WHAT ACTUALLY WORKS?
CAREERS ADVICE IN PUBLIC HEALTH, PART 2
This summer, I continue to focus on building precious and memorable experiences with my young family and to work on maintaining clear boundaries! As you are reading this, I am delighted to report that my current view looks more like this:
While I take a brief hiatus from new writing, I am sharing some of my most popular posts from previous seasons of The Public Health Workforce is Not OK. In particular, I am focusing on the episodes that offer advice for navigating the complexities of the public health job market. Read on, and please join me for conversation in the comments.
This post was originally published at JPHMP Direct on October 5, 2022.
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The public health workforce is not okay. In this series of articles, I will share what it has been like to work on the public health frontline during the COVID-19 pandemic and how these experiences have changed me forever. I will share the lessons I have learned and what I want the people around me to know, both inside and outside of the public health sector.
In the previous entry, I started to offer my advice on building a career in public health in 2022, focusing on use of LinkedIn for networking. In this entry, I will broaden my perspective to more general careers advice in the search for #publichealthjobs — aiming to move beyond the well-worn tropes of advice that is no longer relevant — and answer some of the questions that I have received.
First and foremost, don’t let anyone out there convince you that getting a public health job is supposed to be easy. The well-meaning critics may have heard that there’s a shortage of public health professionals, and that current staffing and funding are insufficient to meet current overwhelming needs, but the result is a shortage of jobsnot a shortage of work. (See earlier columns explaining the context.) You are not alone. There are lots of us out here struggling. But we’re all pretty discreet about it and we still don’t have a good place to come together as a community to communicate these challenges and address them. (Contact me directly if you want to work together to address this…?)
Choices in your studies
Several commenters have asked me questions about the most useful or relevant topics in which to specialize during their studies. For students who are currently studying towards a qualification in public health (most often an MPH): graduate courses currently offer a wide range of specializations with regard to:
technical approach (eg, epidemiology, biostatistics, health policy, environmental health);
topic area (eg, reproductive and sexual health, infectious disease, substance use, nutrition);
skillset (eg, qualitative approaches, longitudinal analysis, GIS, M&E);
geographic focus (eg, global, national, state, local, community); and
relevance to industry destination (eg, private sector pharmaceuticals, Governmental health departments, nonprofits, academia)
(Credit to Razia Aliani.) I strongly recommend selecting courses that build particular technical skills that can be used as cross-cutting tools across topic areas (eg, biostatistics, microbiology, health economics) across different knowledge fields (eg, maternal and child health, substance use, HIV). Focus on practicing specific tools (programming languages and softwares), not general areas of knowledge that you can independently read up on another time. See here for more ideas.
Public health courses rarely include options to study politics; however, recent times have clearly shown how relevant and important the interplay between politics and health communications is to public health these days.
As mentioned in an earlier column, Governmental public health work more often employs quantitative methods for big-picture epidemiologic analysis than the more resource-intensive qualitative methods of enquiry that hone in on seeking a detailed understanding of community realities among subgroups. Draw your own conclusions from this observation: quantitative analytic skills may be more readily employable than qualitative, but qualitative analysis may yet have an important role to contribute within an environment that prioritizes diversity and minority voices.
Specialization and self-defining
Once you have determined the strengths that you want to emphasize, start to be clear about how you would like to define yourself professionally, including your methodological approach and your thematic priorities. Are you an epidemiologist, an infection preventionist, a data analyst, a community health worker? Is your experience focused on infectious diseases or chronic conditions? Do you have specific strengths working among a particular community? Are your skills based upon on quantitative or qualitative approaches? Especially at the early stages of career development, a lot of our skills overlap and we may speak each other’s languages, but our field is ridiculously siloed (see below) and not set up to be flexible in the long term. Even if you would really rather like to think of yourself as a public health generalist, start off by entering the market with some technical skills and preferences up your sleeve. However, beware of the danger of being too specific and specializing yourself out of a job (my fellow PhDs, I’m looking at you!) — there is a balance to be struck.
Public health professionals frequently work in silos that don’t communicate or prioritize each other’s skills. Choose your discipline or topic and stick with it. Develop the technical niche you want to become known for. Learn the associated jargon and software and tools. Seek out online professional groups who are discussing your technical specialization, and look out for the experts and the interesting opinions. I’m all in favor of working towards the demolition of these technical silos in the future, but building a career right now requires acknowledging the dysfunctional way in which we are currently set up.
Stay open to using your technical knowledge in a new way. Write your bio (on your resume and on your LinkedIn profile) so that it is accessible to a nonspecialist in your field, but also shows a specialist that you know what you are talking about. Don’t use acronyms or abbreviations. Don’t assume that your colleagues use the same jargon as you. Indicate in your bio the extent to which you are aware of and/or support trending institutional priorities at your target employers, eg, health equity, DEI, infrastructure reform. Do I sound cynical? Of course I am cynical. Doesn’t mean I don’t share these priorities. Make sure to espouse the values du jour, but keep it real: learn about them and have opinions and questions. Your authenticity will show up.
Bring your authentic self to the job search process but try not to be too vulnerable. Show who you are but don’t over-invest or expose yourself to hurt. Easier said than done, I know.
To PhD or not to PhD
I am frequently asked whether a PhD is required or helpful in public health. After many years of debate, my current answer is a fuzzy probably not, depending on your career goals. My PhD has undoubtedly helped me to get positions teaching public health and global health in Universities — but that led me down a very restrictive road to the dead-end of adjuncting (see earlier column). Academic and applied public health are different worlds with different values and skillsets. Since I started to move away from academia, my PhD has not been an asset to my career search in applied public health (public sector and nonprofit) in the slightest. Without asking me for my expectations, recruiters consistently call me overqualified and tell me that they cannot afford to pay me. Potential employers expect me to be some kind of demanding public health primadonna who will not stand for compromise on the integrity of my data collection methodology. Insecure managers feel threatened by my ambition and think I am trying to steal their job. Perhaps it might be different with the more practical and management-oriented doctorates such as DrPH, but I have not yet seen the evidence and I remain unconvinced that the difference is widely understood. Several times I have been advised to remove my PhD from my CV, but I can’t bring myself to undermine the hard work of that experience, and I’ve doubled down and added “Dr” to my name. I have wondered whether there are other qualifications and letters after my name that might be useful for moving ahead in public health: for example, PMP (project management professional) or CHES (certified health education specialist). However, I stand by my own advice: seek only the qualifications listed on the job postings that make you excited, and don’t enroll for more studies just because you need something to do.
Meanwhile, as long as you still have student status, take advantage of discounted membership rates for professional organizations, including APHA, CSTE, your state public health association, in order to access their networking and job board opportunities. (Credit to Rene Najera.)
Volunteering
I have received some questions about the role of volunteering within the public health workforce. Volunteering in a short-term or part-time position can be a great way to gain hands-on experience in public health and make new contacts. However, as I have said before in this column, encouraging public health professionals who are already overworked and underpaid to volunteer for something new opens up new routes of exploitation for an already marginalized workforce. Make sure to establish your boundaries and stick to them. Eg, I sign up for volunteer slots only when I can be sure that I already have completely reliable childcare.
The US Medical Reserve Corps has provided important and much-needed emergency support services from volunteers throughout the COVID-19 pandemic. I am proud to be a long-term volunteer serving in multiple roles, including as an Epidemiologist at my county’s Department of Health and Human Services in the crazy and frightening early days of the response, and subsequently as a clinic volunteer providing vaccination and testing services for COVID-19 and now monkeypox too. I encourage public health professionals to explore volunteer service opportunities with their local MRC. But keep in mind that a volunteer-led response is no substitute for long-term investment in public health jobs and developing a skilled public health workforce. What are our professional organizations doing to generate funding and visibility for public health professionals? Let’s focus on lobbying and advocacy towards building a sustainable workforce, where skilled individuals are paid in accordance with their experience and qualifications and receive appropriate benefits and ongoing opportunities for professional development.
Welcome to the jungle
There is no denying that there is a lot about the current state of the public health job market that is utterly bonkers. Throughout this column, I have outlined so many crazy ways in which the odds are stacked against us and so many stupid hoops that employers continue to make us applicants jump through. But the system is broken and we gotta deal.
Toxic management remains a widespread problem in public health. The people who succeed are the people who are good at navigating toxic office politics. Sometimes that means they have learnt to be toxic too. Rise above, I implore you. Let’s work towards change and build a better system. Join the conversation about challenges to the public health workforce and how to address them. Speak out for lobbying and advocacy for change. Seek out people with similar skills who are experiencing similar challenges and feel less alone together. Build mechanisms for collective support and action.
Be realistic: the search for your dream job may take some time. In the meantime, be open to different ways of working: my holy grail is to eventually secure a long-term stable job with benefits and career development opportunities, but in the meantime I have taken up short and medium term contract opportunities and freelance writing assignments, and I have set up my own LLC for private consulting clients.
I encourage you to continue to work towards broad systemic change and call out the craziness, but avoid being directly critical towards the specific institutions that you will eventually want to hire you. They make their rules and we have to play by them, at least for now. So in the meantime, continue to show up and ask thoughtful, reflective questions. Jump through the hoops, but make the process work for you. Seek and offer help. (Credit to Sherri Carpineto.) And tell yourself that when you make it through to the next step, you will reach down below to the people who are applying to be where you are and work towards making it easier for them next. We will build a better system when it is our turn. Nolite te bastardes carborundorum.
Questions (join me for discussion in the comments or on LinkedIn)
What you think of this advice? What has or hasn’t worked for you?
Please share your own tips for the search for #publichealthjobs, based on your experiences?