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. 

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. 

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