesitancy isn’t anything new, but the ramifications of our response to it right now loom large over our future with the pandemic both in the US and abroad. In March, Dr. Robert Bednarcyzk talked about vaccination behaviors and hesitance in Epidemiology and Vaccine Hesitancy. The quote:

“Epidemiologists cannot remain siloed – interprofessional collaboration is necessary to overcome vaccine hesitance.”

There is no ‘EPI’ without ‘Advocacy’

In this two-part series, Dr. Anke Huels talked about how to engage in health advocacy through epidemiologic research. In From Epi to Advocacy Part 1 Dr. Huels emphasized working with interdisciplinary teams and community stakeholders to make relevant recommendations for action. In part 2 she explained how to ensure your work reaches the right audience and creates an impact. The quote: 

“If you discuss your epidemiologic findings only with other epidemiologists, it is very unlikely that you will reach the general public and decision makers. You can conduct a perfect epidemiologic analysis and write a beautiful research article. However, if you want your work to make a difference, you need to discuss it with people from different fields and have a good answer to the question ‘so what?'”

From everyone at the Confounder, we want to thank our contributing authors from this past year for sharing their voice and insights. Remember, you can also read though past articles anytime on the PROspective page. If you are interested in contributing to PROspective, please send us an email at Confounder [at] emory [dot] edu with your article idea!

Featured Image by engin akyurt on Unsplash

When does a pandemic begin and end?

In the public discourse, the coming and going of a pandemic has often been compared to a light switch – it comes on quickly and, certainly this time with COVID19, abruptly. As an epidemiologist, an even more apt metaphor comes to mind – a dichotomous process – that the pandemic is either present and posing a certain risk, or not and posing little risk, with no room in between for variability. While this may be a useful comparison for the rapid increase in cases and social challenges characterized by the onset of a pandemic, certainly its exit is a much less discrete – instead more similar to a light on a dimmer – its a continuous, society-wide tapering of perceived risks over the course of several months (at best), represented by a near infinite variety of individual experiences.    

So, as the pandemic in the United States begins to dim, I often think about the changes that are afoot – and wonder what it will be like as we all begin to transition back to a routine that looks more like 2019 than 2020. We know that change is inevitable – but it is rare for there to be a transition that impacts so many of us all at the same time. Undoubtedly, there will be a wide range of reactions to this change – some will be eager to jump back in with both feet, while others will wish to stay on the side of the pool for a while longer. Our reactions may be driven by health-related considerations, or perhaps by a change in perspective brought on by the events of the last 15 months.  

In the midst of this transition, vaccinated epidemiologists are now faced with an interesting dilemma: to mask or not to mask? You must know that the answer to this question is, of course…it depends!

To Mask or Not to Mask

On the one hand, we know that the COVID-19 vaccines are incredibly effective – and the CDC notes that those who are fully vaccinated can resume pre-pandemic activities without a mask (where allowable).

But this hasn’t always been about just protecting ourselves – we know that we’ve been wearing masks to protect ourselves and others. For me, part of protecting others isn’t just about the physical protection, but about psychological protection as well. Unless we adopt Dr. McCullough’s suggestion and start wearing conference-style badges to note our vaccination status, there’s no way for those we interact with to know whether we’re vaccinated. We’ve all had enough second guessing over the course of this pandemic, and I’d prefer not to cause anyone undue anxiety wondering about whether I’m two-weeks past my last dose if we accidentally get too close. So as a Moderna vaccinee, I find myself continuing to wear a mask when out in public – even in spaces where it’s not required. I mask in solidarity with my three sons – who are still too young to be vaccinated – and as a small gesture to those whose paths I might cross in the grocery store.

There’s no right answer here – let’s all just remember to be gentle with ourselves and others. If this territory is challenging for us to navigate, imagine what it must be like for those outside of our field.

Communication

The challenges don’t just end with masking – but questions abound about vaccination, too. A dear friend of mine has been working the COVID-19 response in Detroit, Michigan – with waning cases, her team is transitioning from contact tracing to making calls to increase vaccination coverage. A few members of her team were nervous about making these calls – they were confident about their work with those who had tested positive, or who had been in contact with a positive case, but they didn’t feel like their expertise translated to vaccine promotion. One of her first calls was to a woman who had only received one dose of the Pfizer vaccine – and shortly thereafter had been diagnosed with COVID. She wasn’t sure what to do about getting her second dose, and was thrilled to have been contacted by the health department, saying, “you are exactly the person I need to talk to!” My friend relayed this conversation to her colleagues and reminded them that although they may not know everything that there is to know about the COVID-19 vaccines, that they have a wealth of knowledge to be shared with the community.

Looking forward

Throughout the summer, I encourage you to have these conversations with your family and friends. Whether it be about when or whether to wear a mask, or about vaccination – believe it or not, you do have something to offer that could make a meaningful difference in the slow process to definitively end the pandemic. We may be epidemiologists – and not behavioral scientists or health educators – but we do have a wealth of knowledge to share. We’re comfortable with the fact that there isn’t always one correct answer, and we can use our love of it depends to explain different scenarios that our loved ones might want to consider. And as I always tell my teaching assistants: no one knows everything – it’s always ok to say “I don’t know” – and you can follow-up with more information at a later time.

Featured image by Vera Davidova on Unsplash

To the Class of 2021

By Jodie L. Guest, PhD, MPH

Our first day in class, August 28, 2019, came with table nametags, so I could learn every one of your names.  It also came with a questionnaire asking a few additional questions including, “I would like you to know: __________” and space for you to share anything you wanted. I still have these 161 forms in my office.  They made me laugh, they made me happy, they gave me information to help know you, and they explained silly and important things that make each of you unique. One of you told me you had to walk between classes and so would be late, and likely sweaty. Some of you shared your uneasiness with the beginning of grad school and specifically called out math, English speaking skills, and a new location as anxiety-provoking. I learned about your excitement to get started, your love of chocolate, and that you are a first generation college student. One of you wanted my cats to have their fair share of time on my slides and not just my dogs and several of you told me about your talented dogs and their tricks (hello, Estes, who can close the door by herself!).

As a class, you have endured the oddest of school circumstances. On one hand, you started your public health career during the vaping lung epidemic. As we finished your first semester, I said, “it’s incredible to study public health during an epidemic.” By March of your second semester, we traded the vaping epidemic for a pandemic the likes of which I hope we do not see again in our lifetime.  You were moved to fully online classes with just a few days’ notice. We never expected your second year would still be so heavily impacted by the SARS-CoV-2 pandemic or that so many would suffer and die.  Vaping lung was gone and everything was COVID-19. You watched people on social media become experts in your new field, with training or not. You got a crash course in science messaging including disastrous messaging that cost lives.

Between zoom classes, hybrid classes, APEs and thesis work, you engaged with this pandemic in important ways. You cared for family members and each other. You volunteered at the local health department doing contact tracing or at testing events. You supported COVID-19 studies by collecting samples and doing data analysis. You supported communities by handing out masks, providing translated prevention materials, and smiling behind your masks. You countered conspiracy theories on social media and used your new vocabulary to synthesize the rapidly growing and changing understanding of COVID-19. Concurrently, due to continuous violence towards and deaths of black men and women, transgendered persons and the Asian community, you helped push us all to declare racism as a public health crisis. You asked us to be better and work harder as anti-racists.  You led us and we, as individual people and as a community, will continue this good and hard work.

So my thoughts as you graduate?  First, you are a special, remarkable class of good humans.  That cannot be said enough. Second, I think it is clear that the world needs you. We need you as our trained public health colleagues and we need you as the engaged, compassionate, and persistent group of people who have both persevered and succeeded during the wildest of times. My next thought is to urge you to not shy away from politics in public health but to fight to get it back on bipartisan footing. Find good trouble and lead with science. My last thought for you is to ask you to continue to share yourselves. Each of you has a different story, a different lens and that is what makes the world beautiful. 

It has been an honor to know each of you, to work alongside you, and to learn from you.

Dr. Jodie L. Guest (PhD, MPH) is the Vice Chair of the Department of Epidemiology and serves as a Research Professor. Dr. Guest is also on the leadership team for the Emory COVID Response Collaborative (ECRC) and leads the COVID-19 Outbreak Response Team. 

Look How Far We’ve Come

By Lauren Christiansen-Lindquist, PhD, MPH

Over the last 14 months, a recurring theme for me has been a complete disorientation regarding time; some days have felt endless while others have gone by in a flash. I’ve done more than one double take as I’ve looked at my calendar and realized that it really is May 2021 and that the spring semester is coming to a close. 

Many of you have wrapped up your spring semester obligations, and others will be putting on the finishing touches in the coming days. Whether you’re graduating, preparing for a summer of thesis wrap-up, looking ahead to your APE, or awaiting some other adventure – I encourage you to take a moment to pause and reflect on all that you have accomplished over the course of this academic year. 

The circumstances under which you have studied, worked, and grown have been truly extraordinary. It can be easy to get caught up in our day-to-day challenges and lose sight of just how far we’ve come. One of the greatest lessons that I have learned over the course of the pandemic is that I am far more resilient than I led myself to believe – and I hope the same is true for you. 

ICYMI – Emory’s President, Greg Fenves, penned an open letter of recommendation for Emory’s Classes of 2020 and 2021, which ran in the Washington Post, Wall Street Journal, and Atlanta Journal Constitution on Tuesday, May 4th. I read his letter with such pride and admiration for all that you have done (this goes for you, too, Class of 2022!). There is no exaggeration in President Fenves’s message – you are a remarkable group of students, who have made, and will continue to make the world a better place. 

Bookmark his letter – and when you find yourself feeling tired or worn down, pull it up and know that, yes, President Fenves was indeed talking about you when he wrote it. 

Graduation always stirs up so many emotions for me – but this one will be particularly special as the Class of 2021 is the first class that I had the privilege of welcoming as the Director of Graduate Studies for our MPH & MSPH programs. While I certainly wish we could have seen each other in person a whole lot more, I am so grateful for the ways that you have fostered growth not just in our program and department, but within myself as well. 

Wherever the next leg of your journey takes you – I wish you all the very best! We cannot wait for updates on all the incredible things you’ll go on to do! And above all, take good care of yourselves.

Congratulations on a job well done!

LCL 

Dr. Lauren Christiansen-Lindquist, (PhD, MPH) is a Research Assistant Professor in the Department of Epidemiology, and serves as the Director of Graduate Studies for MPH and MSPH programs in Epidemiology.