There’s a LinkedIn group for Global Public Health that occasionally has good discussion. One example, albeit a sobering one, is the current discussion of employment opportunities after MPH. I’ve been meaning to write about jobs for a while because now that I’m on the other side of the picture — an employed professional with a job at a reputable organization, rather than a grad student — I find myself doing an increasing number of informational interviews, and saying much the same thing each time.
[First, some caveats on the generalizability of the advice below: first, folks with an MPH from another country often have less debt burden than Americans, so may find it easier to do long unpaid or underpaid internships. Second, folks from low- to middle-income countries are and should be more employable, especially in their own countries. Why? Because they have incredibly valuable linguistic and cultural talents (see Alanna Shaikh's recent post on this), so much so that an organization choosing between an outsider and a local with the same technical skills, communication skills, etc, should almost always choose the local. If they don't, that's generally a sign of a dysfunctional or discriminatory organizations.]
The problem is that there is something of an MPH bubble, especially in global health. The size of MPH classes has increased and – more importantly – the number of schools granting degrees has risen rapidly. Degrees focusing on global health also seem to be growing faster than the rest of the field. (I’d welcome data on class size and jobs in the industry if anyone knows where to find it.) This is happening in part because public health attracts a lot of idealists who are interested in the field because they want to make a difference, rather than rationally choosing between the best paying jobs, and global health has gotten a lot of good press over the last decade. Call this the Mountains Beyond Mountains Effect if you like.
If you know this, and still go into the field, and don’t have an MD or PhD that qualifies you for a different sort of job altogether, then you need to distinguish yourself from the crowd to be employable. I’m assuming your goal is to get a good job in global health, where “good job” is defined as a full-time professional position with a good (not necessarily big-name) organization, working on fulfilling projects and being paid well enough to live comfortably while paying off the loans that most American MPH grads will have. For some, though not all, a good job might also mean one that’s either based abroad or involves frequent international travel. If that’s the goal, then there are several ways to distinguish yourself:
- get some sort of hard, transferable skills. This can be research or M&E skills, especially quantitative data crunching ability, or it can be management/coordination experience with serious responsibility. Or other things. The key point is that your skillset should match jobs that are out there, and be something that not everyone has. A lot of MPH programs feature concentrations — or the lack thereof — that are more appealing to students than they are to employers. A biostatistics concentration will likely serve you better than a global health concentration, for instance, and with some exceptions.
- get solid international experience, preferably a year or more. Professional experience in public health — even with a lesser-known organization — is much more valuable than experience teaching, or studying abroad. Travel doesn’t count much, and it’s better to have experience in the region you’re interested in working in. There’s a huge catch-22 here, as you need international experience to get it, so that many global health folks start off doing work they’re critical of later in their careers.
- relatedly, speak an in-demand language, though this will only help you to work in the region where it’s spoken.
- have professional work experience. Even if it’s not in global health, having worked an office job for a year or two makes you more desirable to employers. No one wants to be your first employer, so folks who go straight to an MPH may find themselves less employable than peers who worked for a bit first.
- go to a top school, which signals that you’re smarter or better qualified than others (this often isn’t true, the key part is the signalling, and the networks you acquire). Also, graduates of top schools often get good jobs in part because those schools select people with good work experience, skills, and connections to begin with, so that a superior candidate at a school that’s perceived to be a second or third-tier school can do just fine.
- avoid debt (which often conflicts with ‘go to a top school’) to give yourself the flexibility to work for less or for nothing at first, until you can do the above.
Any one or two items from this list probably won’t cut it: you need to acquire several. For example, I’ve known peers with a solid technical degree from a top school and some international experience who still struggled to get jobs at first because they had never had a regular office job before grad school. Also, the relative importance of each will vary according to the subfield of global health you’re interested in. For instance, learning languages might be more important for an implementation person (program coordinator or manager) or a qualitative researcher than it is for a data cruncher.
I used to be pre-med, until I realized I was more interested in policy and did not want to be a clinician, and the path to doing so in the US is long and expensive. Like many former pre-med students who decided not to go to medical school, it took me a while to figure out what I wanted to do, and how to do that without an MD. A couple years post-undergrad I found myself working a job that was interesting enough but not what I ultimately wanted to do, and unable to get a first job in global health without the requisite skills or longer international experience, and I didn’t have the resources to just up and move abroad on my own. So, I went to go to grad school with a technical focus (epidemiology) at a top school, and then used the practicum requirement to build more international experience (Ethiopia). The combination of school and work experience gave me solid quantitative skills because I chose to focus on that each step of the way. But, it also meant taking on quite a bit of debt, and the international practicum would have required even more had I not had generous funding from the econ/policy degree I did. This has worked out well for me, though that same path won’t necessarily work for everyone — especially if you have different interests from mine! — and I think it’s instructive enough to share.
The upside of this bubble is that organizations often hire well-educated, experienced people for even entry level position. The downside is that people from less privileged educational or financial backgrounds often get blocked out of the sector, given that you might have to volunteer for an extended period of time to get the requisite experience, or take on a lot of debt to get a good graduate degree.
In conclusion, getting an MPH — and trying to break into global health — is a personal decision that might work out differently depending on your personal goals, the lifestyle you’re looking for, and your financial background. But if you do get one, be aware that the job market is not the easiest to navigate, and many MPH grads end up unemployed or underemployed for a stretch. Focus on acquiring the skills and experience that will make organizations want to hire you.