From Epi to Advocacy: Part 2

In this second segment on translating epidemiologic work into advocacy efforts, Dr. Anke Huels follows up on her discussion of the importance of building interdisciplinary teams and engaging with stakeholders during the research process. In this piece, Dr. Huels provides advice from her experiences working with the Trisomy 21 Research Society’s COVID-19 task force on how to ensure that your findings reach the right audiences and promote change and accountability in real-time.

How do you reach the right audience to promote advocacy?

By Anke Huels (PhD, MSc)

1) Consider uploading your manuscript to a preprint server

When you submit your work to a peer-reviewed journal, it usually takes 3 months (very rare) to about a year from first submission to publication. And if you have to try more than one journal after it has been rejected by your first choice(s) (very common!), it can take even longer till it’s published. It took less than a year till we had several vaccines against COVID-19. Do we really want to wait for a year till we learn about the consequences of COVID-19 on individuals with Down syndrome? When the pandemic is over, no one would be interested in such a paper. Therefore, we decided to upload our manuscript to a preprint server at the same time as submitting it to a peer-reviewed journal. Our preprint already got some attention from the media. I was interviewed by Science Magazine about our study and shortly after the CDC included individuals with Down syndrome as high-risk group.

2) Choose the right journal

How do I reach the right audience? Who will be most interested in our research? Do I want other epidemiologists to read my work? Submit it to an epidemiological journal! Are the findings more interesting to a medical audience? Submit it to a medical journal! Another criterion (especially for time-sensitive work) is, how long it usually takes from submission to publication and if they offer open access. For our project, we decided to submit it to a general medicine journal with open access and published in The Lancet’s EClinicalMedicine.

3) Know your audience!

Scientific articles usually don’t reach the general public and caregivers of individuals with Down syndrome, who are the target group for the recommendations we were trying to bring across. Therefore, we decided to make our findings more accessible to the general public after it had been published in a peer-reviewed journal. We gave several interviews and the reporters did a great job in providing a lay summary of our findings in several newspapers, like USA Today and Verywell Health. In addition, we published regular updates of our findings on the T21RS website, including infographics that provided a brief and simply overview of our findings.

4) Advocacy efforts begin after publication

Partly based on our findings, governments from all over the world included Down syndrome as high-risk medical condition for severe COVID-19. Does that mean our job was done? Not really. Many states in the US decided to ignore the CDC recommendations and came up with their own list for prioritization. We were then asked to write a brief report for the Biden administration’s COVID-19 Health Equity Task Force about the progress in vaccinating individuals with Down syndrome. Lauren Russel, a 2^nd year MPH student in Epidemiology, went through the states’ local public health websites and prepared a vaccine tracker which provided regular updates, in which states individuals with Down syndrome were eligible for vaccination. This vaccine tracker was distributed via the T21RS website, Twitter and various Down syndrome societies. And we gave interviews on the local news channels. In Georgia, Governor Kemp announced that individuals with Down syndrome would be included in the upcoming vaccination phase just two days after our interview on 11Alive. While this could have been a coincidence, I strongly believe that giving many interviews on different channels has made a big difference for our advocacy efforts.

5) Don’t be scared of interviews

I was extremely nervous before the first interviews (especially before the first TV interview), but it became much easier over time. I can strongly recommend using the available resources for media training! For me, it was extremely helpful to talk to the Rollins Communications experts before I gave my first interview. They even attended most of my interviews and gave me great feedback afterwards about what I could do better next time. Furthermore, interviews are a great way to practice science communication and explaining your findings to the general public. Another good way to practice your science communication skills, is to talk to your parents, grandparents or friends about your research – especially to those who have no background in epidemiology, medicine or public health. If you are able to convince them of the importance of your research and they can summarize your research in their own words, you did a good job in science communication!

6) Use Twitter to promote your research!

Twitter is a powerful platform to promote your research. We successfully used Twitter during all stages of our project: 1) To promote our survey, 2) To share our findings, 3) To advocate for individuals with Down syndrome being prioritized for vaccination, 4) To share information on  which states were already vaccinating people with Down syndrome. Especially when you want to reach a broader audience, Twitter is a great platform to share your findings. Consider using Twitter threads to explain your main research findings in 4-5 tweets. Impossible to bring it down to such a small number of characters? That’s a sign that you need to work on your science communication skills! I see Twitter as a modern version of an Elevator Pitch. Giving a brief lay summary of your research needs practice but it’s an essential skill for science communication.

Overall, to translate your epidemiologic work into advocacy efforts, 1) it is essential to work in interdisciplinary teams to integrate different perspectives into your conclusions and recommendations, 2) practice your science communication skills so that you are able to communicate your findings to the general public, 3) promote your findings on social media and don’t be scared of giving interviews! Not every epidemiologic work can be translated into advocacy efforts. But take the opportunity to make a difference, whenever you have the chance to do so! That’s our responsibility as public health professionals!

Dr. Anke Huels (PhD, MSc) is an Assistant Professor in the Department of Epidemiology, with a joint appointment in the Department of Environmental Health. To learn about Dr. Huels’ ongoing projects, visit her website to hear more about the current work in the Huels Lab. 

From Epi to Advocacy: Part 1

In this first of two segments on using epidemiologic research to power health advocacy efforts, Dr. Anke Huels discusses the importance of working with interdisciplinary teams and engaging with stakeholders to create recommendations that are actionable and relevant to affected communities during her work with the Trisomy 21 Research Society’s COVID-19 task force. 

How do you translate epidemiologic work into advocacy efforts?

By Anke Huels (PhD, MSc)

Let’s be honest: How many of our epidemiologic research projects have a direct impact on public health? When I review my own research from previous years, I would say not that many. Don’t get me wrong. Some projects we work on make a difference in our specific fields of research. But we usually don’t expect the general public to be interested in our research findings and we don’t expect them to have a direct impact on political decisions.

At the beginning of the COVID-19 pandemic, I joined the Trisomy 21 Research Society (T21RS) COVID-19 task force as expert for biostatistics and epidemiology. Health conditions, immune dysfunction, and premature aging associated with trisomy 21 (Down syndrome) were hypothesized to impact the clinical course of COVID-19. Our goal was to better understand the impact of COVID-19 on individuals with Down syndrome and to find out whether they are more vulnerable to severe COVID-19 than the general population.

Get out of your comfort zone and work in interdisciplinary teams!

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?”. As epidemiologists, we are trained to cautiously discuss all limitations of our analysis and often told to avoid stating any policy recommendations based on our findings. But what if our study is by far the largest study that has ever been conducted on this topic, and the community and policy makers are begging for information and advice?

Our study on the impact of COVID-19 on individuals with Down syndrome was based on more than 1,000 COVID-19 patients with Down syndrome from all over the world. Most previous studies were case reports of less than 10 COVID-19 patients with Down syndrome. Most importantly, the Down syndrome community was begging us for information about how dangerous COVID-19 is for individuals with Down syndrome and recommendations on what they could do to protect them in the best possible way. The other members of the T21RS task force were clinicians from all over the world – most of them with limited knowledge of epidemiology but an excellent understanding of the medical conditions and the kind of questions and worries patients (and their caregivers) had. Consequently, it was a continuous back and forth within the task force until we agreed on the conclusions we could draw from our data and which questions we could not answer.

In addition, we had regular stakeholder meetings with members of various Down syndrome advocacy initiatives and societies. During the stakeholder meetings, we shared our epidemiologic results and discussed the best ways of communicating them. In our study, we found that individuals with Down syndrome have a three-fold increased risk for mortality after infection compared to the general population. But what are the consequences of these findings? Does that mean that individuals with Down syndrome should be shielded? What about the adverse impact of having to stop the therapies and care they need and losing their daily routine? What about children with Down syndrome? What happens if parents of children with Down syndrome panic after reading our findings and take their kids out of their daily routine? It was clear that we could not simply report or findings without discussing their impact on the Down syndrome community. Therefore, it was crucial to have on-going discussions with clinicians and stakeholders to find the right balance between reporting our results and being clear about their implications.

Stay tuned for next week’s segment where Dr. Huels will discuss specific strategies for disseminating research in a timely and effective manner, and connecting the findings to direct advocacy efforts!

Dr. Anke Huels (PhD, MSc) is an Assistant Professor in the Department of Epidemiology, with a joint appointment in the Department of Environmental Health. To learn about Dr. Huels’ ongoing projects, visit her website to hear more about the current work in the Huels Lab. 

Post-MPH Planning: Is a Dual Degree Right for You?

By Jazib Gohar, MPH (EPI, 2020)

A dual degree MD/DO-PhD program isn’t the first path one might immediately think of after graduating with your MPH. However, if you’re passionate about a career where you get to practice medicine AND conduct research, then a dual degree program might be for you!

The Dual Degree Program

An MD/DO-PhD program is a joint degree program where you are trained in medicine and research, formally earning both your medical degree and your PhD. Dual degree programs, on average, take about 8 years to complete, though the length can vary depending on your field of research and your research project. There are currently 129 MD-PhD and 6 DO-PhD programs that currently exist in the United States. Annually, these programs accept anywhere between 1 and 10 students a year, making the process competitive due to the limited number of spots. The application process requires a bit of extra work and can vary depending on whether you are applying to MD-PhD and/or DO-PhD programs.

While MD/DO-PhD programs require a lot more time than either degree alone, have a more intensive application process, and are highly selective, there are fantastic benefits that are appealing for applicants. For those who are incredibly passionate about both practicing medicine and researching, you have the unique opportunity to pursue both career paths in a single program. Additionally, most, if not all, MD/DO-PhD programs offer some level of funding, often paying for the entirety of your schooling AND providing you with a stipend. Finally, these dual degree programs offer you the unique experience to bridge the gap between research and medicine, allowing you to take your work from bench to bedside.

Why I Chose a Dual Degree Program

I am currently a 1^st year DO-PhD student at Michigan State University, pursuing my PhD in Epidemiology. MSU follows a unique 1-2-3-2 format, where your first year is within your PhD program, the following 2 years is dedicated to your pre-clinical medical coursework, the 3 years after are focused towards finishing the rest of your PhD program while doing clinical rotations one day a week, and the final 2 years conclude with the remainder of your clinical rotations. I chose MSU because they offered a dual degree program in epidemiology (not all schools do!), it was close to home (I’m from Skokie, Illinois), and the 1-2-3-1 format really appealed to me. This last point was important, because MSU does a great job integrating the medical and the research sides of a physician-scientist career by implementing this alternating-years format, as opposed to the 2-4-2 format where the entire PhD is sandwiched between your pre-clinical and your clinical years.

 I went from arriving at Rollins in 2018 not even knowing what epidemiology really was, to falling in love with the field and the limitless opportunities one can pursue within it. While I knew my whole life that I’ve always wanted to pursue medicine, it wasn’t until I started my research with Dr. Lauren McCullough when I realized how much I enjoyed epidemiological research. During the summer between my 1^st and 2^nd year at Rollins, I decided to primarily apply to dual degree programs, knowing that I would be happiest pursuing a career that allowed me to balance a medical and a research career. My goal was to meld the worlds of epidemiological research and medical practice into a single career, being able to analyze population-level issues while working with patients at an individual level. With my research interests being rooted in neighborhood-level disparities and epigenetic mechanisms, and my medical interests focused on serving underserved populations, I knew that a dual degree program would be the perfect intersection for my interests.

I cannot overstate how useful and practical my MPH and my experiences at Rollins has been during my DO-PhD program. I was able to gain equivalency credits for nearly half of my courses at MSU because I had already taken them at Rollins, which shortens the total length of my program. Further, having a strong epidemiological background from my time at Rollins has prepared me in being able to code fluently in both SAS and R, engage in meaningful and thoughtful conversations in my courses, and most importantly has allowed me to get started on research as well. All of my training at Rollins gave me the foundation and the bandwidth to take more courses per semester and to engage in multiple research projects, including my dissertation research. I don’t think I would be where I am today if it wasn’t for my experiences at Rollins, which is a pretty awesome indication of how powerful a Rollins education is!

My Advice to You

First and foremost, I think the biggest piece of advice I can offer is to think long and hard about your desire to pursue a dual degree program before applying. Talk to people you may know who are currently in these programs, talk to people who have completed this program, and talk to your family as well. 8 years is a lot of your life to commit to a rigorous program, and you don’t want to realize a few years in that this may not be for you.

Understand what the life of a physician-scientist may look like after your schooling is complete. A majority of graduates pursue a career in academia, often researching 4 days a week and seeing patients 1 day a week. If you like both research and medical practice but you don’t think you want to commit that much time to research, or that little time to medicine, then maybe just a medical degree would make you happier (remember you can still do research in some capacity as a medical student!).

That all being said, I personally believe epidemiology is a unique field where you may be able to strike a more perfect balance between research and medical practice. The convenience (and beauty) of epidemiological research is that it can be done on our computers wherever we are in the world, compared to basic science fields that may require a lot more hands-on bench research that require you to be in the lab to progress your research. Further, having your MPH beforehand may also shorten your program and reduce your coursework, depending on your institution.

There are many pros and cons for pursuing a joint MD/DO-PhD program but if you know that this is the route for you, then go chase that dream!

Jazib Gohar, MPH (EPI 2020) is currently a first year DO-PhD student at Michigan State University. During his time at Rollins, Jazib was also a member of the Department of Epidemiology’s social media team. 

Publishing Your Thesis

By Patrick Sullivan, DVM, PhD

Your Masters thesis is a major part of your MPH education and represents hundreds of hours of your work and a significant amount of time invested on the part of your thesis advisor or field advisor.  A great way to get the most out of your thesis — both for your career and for the people whose health we hope to improve — is to publish your work in a peer-reviewed journal.   As a frequent thesis advisor and the Editor of an epidemiology journal, I’ll share some things to consider as you decide how to move from thesis to journal article.  This isn’t an exhaustive list of what makes a great paper; it is a list of some common things that can help you make the transition from your thesis document to a successful submission to a journal.

1) Pick the right journal.  

In a world where everything is available electronically, the decision about which journal to submit to should be based on which journal will most likely get your work to the people who can use it to take the right public health actions and improve health.  Talk to your thesis advisor or other faculty or colleagues who work in the area of your research.  There are often subtle differences in who actively reads which journals and in which journal is most likely to see your work as a great fit for their readership.

2) Right size it. 

Different journals have different limits on word count for research articles, and there’s a good chance you’ll need to cut the word count from your thesis to get it into shape for a journal.  Most journals have an “Instructions to Authors” section that will give you the rules.  Often the background sections of academic theses have a lot of literature review, and that’s a prime place to consider cutting back.  Depending on the journal you submit to, the Editor and the readers might already have a lot of background knowledge about your area of research.  A great introduction can be 3-4 paragraphs long.  It makes the case of why your research is important, what is known on the topic already, what gap you’re trying to fill, and includes a short statement of what you did to fill that gap.

3) Pay attention to the rules. 

The instructions to authors section will also let you know how many and what types of figures are allowed in the journal for different article types.  Always take the time to read these and follow them.  As a journal editor, I won’t reject an article just because the authors didn’t follow the guidelines, but it always helps your case when the Editor can tell that you really prepared this manuscript for the journal she leads.  If you get a rejection from one journal and need to submit to another journal, take time to check the rules of the new journal and get your paper in line with those expectations.

4) Write a clear cover letter. 

Some journals require this, but it’s always an option.  A cover letter is your 1-page “elevator pitch” for your paper — a succinct case for why the journal editors should care about this topic and prioritize your work in their journal.  If the journal has published papers on similar topics, this is a good place to let the Editor know that you are aware of the prior published work in the journal, and how your paper furthers that knowledge.  Always point out why your work is important to improve health or the field — concisely.  Let the Editor know that you are publishing your thesis work.  I am always excited to see people early in their career bringing their work to the journal I edit.  Finally, offer several suggestions for knowledgeable peer reviewers who you think could provide an informed and objective peer review.  This helps the Editors get timely and high quality peer reviews.

5) Your Discussion section is key.

The discussion section is another place where you might need to cut back a bit from your thesis document.  For most journals, a 7 or 8 paragraph discussion is about the right length.  Even if you wrote the discussion for your thesis alone in the late night hours, I encourage you to set up a time with your thesis advisors and others who helped with your thesis to brainstorm the contents of the discussion section of the manuscript.  In my editorial role, I’m looking at the Discussion to tell me what was learned, what we should do as a result, what the limitations of the knowledge gained are, and how this might help improve people’s health or help researchers improve their work.  After all the literature review, working on methods, and fighting with word processing apps to get your tables looking right, this is your chance to think and communicate how your work will make the world better.

6) Don’t let the editors (or the reviewers) get you down. 

At Annals of Epidemiology, where I am Editor, last year we accepted less than 10% of the manuscripts we received.  In your career, you will have several rejection decisions for every acceptance.  When you get a rejection, before or after reviews, it’s an opportunity to rethink your strategy.  If you got a rejection without peer reviews, was the fit for the journal right?  Some editors will provide you with a categorical reason for the rejection, but if not you can always ask.  If you got comments from reviewers, you got a free gift — a list of ways to make your work better or to communicate more clearly for the next journal.  I try to make revising and resubmitting a rejected manuscript a high priority — all the work is done in preparing the manuscript, and there’s no reason to let a good manuscript sit outside of a review process. In authorship (as in most parts of life), persistence is the only real predictor of success.

7) Share the news. 

As someone who trained before social media ruled, this is a new one for me as a writer.  When your publication comes out, share the link and your high-level highlight through social media to help people learn about the new knowledge you’ve shared.  You can tweet a figure or a main message from the paper.  The Emory Epi department and the Rollins communications staff are great about retweeting our work, so be sure to tag them when you tweet.

I hope you’ll make time to turn your thesis into a paper for peer review.  If the research is worth doing, then the knowledge is worth sharing.  

Dr. Patrick Sullivan (DVM, PhD) is a professor in the Department of Epidemiology at the Rollins School of Public Health and serves as the Editor-In-Chief of Annals of Epidemiology.

Join the Conversation

Are you an alumni or current student in the Department of Epidemiology? Do you want to share your professional advice and experiences with a large audience of your peers? We want to hear from YOU! Consider becoming a contributing author for PROspective! To inquire, email your article idea directly to the editors at Confounder [at] emory [dot] edu!

Preparing for Interviews

By Timothy Lash, MPH, D.Sc.

The spring season often brings a calendar with interviews for Applied Practice Experiences, summer internships, post-graduation jobs, and graduate school admissions. These are an important part of the path towards achieving your career goals, yet are also unfamiliar territory for students early in their careers. Like most things, preparation and practice are the key to success. Here are a few tips to get ready.

Questions to Prepare For

First, most interviews will start with some variation of the question “Tell me about yourself.” Because you can count on getting this type of question early in the interview, it’s an opportunity to be prepared and practiced. This week’s suggested reading (Entrepreneur, 2019) gives concrete advice about the importance of this question and being prepared for it. Avoid simply restating the chronology on your resume or CV – the interviewer has already seen that. You will want to give a brief biography, but focus on your career interests and how they fit with the position. Talk about anything in your work or education history that is particularly relevant to this position. Conclude with a clear statement about your interest in the position and how well suited you would be to it. Most important, prepare for this question, even if you write out the answer. You do not want to read it during the interview, but you should be prepared for this question and ready to answer it effortlessly when it comes.

Second, there will almost always be a question about why you are interested in this particular position. Again, because you know this question will be asked, you can be prepared to answer. Research the position and what will be required so that you can tie particular aspects of your knowledge, skills, and experiences to what you think will be required to succeed in the position. A subtle but important point is to frame your answer (and the whole interview) in terms of what you can do for the position, not what the position will do for you. This is a subtle reframing that becomes important as you advance in your career. Early in our trajectory (college and graduate school interviews), it’s only natural to think about why you would like to join a particular educational institution. However, once you have a graduate degree, interviewers want to know that you will add value to their organization. They are less interested in what the organization can do for you. So frame your answer in terms of how you will help the organization to achieve its goals, and less so on how happy you will be to have the position.

Third, there might be a question about how you would define your ideal workplace. Here it’s important to be authentic about the type of work style where you are most productive. Unless specifically asked, avoid answering in terms of the physical workspace (office, cubicle, open office, remote work). It is better to answer in terms of the work style. Do you prefer to have several projects at once, or one project at a time? Do you prefer to work regularly with a team, or do you prefer to work alone and then combine your work with others. Do you prefer to travel often for work, or to spend most time working near to home? These are all elements of an answer that you can give that demonstrate that you are self-aware of your work style that is productive. Wherever possible, it’s best to answer these questions as a  balance, not one or the other. For example, instead of saying “I work best when I have only one project at a time,” you could say “I work best when I have one project that is my focus, and I usually expect there would be several other smaller projects ongoing at the same time.” The second answer demonstrates that you are not rigid about this work style, and still conveys your authentic preference.

Fourth, there will almost always be a question at the end such as, “Is there anything else you would like to discuss.” Many times candidates pass on this question and answer “No, I think we have talked about everything I had in mind.” This is then a missed opportunity to seize the moment. Again, with some preparation and practice, you can take advantage of this opportunity to leave a terrific final impression. Instead of answering with some version of “No,” answer with “I would just like to reiterate that I am enthusiastic about this opportunity, think it’s a great fit for my skills and experience, and that I would really do a terrific job working with all of you.” With this answer, you leave the impression of your enthusiasm for the job, confidence that you can do it, and understanding that you will be joining a team that aims to succeed. Avoid using this opportunity to ask about salary, start date, or when you will hear back from them. Skilled interviewers will tell you as the interview wraps up about the process moving forward. If they don’t, you can always ask before saying goodbye. I advise against asking about salary or start date, or any of the other offer terms, at a first interview. If you are asked, it is fine to say what you expect.

Getting Ready for Zoom Interviews

Given that these interviews now occur by video (and that may continue for first interviews indefinitely), there are a few tricks to keep in mind. First, be sure that you are professionally dressed and that your background is clean and orderly (or use a background). Second, be sure that there is no window or bright light behind you. You want the light in front of you (even if you use a background). Third, raise the height of your camera so that it’s level with your forehead. It gives a better impression to be looking up at the camera than to be looking down at it. Fifth, and this one is difficult, try to look at the camera and not at the screen. Looking at the camera gives the feel of eye contact, whereas looking at the screen does not. It’s difficult because looking at the person on the screen feels like you are making eye contact, but it does not look like that on the other side. Try it out with some friends and you will see a big difference. Finally, it’s possible to write some bulleted notes and tape them to a wall behind the screen. You can glance at them during the interview to be sure you covered the points you prepared to answer. No one will know it’s there (so long as you do not use it to read!). Do not put the notes on a paper on the desk or table in front of you – then it will be easy to see that you are reading.

Finally, the most important part of the interview is to be your authentic self. People are very good at seeing when others are not being authentic. You are prepared for the job and the interview, try to enjoy it and that will allow you to be the best version of yourself. 

Dr. Lash is the Chair of the Department of Epidemiology, co-author of Modern Epidemiology, 4th edition and Applying Quantitative Bias Analysis to Epidemiologic Data, and the Editor-in-Chief of Epidemiology. 

Join the Conversation!

Are you an alumni or current student in the Department of Epidemiology? Do you want to share your professional advice and experiences with a large audience of your peers? We want to hear from YOU! Consider becoming a contributing author for PROspective!

To inquire, email your article idea directly to the editors at Confounder [at] emory [dot] edu!

How to Write Post-Interview Thank-You Notes

An important, but often forgotten, piece of job interview etiquette is sending your interviewer a thank-you note afterward. While it may seem like a simple formality, sending a thank-you email can set you apart in the application process and reinforce your interest in the position. Even if you find you are no longer interested in the position after interviewing, it is still important to send a thank you to show your appreciation for their time and leave them with a good impression. After all, you never know if, in the future, you might be interested in another position with the organization, or if they may pass your name on to other professional contacts in their network.

As first years are getting ready to apply for APEs and many second years are in the midst of the post-grad job search, we put together some tips for how to write the perfect post-interview thank you email.

1. Don’t Wait!

It is best to send the note as soon as possible, but be sure to send it no more than 24 – 48 hours after your interview so that your conversation is still fresh in their mind. If you do not have your interviewer’s specific contact information, you can reach out to the hiring coordinator, or the individual that set up the meeting, to ask for their contact information so that you can send along your thanks.

2. Add a Personal Touch

Make sure to include one or two details that stood out to you during your conversation, whether it was a something new you learned about the organization, an opportunity within the position that excited you, or a recent project they mentioned that you found interesting. Adding something personal can both demonstrate your enthusiasm about the position and make your application memorable during the hiring process.

3. Keep It Short & to the Point

A thank you note does not need to be much longer than a few sentences, it just has to cover three key components. You should thank the interviewer for their time, mention something that was discussed in the conversation, and reaffirm your interest in the position. To make sure that your note is professional and impactful, review it a few times for grammar and spelling issues.

If you are still stuck on what to write, there are many examples and templates available online that can provide useful guidance for getting started. Once you figure out your preferred style for these types of notes, it can even be helpful to create your own template so that after every interview you can fill in the specific details based on that conversation and send off the email quickly and easily. The interview process can be stressful in many ways, but with these tips and a little practice you can check the post-interview thank you note off of your list of things to worry about.

Join the Conversation!

Are you an alumni or current student in the Department of Epidemiology? Do you want to share your professional advice and experiences with a large audience of your peers? We want to hear from YOU! Consider becoming a contributing author for PROspective!

To inquire, email your article idea directly to the editors at Confounder [at] emory [dot] edu!

Hitting the Pandemic Wall

By Farah Dharamshi, MSEd., JM

Hitting the wall…

I get it. It has been a year since the WHO declared COVID-19 a pandemic. A year since your classes went online. A year since your classroom or office became your bedroom, kitchen, closet. A year since you left the house without your mask and hand sanitizer.

What a year it’s been.

You haven’t “seen” or hugged your parents, you lost your uncle, your neighbor’s wife passed away, your friends have been reduced to squares of pixels on your display.

So you’ve turned to something, to do- anything to fill the creeping expanse of a seemingly endless year (decade? Who even knows anymore?).

You have attempted bread baking and quilting, you have tried to compete in virtual races, you have watched every Netflix, HBO Max, Amazon series/movie (and found out that some things just should not be made), started reading five books each month (but never actually finished one), reorganized every drawer in your home while writing hundreds of Vote Now postcards, and rallying against social injustice, and now…

You are done.

You are depleted.

You have APEs to secure, midterms to study for, jobs to apply to, a thesis to complete, grants to write and you are too exhausted to move. Perhaps you are also struggling with feeling bad for – feeling bad. Rationally, you’re upset with yourself. You are scientists. You know the value of social distancing, and the importance of all the mitigation procedures in place.

But knowing why we need to remain as Zoom-connected islands doesn’t make it any easier. So many of us feel immobilized and stuck in a never-ending downward spiral.

When I have found myself struggling this past year, I have delved into the science of motivation. According to Brad Stulberg, a performance coach, there are two types of fatigue. The first in which your body and mind are genuinely exhausted (“real fatigue”), and the second in where your body has tricked yourself into feeling drained because you have been in the same old routine for the past twelve months (“fake fatigue”).

Dealing with this fatigue requires two diametrically opposed responses: stopping or moving.

The first type is easy to spot – your body is achy and sore, your mind feels psychologically fried. You need to stop, rest, prioritize sleep hygiene, and disconnect (spending time in nature always helps). While the second type is easier to discern physically, it feels the same mentally; the psychological inertia: sluggishness, apathy. The longer you wait for the drive and motivation that got you to Rollins to appear, the more weighted down you feel. A core tenet of behavioral activation  is that mood follows action. According to Brad Stulberg, “you don’t need to feel good to get going, you need to get going to give yourself a chance to feel good.”

Clinical psychologist, Thea Gallagher offers some helpful suggestions to push through the wall:

• Give yourself credit for all that you are doing and write it down at the end of the day.
• Find joy in the little things where you can.
• Get outside for some mood-boosting fresh air.
• Don’t beat yourself up. Treat yourself with the compassion that you would treat someone you love.
• Engage with what you can control (regular meals, sleep hygiene, exercise).
• Don’t be afraid to reach out for help. Your mental health is as important as your physical health.

For me, the daily practice of running served as the one thing I was able to maintain control over. When the world stopped, I could still put on my shoes every morning and go somewhere (even if they were endless loops around the school track). While I cringed almost every time the alarm rang, I knew it was the only semblance of my life pre-COVID that I could retain. That agency has powered me through.

We are in the home stretch. There is a visible light just around the corner. Plants are budding and spring is in the air. The time change “forward” is more meaningful this year than ever before. I know it’s hard, but after a brief respite get up again. The world needs you.

You’ve got this.

Farah Dharamshi, MSEd., JM,  is an Associate Director of Academic Programs (ADAP) in the Department of Epidemiology at the Rollins School of Public Health.

Join the Conversation

Are you an alumni or current student in the Department of Epidemiology? Do you want to share your professional advice and experiences with a large audience of your peers? We want to hear from YOU! Consider becoming a contributing author for PROspective!

To inquire, email your article idea directly to the editors at Confounder [at] emory [dot] edu!

References 

1. https://www.therapistaid.com/therapy-guide/behavioral-activation-guide
2. https://www.scientificamerican.com/article/on-the-other-side-of-that-pandemic-wall/
3. https://www-scientificamerican-com.proxy.library.emory.edu/article/how-we-can-deal-with-pandemic-fatigue/

Epidemiology & Vaccine Hesitancy

The Importance of Epidemiology (and Epidemiologists) in Addressing Vaccine Confidence

By Robert Bednarcyzk, PhD

In 1997, when I graduated with a BS in Biochemistry and headed into the lab for the next seven years, I hadn’t thought much about vaccine hesitance. At that time, vaccines were just something I assumed everyone got, just like I had. Leaving the lab, I started my graduate training in 2004, with a goal of doing epidemiologic surveillance using my laboratory background.  However, the more I learned about vaccines and infectious diseases, I moved more and more into the study of vaccine hesitance. It was at that time that my mentor told me one of the few pieces of advice I didn’t take at the time – “You should take some behavioral science classes. All infectious disease is behavior.” At the time, I felt like there was no problem that couldn’t be figured out with a binary outcome regression analysis. After finishing my PhD in epidemiology and coming to Emory in 2011, I took a deep dive into the world of vaccine hesitance, including getting an NIH Career Development Award which included training in behavioral epidemiology and behavioral science and health education.

Why do I bring all of this up? COVID-19 has shown just how much the behavioral aspects of infectious disease control and vaccination need to not just be identified, but fully developed to control both this pandemic and other “everyday” vaccine-preventable diseases.

Through the Lens of COVID-19

The behaviors we are evaluating through our COVID-19 research projects go beyond intention to receive a COVID-19 vaccine. We are looking at mask wearing, hand hygiene, and physical distancing as well. While each of these are very different behaviors, adherence to them is rooted in the same behavioral constructs – protection of self, protection of others, and perception of personal liberties. Infectious disease epidemiologists need to consider these issues concomitant with measuring geographic spread of the virus, calculating R0 values, and assessing risk factors for severe disease and mortality.

When we consider vaccine hesitance, we need to hold many concepts in our mind at the same time. Dr. Cornelia Betsch has identified five constructs that explain vaccination behaviors and hesitance – complacency, constraints, calculation, collective responsibility, and confidence.  Too often, we consider vaccine hesitance and vaccine confidence to be complements of one another.  But, confidence is just one piece of this puzzle.  If people have evaluated the issues around vaccination (calculation) that has led them to believe they are at risk of disease (i.e. no complacency), believe that vaccination is a benefit to their community (i.e. sense of collective responsibility), and believe that vaccines and the systems that produce and monitor them are appropriate (i.e. have confidence in vaccines and the vaccination system), the probability they will get vaccinated is likely high.  However, external constraints (e.g. vaccine availability, limited access to clinics, geographical difficulties in accessing vaccines) can overcome all of these positive factors. We are currently seeing that with COVID-19 vaccinations – appointments are scarce and vaccines are not always readily available. To ignore these structural issues that impact vaccine hesitance is to miss potential opportunities for intervention and improvement.

What Can Be Done?

So, what does this mean for infectious disease epidemiologists who are working to improve uptake of not just COVID-19 vaccines but all routinely recommended vaccines? Epidemiologists cannot remain siloed – interprofessional collaboration is necessary to overcome vaccine hesitance.  When looking at Dr. Betsch’s 5C model, it is clear that this work needs to encompass all aspects of public health – behavioral science, health education, health policy, health systems management are all critical in understanding and addressing vaccine hesitance. These types of collaborations are not just lip service, and are more than just an afternoon training on interprofessional teams. Epidemiologists do not have to be experts in all of these areas, but do need to know who to engage to ensure the most well-rounded approach to study vaccine hesitance. 

The COVID-19 pandemic has shown us an acute rendering of all of these issues, in an emergency setting. But all of the issues coming up with regard to COVID-19 and COVID-19 vaccines are just more focused manifestations of these issues across vaccines and prevention. All we are learning through this pandemic and COVID-19 vaccination programs cannot just simply be filed away once we move into a post-pandemic (or, potentially more accurately, inter-pandemic) state.  We need to continue learning and building our skills to ensure that children, adolescents, and adults are as well-protected from vaccine-preventable disease as possible. And the best way to tackle this complex issue is through open collaboration across disciplines.

Dr. Robert Bednarcyzk, PhD, is an Assistant Professor at the Rollins School of Public Health. His primary appointment is in  the Hubert Department of Global Health, with a joint appointment in the Department of Epidemiology. 

Join the Conversation

Are you an alumni or current student in the Department of Epidemiology? Do you want to share your professional advice and experiences with a large audience of your peers? We want to hear from YOU! Consider becoming a contributing author for PROspective!

To inquire, email your article idea directly to the editors at Confounder [at] emory [dot] edu!

Considering work in local public health – now’s the time

By Allison T. Chamberlain, PhD

In 2017, I had been on the faculty at Rollins for about 2 years.  Thinking back on that time, the best way to describe how I was feeling about my role was that I was indeed liking it, but not loving it.  Something was missing.  I couldn’t quite put my finger on it at the time, but it had something to do with finding more practice-oriented uses of my research skills within the larger community.

In that same year I had the chance to begin working part time at the Fulton County Board of Health in downtown Atlanta.  I didn’t entirely know what I was saying yes to, but I accepted the opportunity as I knew it would likely provide ways to connect my epidemiologic talents more directly with community-based needs.  Plus, I had never worked in a state or local health department, and that was something I had always wanted to do.

For me, working inside the local health department has been that missing piece of job satisfaction.  I have learned so much about how public health works at that most operational, community-based level.  I have gotten to use my epidemiologic skills to help the health department collect data, analyze data, respond to outbreaks and prepare for the Super Bowl.  In fact, I was downtown sitting with my colleagues at the health department exactly one year ago today (February 25) when the CDC announced that we “will see community spread” of SARS-CoV-2 in the U.S….it was a matter of when, not if. 

So why share all of this?  Because working at the local level is invigorating.  For those of you who are debating whether to apply to jobs or fellowships at the local level, I say go for it.  Get exposure to this environment sooner rather than later in your careers.  You will learn so much.  You will get so much real-world experience.  You will see how much impact your efforts can have on real communities.  You will not regret it.  

Right now, our second call for applications is open for the Rollins COVID-19 Epidemiology Fellows Program.  This program is part of our Emory COVID-19 Response Collaborative aimed at enabling our Rollins School of Public Health to do as much as it can to support our state and local health departments during this COVID-19 pandemic.  This fellowship supports that mission by matching talented, early career epidemiologists with local health departments across Georgia – as well as at the state – to help build Georgia’s epidemiologic workforce.  By keeping the fellows anchored to Emory, we are able to provide them with trainings, mentorship and special events that our top-tier school of public health can provide.

If you have an interest in working at the local level after graduation, now’s the time.  It’s a wonderful place to learn, grow and serve, especially during the public health crisis of our lifetimes.  I encourage you to apply to our fellowship program; the application period closes on Friday, March 5^th. 

Dr. Allison Chamberlain, PhD, is the Director of the Emory COVID-19 Response Collaborative (ECRC) and a Research Associate Professor of Epidemiology at the Rollins School of Public Health. To learn more about the ECRC, their current projects, and the fellowship program, click here. 

Join the Conversation

Are you an alumni or current student in the Department of Epidemiology? Do you want to share your professional advice and experiences with a large audience of your peers? We want to hear from YOU! Consider becoming a contributing author for PROspective! To inquire, email your article idea directly to the editors at Confounder [at] emory [dot] edu!

Public Health Consulting

One Epidemiologist’s Journey in Consulting 

By Cassie Kersten, MPH (GLEPI, 2020) 

I want to start this off by congratulating each and every one of you—the strength and resilience that you all have shown as public health students and practitioners during a pandemic is truly inspirational. Whether you’ve been volunteering, working REAL jobs with local institutions, or just completing your thesis and getting ready to join the workforce—you’re doing great.

I also vividly remember how overwhelming the job hunt is from my experience last year. Not only do you need to decide what sector you want to work in, you also need to make back-up plans, and back-up plans for the back-up plans. Yet, it’s also incredibly exciting—you’ll finally have the degree that you worked hard for and you can begin a meaningful, impactful career. 

When I was at Rollins, I fell in love with public health preparedness. During my two years, I worked with local Medical Reserve Corps (MRC) units, the Georgia Department of Public Health, and the Centers for Disease Control and Prevention (CDC) on a variety of projects. Many of these experiences occurred during my time on the Student Outbreak and Response Team (SORT). During my tenure as 2019 SORT Co-President, I loved facilitating and maintaining connections with leadership from local organizations, strategizing with the executive board to achieve our goals, and coordinating members and professionals for regular meetings and events. Ultimately, it was one of my absolute favorite student experiences and one that I wanted to mirror in my professional endeavors.

Gathering all my experiences, I was able to start putting together the pieces of my career puzzle. I wanted to find something that would incorporate the aspects that I loved from SORT, make an impact, push me outside of my comfort zone, and allow me to grow and evolve as a professional. After talking with career services and the Rollins alumni that they connected me with, I felt fairly confident that consulting was the path for me.

Adaptability & the Job Search Process

However, the path wasn’t always straightforward. Since I didn’t realize this until my second year of graduate school, I felt like I was behind some of the other students in making those important networking connections and preparing for the consulting application process. I also didn’t realize the importance of referrals when applying to competitive firms. As such, I wasn’t having much luck until the end of April, when I was offered a position with a small firm primarily focused on emergency management. Unfortunately, due to the pandemic, they ended up having a contract delayed and kept me at part-time through the summer, which was less than ideal for my budget and passion for doing meaningful work.

While at the time I was frustrated to be back on the job hunt mid-summer after graduating, I had begun to dip my toes in the consulting world and felt confident that it was the correct path—I just needed to find somewhere new to continue my journey. I reached back out to a few networking contacts, including an alumnus who worked for Booz Allen Hamilton. He put in a referral for me and I was interviewed, had my paperwork processed, and onboarded in less than a month.  Since Booz Allen was originally one of my target firms, it felt like things were finally coming together.

Jumping into Work & Making Connections

On my first day, all I knew was that I was hired as a Senior Consultant on the health account, with a team that focused primarily on military health. I didn’t have any details on my project, and quickly realized that it was because I didn’t have a project yet! I was brought on as a “capability hire,” which loosely translates to “someone we know that we want and aligns with projects that we expect to have, but don’t necessarily have yet.” My first task was networking to find a project—which essentially meant talking with employees who have similar interests and seeing if they have any connections who might be onboarding for projects. As someone who loves connecting with others, I scheduled lots of meet and greets and quickly ended up joining a short-term project analyzing chemical, biological, radiological, and nuclear (CBRN) policies. During this short-term project, I was still searching for something that would be longer-term and talked with colleagues supporting a wide array of federal agencies. Ultimately, I decided to join a team that supports a comprehensive medical readiness program for Department of Defense clients. As a public health subject-matter expert, I assist in the development of trainings and exercises related to public health, disaster mental health, patient decontamination, and more. Once COVID-19 travel restrictions lift, I will be traveling worldwide with my team to facilitate these trainings and exercises approximately 2 weeks per month. I’m keeping my fingers crossed to start that soon!

Ultimately, I really enjoy working in consulting. 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. Additionally, the wide array of project options displayed to me during my project search demonstrated that I have control over my path—I had options within Booz Allen to branch more into policy, data science, emergency management, or continue to work on the COVID-19 response. There are also communities of practice that meet monthly and function similarly to student organizations—one even focuses on health security and biodefense! Also, my team rarely works over 45-hour weeks, which allows me to maintain a strong work-life balance.  For my future at the firm, I’m planning to expand my expertise into emergency management by pursuing relevant certifications and attending conferences (which are covered by the firm’s flexible education benefit). I’m excited to continue growing and developing as a public health consultant!

 

Cassie Kersten, MPH (GLEPI 2020) is currently a Senior Consultant at Booz Allen Hamilton. If any students are interested in connecting with Cassie, please contact her at Kersten_Cassandra [at] bah [dot] com.

 

 

Join the Conversation

Are you an alumni or current student in the Department of Epidemiology? Do you want to share your professional advice and experiences with a large audience of your peers? We want to hear from YOU! Consider becoming a contributing author for PROspective! To inquire, email your article idea directly to the editors at Confounder [at] emory [dot] edu!