Archive for the ‘school’Category

Is there a global health bubble? (Or: should you get an MPH?)

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:

  1. 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.
  2. 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.
  3. relatedly, speak an in-demand language, though this will only help you to work in the region where it’s spoken.
  4. 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.
  5. 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.
  6. 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.

27

02 2014

NYC and London from the air

My recent New York to London flight featured both good approach paths and nice weather, so I snapped a few shots. Here’s New York, taking off:

And London:

I was going to include a quote here from Gotham, an epic and impressively readable history of New York City, regarding how communication and travel times between London and New York decreased during the 17th and 18th centuries, but can’t find the quote readily now… So, short version: things got faster.

30

06 2013

Next up!

After three years, I’m done with grad school! I finished my MSPH (Global Disease Epidemiology and Control focus) at Hopkins in late May, and my MPA (Economics and Public Policy focus) at Princeton in early June. It’s been a lot of work: 10 months of internships, 3 comprehensive qualifying exams, and a Masters thesis; plus 4 quarters of Hopkins classwork and 3 semesters of Princeton classwork for a total of 33 graduate classes. I loved being in school again — not all my classmates did — but I’m also happy to have wrapped things up. One consequence of studying applied subjects like public health and public policy is that you’re rarely delving into a subject just for kicks (at least for long); the goal is always to get out and do good work with the knowledge and skills you’ve acquired.

This week I started a job I’m really excited about: working with the Clinton Health Access Initiative (CHAI)’s Applied Analytics Team. If you’re curious about CHAI here’s their about page, and this profile of Elizabeth McCarthy tells a bit more about the Applied Analytics Team (which she runs). We’re also hiring. As with my previous internships and work, I won’t be writing directly about what I’m doing much at all, but I’ll still be writing more broadly about global health and development policy. (And this is probably a good time to reiterate that the views here are just my own.) I’ll be working on projects throughout sub-Saharan Africa — I’m headed to Nigeria for a couple months on Saturday! More on that soon.

Now, back to my (ir)regular blogging…

11

06 2013

Housekeeping

I recently updated the post categories on this blog, trying to clean things up a bit. Since a lot of my posts are link roundups, shorter commentary, or photography, I added a category called “prose” that includes all the slightly longer, more substantive things I’ve written. You can browse that category here.

15

12 2012

Still #1

Pop quiz: what’s the leading killer of children under five?

Before I answer, some background: my impression is that many if not most public health students and professionals don’t really get politics. And specifically, they don’t get how an issue being unsexy or just boring politics can results in lousy public policy. I was discussing this shortcoming recently over dinner in Addis with someone who used to work in public health but wasn’t formally trained in it. I observed, and they concurred, that students who go to public health schools (or at least Hopkins, where this shortcoming may be more pronounced) are mostly there to get technical training so that they can work within the public health industry, and that more politically astute students probably go for some other sort of graduate training, rather than concentrating on epidemiology or the like.

The end result is that you get cadres of folks with lots of knowledge about relative disease burden and how to implement disease control programs, but who don’t really get why that knowledge isn’t acted upon. On the other hand, a lot of the more politically savvy folks who are in a position to, say, set the relative priority of diseases in global health programming — may not know much about the diseases themselves. Or, maybe more likely, they do the best job they can to get the most money possible for programs that are both good for public health and politically popular.  But if not all diseases are equally “popular” this can result in skewed policy priorities.

Now, the answer to that pop quiz: the leading killer of kids under 5 is…. [drumroll]…  pneumonia!

If you already knew the answer to that question, I bet you either a) have public health training, or b) learned it due to recent, concerted efforts to raise pneumonia’s public profile. On this blog the former is probably true (after all I have a post category called “methodological quibbles“), but today I want to highlight the latter efforts.

To date, most of the political class and policymakers get the pop quiz wrong, and badly so. At Hopkins’ school of public health I took and enjoyed Orin Levine‘s vaccine policy class. (Incidentally, Orin just started a new gig with the Gates Foundation — congrats!) In that class and elsewhere I’ve heard Orin tell the story of quizzing folks on Capitol Hill and elsewhere in DC about the top three causes of death for children under five and time and again getting the answer “AIDS, TB and malaria.”

Those three diseases likely pop to mind because of the Global Fund, and because a lot of US funding for global health has been directed at them. And, to be fair, they’re huge public health problems and the metric of under-five mortality isn’t where AIDS hits hardest. But the real answer is pneumonia, diarrhea, and malnutrition. (Or malaria for #3 — it depends in part on whether you count malnutrition as a separate cause  or a contributor to other causes). The end result of this lack of awareness — and the prior lack of a domestic lobby — of pneumonia is that it gets underfunded in US global health efforts.

So, how to improve pneumonia’s profile? Today, November 12th, is the 4th annual World Pneumonia Day, and I think that’s a great start. I’m not normally one to celebrate every national or international “Day” for some causes, but for the aforementioned reasons I think this one is extremely important. You can follow the #WPD2012 hashtag on Twitter, or find other ways to participate on WPD’s act page. While they do encourage donations to the GAVI Alliance, you’ll notice that most of the actions are centered around raising awareness. I think that makes a lot of sense. In fact, just by reading this blog post you’ve already participated — though of course I hope you’ll do more.

I think politically-savvy efforts like World Pneumonia Day are especially important because they bridge a gap between the technical and policy experts. Precisely because so many people on both sides (the somewhat-false-but-still-helpful dichotomy of public health technical experts vs. political operatives) mostly interact with like-minded folks, we badly need campaigns like this to popularize simple facts within policy circles.

If your reaction to this post — and to another day dedicated to a good cause — is to feel a bit jaded, please recognize that you and your friends are exactly the sorts of people the World Pneumonia Day organizers are hoping to reach. At the very least, mention pneumonia today on Twitter or Facebook, or with your policy friends the next time health comes up.

Full disclosure: while at Hopkins I did a (very small) bit of paid work for IVAC, one of the WPD organizers, re: social media strategies for World Pneumonia Day, but I’m no longer formally involved. 

12

11 2012

Friday photos

The Saturday market at Lalibela:

the Lalibela market

I loved the impressionist texture of the moss growing on the side of one of the churches at Lalibela:

Moss

17

08 2012

Busy

In lieu of observations about Ethiopia, notes from my work here, or discussion of recent news/articles/links, here’s a picture of the books currently occupying my time at work (fascinating, I know):

Tomorrow I’m off to Mek’ele, the capital of Tigray region in northern Ethiopia, for work for about a week. If you have blog withdrawal in the meantime, I share links to maybe 5-10 articles or blog posts each day on Twitter.

20

07 2012

Marabou stork

Marabou stork are some of the largest landbirds out there. Some of the ones I saw around Lake Hawasa stood as high as my chest. And unlike the storks of popular culture, these ones have been known to eat children.

Beautiful, aren’t they?…

03

07 2012

Ethiopia bleg

Bleg: n. An entry in a blog requesting information or contributions. (via Wiktionary)

Finals are over, and I just have a few things to finish up before moving to Addis Ababa, Ethiopia on June 1. I’ll be there for almost eight months, working as a monitoring and evaluation intern on a large health project; this work will fulfill internship requirements for my MPA and MSPH degrees, and then I’ll have just one semester left at Princeton before graduating. After two years of “book-learning” I’m quite excited to apply what I’ve been learning a bit.

One thing I learned from doing (too many?) short stints abroad is that it’s easy to show up with good intentions and get in the way; I’m hopeful that eight months is long enough that I can be a net benefit to the team I’ll be working with, rather than a drain as I get up to speed. I plan to get an Amharic tutor after I arrive — unfortunately I figured out my internship recently enough that I wasn’t able to plan ahead and study the language before going.

I’m especially excited to live in Ethiopia. I have not been before — this will be my first visit to East Africa / the Horn of Africa at all. I’ll mostly be in Addis, but should also spend some time in rural areas where the project is being implemented. I’ve already talked with several friends who briefly lived in Addis to get tips on what to read, what to do, who to meet, and what to pack. That said I’m always open for more suggestions.

So, I’ll share what I’ve already, or definitely plan to read, and let you help fill in the gaps. Do you have book recommendations? Web or blog links? RSS suggestions? What-to-eat (or not eat) tips? Here’s what I’ve dug up so far:

  • Owen Barder has several informative pages on living and working in Ethiopia here.
  • Chris Blattman’s post on What to Read About Ethiopia has lots of tips, some of which I draw on below. His advice for working in a developing country is also helpful, along with lists of what to pack (parts one and two), though they’re obviously not tailored to life in Addis. Blattman also links to Stefan Dercon’s page with extensive readings on Ethiopian agriculture, and helpfully organizes relevant posts under tags, including posts tagged Ethiopia.
  • As for a general history, I’ve started Harold Marcus’ academic History of Ethiopia, and it’s good so far.
  • Books that have gotten multiple recommendations from friends — and thus got bumped to the top of my list — include The EmperorCutting for StoneChains of Heaven, and The Sign and the Seal. Other books I’ve seen mentioned here and there include Sweetness in the BellyWaugh in AbyssiniaNotes from the Hyena’s BellyScoop, and A Year in the Death of Africa. If you rave about one of these enough it might move higher up the priority list. But I’m sure there are others worth reading too.
  • For regular information flow I have a Google Alert for Ethiopia, the RSS feed for AllAfrica.com’s Ethiopia page, and two blogs found so far:  Addis Journal and Expat in Addis. (Blog recommendations welcome, especially more by Ethiopians.) There’s also a Google group called Addis Diplo List.
  • One of my favorite novels is The Beautiful Things That Heaven Bears — the story of an Ethiopian immigrant in Washington, DC’s Logan Circle neighborhood in the 1980s. It’s as much about gentrification as it is about the immigrant experience, and I first read it as a new arrival in DC’s Petworth neighborhood — which is in some ways at a similar ‘stage’ of gentrification to Logan Circle in the 80s.
  • I’ve started How to Work in Someone Else’s Country, which is aimed more at short-term consultants but has been helpful so far.
  • Also not specific to Ethiopia, but I’m finally getting around to reading the much-recommended Anti-Politics Machine, on the development industry in Lesotho, and it seems relevant.

Let me know what I’ve missed in the comments. And happy 200th blog post to me.

(Note: links to books are Amazon Affiliates links, which means I get a tiny cut of the sales value if you buy something after clicking a link.)

23

05 2012

What happened?

What happened during the 2007-8 financial crisis? Here’s a reading from my classes that I think may be of interest to a broader audience: “Getting up to Speed on the Financial Crisis: A One-Weekend-Reader’s Guide” by Gary B. Gorton and Andrew Metrick, writing in January 2012 (PDF from NBER).

Covering 16 sources (academic papers, a few reports by institutions, and Congressional testimony by Bernanke) Gorton and Metrick provide a timeline of the crisis, some historical perspective on past banking crises, the build-up to this crisis, phases of the crisis itself, and government responses.

It’s just 34 pages and interesting throughout — the only shortcoming is that the PDF is rendered in Calibri.

A related article is Andrew Lo’s “Reading About the Financial Crisis: A 21-Book Review” (PDF), which includes this:

No single narrative emerges from this broad and often contradictory collection of interpretations, but the sheer variety of conclusions is informative, and underscores the desperate need for the economics profession to establish a single set of facts from which more accurate inferences and narratives can be constructed.

Discussions of causes are difficult when you don’t agree on the simpler matters of what actually happened — which speaks to the importance of trying to simply get at (as Gorton and Metrick are trying to do) an account of what happened.

23

04 2012