Clinical knowledge is still useful. Even in environmental epidemiology, helps me see both ends of the equation really, you know how that exposure can translate to health effects in the long term.
Welcome to PH SPOTlight, a community for you to build your public health career with. Join Us Weekly right here. And I’ll be here too, your host Sujani Siva, from PH SPOT.
Hi, Yang, and welcome to the PH SPOT podcast. It’s so wonderful to have you here. And I can’t wait to hear about you know, your career journey and to share, you know, with our listeners, everything that you’ve achieved so far.
Hello, Sujani. Thank you so much for having me. It’s a great pleasure to be here and have this conversation here.
Yes. So I read that you are an epidemiologist. And you know, I come from a similar background. So that’s something we can both connect on. And, and I’m sure our conversation will be quite interesting from that perspective. I did infectious disease epidemiology, more applied epi. And I read that you did environmental epidemiology. But the unique part is that you come from a clinical medicine background. So I’m curious to know, you know, when did you discover the field of public health, and kind of decide that you wanted to build a career in this field? Because typically, I’ve heard from my guests and from my personal experience, it was an accidental discovery, because public health is not a profession that I knew too much about. Nor did I have individuals in my network who were public health professional. So I really discovered it because it was a course and elective course that I took in my undergraduate years that kind of opened the door for this possibility. So curious to hear how you discovered public health.
Yeah, thank you for the question. For Johnny. So my journey in public health really started as a career physician, I started overseas as a physician, then I had this opportunity to attend a summer institute at the Johns Hopkins School of Public Health. And the aim of that some, is a really, you know, continuing education for practicing physicians and nurses and people in the health field that really wanted you know, that extra certification and training in tropical medicine, I was working in the tropics, so I was like, okay, perfect, you know, opportunity to gain more skills and extra training. And he was well there that I really got exposed to the field of public health, because it was, but tropical medicine and public health, amazing experience, you know, we’re focused the major focus on of course, infectious disease, but there was also a public health aspect to it. And after that program, I went back to practice. And, you know, I kept thinking about public health, I was like, you’d be really neat if I could learn more about public health and make more inquiries about public health and see if it was possible to transition into public health. So I made more inquiries with the school and apply for the master’s in public health program with the intent of pursuing infectious disease, because I mean, to me, that was my comfort zone. That’s what I’ve been trained in and most efficient thing where many infectious disease clients, fast forward, I get to help him I begin my master’s in public health, and I get exposed to environmental health signals in the environmental health well, like, wow, I think it’s something that I never really had exposure in to them. Right? And I was like, well, this is fascinating and really intriguing, you know, looking at how exposures in our environment, influence our health, you know, the things we eat type of air we’re exposed to, and breathe in, you know, so many things in environment does impact our health in one way or the other. And coming from an infectious disease background, of course, you know, lots of infectious diseases, also, you know, can be traced back to my environment. So, that made me change my concentration and add on environmental health. So I ended up with a customized public health and infectious disease and environmental health. It was a learning process, but I totally enjoyed it. And the more I learned, the more fascinating it was about environmental health specifically, after my training master’s in public health. I spent some time with the health department here in Houston. Just learning what it takes, you know, when to have a field of field hands on kind of public health practice. In a health a local health department would feel like there was well there. My boss, lady I was working with she’s an epidemiologists, PhD epidemiologist encouraged me to take the next step of pursuing a doctorate in environmental health and epidemiology. So after my brief stint with the health department, I moved on to pursue a doctorate in epidemiology and environmental health. And I did that at the Texas a&m School of Public Health. And he was an amazing experience Absolutely. enjoyed every bit of it. I mean, it was challenging the doctoral program, as you would imagine, but the research the opportunities that came from that, you know, what tremendous, yeah, that’s how I really transitioned from clinical medicine, I never looked back, I was like, it was amazing. I did enjoy bedside medicine, you know, but with public health, it made me look at, you know, more of a population based outcome versus a one on one person outcome, if that makes sense.
That was what really pulled me to public health, you know, that, if I’m able to implement one intervention could really improve the lives of the health outcomes of populations, you know, versus just one individual, you know, so that impact was the major pour into public health and eventually environmental epidemiology.
It sounds like when you first took that step into pursuing the one quarter certificate in tropical medicine and public health at John Hopkins in 2011, it sounds like your intention wasn’t to leave clinical medicine at that point. But when you further expose yourself to public health, were you, you know, ready to leave clinical medicine and pursue a career in public health, was that kind of the goals that you’re setting for yourself?
It was but it was more of a quest for knowledge. And, you know, and self improvement and learning and growth, really, like you rightly said, when I started with the Summer Institute, it was just, you know, like I said, in my mind was the continuing medical education training I was going for, you know, and of course, afterwards, I went back to practice. But you know, when you’ve faced that something, you know, and you have a lingering effect, the captain came back out, like public health, public health, and training in a place that Johns Hopkins School of Public Health, oh, my gosh, it’s like, you know, the number one school of public health. So that poor, you know, there’s a saying they have, like, impacting millions satisfy saving lives millions at a time, you know, that just blew my mind thinking about, you know, population based focus and all that. So it was a struggle I would I kid you not. Because, yeah, I did love clinical medicine. But I felt like the impact widens, I believe, with public health, I could do much more. Yeah, that was one thing that really influenced my decision to move into public health eventually.
So tell us a bit more about your Master’s of Public Health degree and program at Johns Hopkins. Sounds like you had an excellent experience with that.
Yeah, I mean, it was, it was a great experience, and also challenging, great experience in the sense that, you know, we’re trained in all the fields of public health, you know, you had the opportunity to concentrate on one, but you had a ton of courses, a ton of coursework to complete. However, the exposure, the interaction with the professors, and everything was just amazing, you know, just looking back and thinking about all the professors I had encounters with, you know, there were people at all and very encouraging. And you also had an opportunity to meet with being in public health, you know, like the late Henderson, right? Henderson, who found the vaccine dedicate smallpox, you know, they tell you about all this, stories of how the backstory really on how they’re able to find the skills and all that. So it was, it was really fascinating. It was challenging in the sense that, you know, I probably have not mentioned, I was married and a mother of young children, or on the five when I was when I moved to Dubai. And yeah, they I took them along with me, you know, so that was a major challenge being a non traditional student, you know, I’m struggling between motherhood, raising young children in a foreign country, foreign at the time, and just bringing your best self to school, you know, making great grades, you know, and ensuring that, you know, the time you spend in school, you’re able to, you know, learn and grow and meet people and network and think long term, you know, look for opportunities for growth.
Yeah. So I think that was the major challenge, just juggling between the two, back home, you know, bringing your best self home as well, to be there for the kids and support them and, you know, nurture them, you know, as a good parent. Yeah, that was the major challenge.
I can’t imagine that I I just had oh, well, I can’t say just he’s one years old now I had a baby. So.
Thank you, I’m realizing how much effort and juggling it involves just to you know, make sure you’re there for them, and then also pursuing your passion. So,
Kudos to you for doing that.
Thank you, I wouldn’t say I did it myself, you know, I’m in looking back through my public health journey, and schooling and education, and raising kids alongside I would say, yeah, I had to find my network of people, right? A support structure, right, a support network of some sort to be able to balance both areas, really, career as a mother, career, you know, public health professional. So finding that niche of people, you know, that can help and support you, you know, you too can do your part.
I’m kind of thinking about this decision for you to transition away from bedside medicine. Did you at any point kind of still think about, maybe I might go back to that. And I’ll just try public health care a little bit or were you decided, and you thought, Okay, this is the route I’m going to pursue, and I’m gonna give it my all, I asked, because I’m sure you know, a lot of our listeners who, who may be transitioning, whether it’s from an old job to a new job, or they’re moving to a different country, you know, there’s always points in your career where you have to make a decision where, at times, it might seem like it’s irreversible, but through time and to experience, you kind of get that sense that, okay, if I, if I take this step, it’s not the end of the world, I can always go back. But sometimes that fear is there in the moment when you are making that transition. And I’m curious to hear, you know, what that period of decision making was like for you?
Thank you for that question. So looking back, I see that, yes, there was a time I had to make that decision. Right? And because it wasn’t just me, I was here with family. It wasn’t something like your I could, you know, change my mind..
.. in a jiffy. You know, I had to really think through the process and know what I was leaving and what I was getting myself into. So that was the reason right after my master’s program, I started volunteering with the health department, you know, having just to have a feel of what, you know, working in the field of public health really entailed. But typically I was going into environmental epidemiology, I was really curious as to, you know, what were my day to day career be like, you know, day to day activities be like, you know, what are the expectations, you know, really, so I sought out volunteer opportunities, where being volunteer, you’re not full time working, and the onset of that I told the team I was working with, Hey, this is a decision making process for me, I really want to have a feel of what the career in public health is, like, you know, before embarking fully on it, you know, so as to either going on into public health full time or continuing as a clinician. So, like I said, those volunteer opportunities helped me make up my mind. Yes, it is public health, environmental health, environmental epidemiology. And I also mentioned that my supervisor, then or lady I was working with at the health department was very pivotal to that role as well, because, you know, she kind of laid out the pros and cons for me, incidentally, her husband is a clinician, you know, and she went the help the wheel public health and was a PhD had a PhD in epidemiology. So it was a very good experience working with her, because she really let me see both worlds from a different point of view. I mean, she didn’t make the decision for me, but she, you know, how she laid out both and like, Hey, this is what this is going to bring to you. You know, let’s say we want to continue here in the US, and this is how your political career could could be like, you know, with that it helped me make an informed decision when being, you know, involved actively involved, the health department work and also being mentored by someone who was had gone to the peak of public health, so to speak. So, yeah, I think it was that that experience that helped me make up my mind as to Okay, public health videos. We’re going on once and that’s when I decided I will go on and complete a doctorate in environmental epidemiology because of my interest in growing my research, right, and having that research, component, research skill to my toolbox.
I think it’s so interesting, the way you worded your relationship with your supervisor who kind of supported you and guided you in this process is, you said be willing to be mentored. And I think that’s so important. I think like, part of the process of helping yourself, figure things out with your career is kind of putting your goals and aspirations and what you’re hoping to achieve out there and share it with people, because you never know who’s going to kind of, you know, lend a helping hand and help you through that, or, you know, even hold your hand as you make some of those decisions and expose you to different things, so that you can gain more clarity.
Absolutely, absolutely. Being willing to be vulnerable, and opening up and talking to people about, you know, your interests and their careers, and what you would like to do, and also just being teachable and willing to hear, you know, their point of view and say, hey, you know, this is what I’m thinking about, what’s your input? You know, what would you say to that, you know, support structure, that network of people, you know, mentors goes a long way, honestly, to help you grow in the field of public health, I believe in almost any other field, because, you know, we learn from each other and grow, we cannot survive alone, you know, creatures, right. So, yeah, having that network of mentors, and plays a huge role in yours.
Carry us along.
Absolutely. Okay, so my next question is a very, very popular one. And it’s about, you know, your decision to go and pursue a DrPH, so a Doctor of Public Health, you did mention research a few times, and that you have interest in research. So I’m curious why you didn’t go down the route of a PhD, and you chose a DrPH instead?
Yes, thank you for your question. And I get that quite a lot. So.
Yes, so my decision to pursue a doctorate of public health was really, because it had a more public health practice focus, right, that was the poor, the Doctor of Public Health degree is really like the highest terminal professional degree in the field of public health. However, the major difference between a PhD and a Doctor of Public Health is the Doctor of Public Health, I believe it’s more leadership centered, it equips its holders with skills that are necessary for public health practice. That’s us, the PhD with which is more focused on you know, academia or, yeah, research focus. But with public health practice, you know, there’s also a research component to it, as well, for the major pool was, you know, research, health, public health practice, and, you know, leadership career in public health. Those are the reasons why I chose the Doctor of Public Health versus the PhD. I knew I wasn’t interested in pursuing a career in academia. So yes, I felt well, you know, if my focus is more practice based and practice based research, then you know. Interestingly, at the end of the day, most of my training was really PhD focused.
Yes, it was. Because you know, and I’m so thankful to it at the end of the day, because I ended up, you know, doing lab work, you know, I was the only DrPH in my lab, right? But it gave me a feel of both worlds, right? Yes, you got the training as a DrPH. Student. But then again, a had a had the opportunity to also have a sense of, you know, liberal PhD training, where you still do lab work and do a lot of research that major to DrPHs may not have had, so it was a win win for me. Yeah, I worked with a fantastic supervisor, PhD supervisor, or doctoral supervisor. And that really strengthened my doctoral training at the end of the day.
It sounds like you chose a DrPH program based on some key differences that, you know, applied public health experience, and then the leadership component. And then because there was research involved with both of the degrees, you felt like you weren’t losing out on that, like interest for research that you had.
And then it also sounds like you are able to tap into your interests a little bit more and create a program where you could, you know, pursue some of these additional interests that you had. And I don’t know if that’s true to all the rPH programs, but I’m assuming the university that you went to, which was in Texas, that that was available to you and I don’t know if you want to say more about that, just about the at the institution, and then the program that you were in, and that ability to get a bit more on the PhD side, given your interest in the research and kind of like environmental epi.
Yes, absolutely. So it’s not typical. I went to Texas a&m School of Public Health, fantastic School of Public Health, and I had great experiences there. So, but with the DrPH program, it’s not typical to have that PhD, or strong lab work and, and research as the PhDs would have, since they’re going into academia. However, in my case, I was, I would say I was really blessed to have a PhD supervisor who, who felt like well, you know, you’re my first DrPH student, you know, you will get all the training or the DrPH. Student, but she had majority of her students that worked with how she was working with were PhD students. So she was like, well, you have the choice to join the whole team, right, that being separated and saying, oh, no, I’m not doing that. Because I’m a DrPH student. You know, I’m not supported. Like, I’m not required to do that. You know, but I felt Oh, sure, I would get the benefits of both worlds. Right. So I attended all conference with the PhD students, you know, I was part of the mistakes that the whole lab was doing. So I think, in my case, that made my program a little bit different from the typical, DrPH program. And I think it was great for me, I loved it. I loved every moment. I spent there with the team. Yeah, it was great lab.
That’s awesome. And I think, going back to, you know, a phrase you use to describe yourself a lifelong learner, you know, just searching for knowledge, and kind of shows quite a bit when you talk about your experience, whether it was with a certificate at John Hopkins, or the MPH there, and then now the DrPH program, so I suspect that you will continue to be a lifelong learner, and it won’t stop here.
Oh, absolutely. Absolutely. I agree. Yeah, there’s always an opportunity to, or put into self improvement and growth. And I’m a great supporter of going out there and doing something new, learning something new, and just trying to bring it better person, you know, like learning something new and growing in your field, or even personally, as a human being. So, yeah.
I think that that’s what kind of keeps us inspired and motivated to do things. Yeah.
Okay. So I guess, at the end of 2021, year or so after you complete your DrPH, you join the CDC Foundation. And you are a Senior Epidemiologist there. And I’m assuming it’s environmental epidemiology that you’re doing there. So maybe if you can tell us a little bit about yeah, what a day in the life of an environmental epidemiologist looks like.
Right, thank you for asking. So after my doctor public health degree, I did a brief postdoc as well, just to gain extra research skills as well. And publications, then went on to join the CDC Foundation, where I serve the city of Houston Health Department review of pollution control, and prevention. So a day in a life of an environmental epidemiologist? Well, for me, a lot of the work I do is project management, I manage a number of community monitoring Projects Committee, air pollution monitoring projects, where we do a lot of surveillance, you know, in communities for specific air toxics and air pollutants in specific communities, as well as looking into preventive strategies on how to limit those pollutants from getting to you know, the homes of the community. Then, of course, I also have a lot of meetings with stakeholders and community organizations, then a little bit of my work involves writing as well because I handle one of their projects where we’re trying to get one of our labs accredited, so preparing the paperwork for that accreditation and ensuring that we’re on the same page from our training as well as training the staff you know, on certain procedures that need to follow for the air monitoring surveillance program or project so yeah, it’s a mix of all.
Some days is meeting a lot of meetings or the days is you know, more desk work and also if you if we have an event, for example, some admission somewhere from a company or an organization that has chemical plant, right, yeah, we hold out you know, to go investigate and collect air samples to ensure that the community surrounding those plants are protected, and you’re not being exposed to harmful chemicals, basically. Yeah, so it varies no two days ever say really, you know, you go to work some days, there’s going to be quiet and it turns out, oh, we need to go out, you know, to this admission event, or the days, you know, more meetings, you know, other pieces, community engagement meetings, you know, going out to meet the community stakeholders, and all that and other organizations that we collaborate with. So it’s really an interesting mix.
Sounds like it, I’m sure, lots of you know, data analysis and number crunching involved in the research side of things. I noticed, you know, when you had written up a little bit about the work that you do there, that you had qualitative research, also, part of that is one of the skills, I’m wondering where that fits into the role. Because, you know, you talked about air sample collecting and emission events and things like that, and I’m thinking lots of numbers, lots of analyses in kind of the quantitative side. Where does qualitative fit in?
Well, I think the main qualitative layer, is that because we work with data analysts as well, yeah, so they do most of the data crunching, however, the quality side is I go in and periphery, you know, under like a quality control, yeah, kind of thing with the data, to ensure that, you know, was properly collected, you know, there are no errors. And, you know, account for until that everything that needed to be done to get good readings, right, accurate meetings, really, where it was achieved, you know, that they followed the SOPs that I had presented to them to follow, you know, all that checks and balances. Basically, when I see something that is off, you know, I investigate like, Okay, well, what’s going on here and show that it really say what it’s saying, or it’s an error, just ensuring that we turn out quality data before it reaches the data analysis, and is a big role I play in the research side.
When you kind of think about, you know, being an environmental epidemiologist, and you had someone come up to you and say, Okay, what are the top skills that I would need to work on or experience that I should go out and get so that I can be in a role like yours? What would be I guess your answer to that just so that they come out as a strong candidate when they are interviewing, say, for an environmental epidemiologist job?
Right, thank you for that question. So, environmental epidemiologist, it’s important one, to have a strong background in epidemiology as well, right, your epi methods, then, of course, data analytic skills, and also risk assessment skills play a huge role in environmental health and research, you know, so your exposure assessment, that identification and all that, you know, those are skills that you have to hone into, also GIS skills, is, you know, give you an edge over other environmental criminologist that might not have that skill set. So your GIS data analysis and epi methods, I think those are three skills, you know, that you, that would, I would encourage anyone that interested in environmental epidemiology, then if you had a background in toxicology, that also helps because it helps you learn or know more about the compounds or the chemical pollutants that you’re researching, or you’re really doing the research in. So that gives you an additional layer of understanding of the harmful effects of those compounds and how they affect the human body. And you know, how he can end up with health effects in the long run. So having a little bit of knowledge of toxicology plays a huge role as well. But I would say the top three really would be your epi methods, your data analytic skills, as well as GIS.
I’m curious to know if you’re keeping tabs on just the the increase or decrease in opportunities when it comes to public health roles within kind of the environmental health side of things and whether you’re able to comment on that, and I’m wondering if there’s more funding, more opportunities, more jobs for environmental appease in today’s day and age, or are we seeing that go down?
That really depends on what sector you’re interested in working in.
Variety of sectors that an environmental epidemiologist can work in, you know, going work in industry, you can work in pharma, you can work in, in the health department, you can work in nonprofits. So it really depends on where your interest lies in, you know, if you’re more grassroots for cost, you don’t really want to, you know, handle boots on the ground work, then the health department will be a good opportunity to proceed. Also, nonprofits that you know, but stay with climate change, and all that kind of going on environmental justice, health equity, all that, you know, if you’re interested in all that, then the health department and probably not relevant nonprofits would be a good opportunity for you. If you’re more interested in, you know, the research side, you know, then maybe academia will be one industry will be another and pharma. So, it really depends on where your interest lies. Where do you want to practice your environmental epidemiology and what are you looking at core research or, you know, community based research? Or, you know, so it really depends on that. So the trend differs for each sector.
That’s good to know. Yeah, it’s, you know, figuring out your interests first, and then also the environment that you want to work in.
Absolutely. And I would say, you know, once you decide, I would say, just reach out to people in that organization that you’re interested in, you know, and see for the health department is pretty easy to start, you know, by volunteering or asking, you know, how can I learn a little bit more about the work that goes on there, you know, just to get your foot in the door. Yeah, then you can go from there. If you like it? Absolutely, you can stay and apply for more permanent permanent roles. And if you don’t, you know, you can move on to something else. So it really depends on your interest, I would say.
I think just depending on the sector, the work would be just vastly different. And, yeah. Yang, when you kind of look back at the journey that you’ve taken to where you are today, do you think there’s anything you- you would have done differently? You know, just when you’re reflecting and thinking about that journey?
Well, looking back, I see that my career trajectory has been pretty diverse. You know, when I tell people, I’m a physician first they’re like, huh, and then environmental epidemiology. Okay. I always get that question. How did the physician turn environmental epidemiologist, still, but looking back, I would say I enjoyed the journey all the way, I do not have any regrets. I’m glad I took the route that I took. Because it was something I found out as I was, you know, growing in the field, that it was something I was really interested in and grew more passionate about, the more I learned about different skills in environmental health, you know, the more I learned about environmental epidemiology and honed on in those skills, the more training I received, the more my passion grew in epidemiology, so I would say no regrets at all, I value my clinical training as well, because I still feel like it is relevant, even in my Brahma pinos practice, because I can see the whole trajectory, right, the whole outcomes from exposure, you know, to health outcomes, right? And how, for example of pollutants like like toxic and like formaldehyde, for example, will in the long run, if people are exposed to it in large amounts, you know, long term effects can lead to health effects like leukemia, and cancer and all that. So, that clinical background do that clinical knowledge still is still useful, even in environmental epidemiology. Yes. So it helps me see both ends of the equation, really, you know, how that exposure can translate to health effects in the long term.
I had a supervisor who once said, you know, no experience is bad experience. And, I asked this question to a lot of my guests kind of looking back, do you think you would have done anything differently? And a lot of them, if not all, kind of say, No, I am really glad that I took the path that I did. And I’ve been thinking about, like, Why do I even ask this question and everyone’s you know, happy about the path that they’ve taken, but it’s to show that in the moment, it might feel like you’re wasting time or you’re not pursuing the path of your dreams, but in hindsight, and when you reflect on it, like you just explained, you know, no experiences, bad experience, and a lot of those experiences really shaped who you are and shaped the work that you’re doing today and the skills that you’ve developed along the way they- they really do matter.
You’re spot on and that absolutely because, you know, no experience was really a waste of time. You never know when it would be relevant, you know, in the future, right? Like, oh, okay, I can hone in on the skill I do have experience, as I’m like, wow, okay, you know, so every experience matters. Every encounter matters, you know, making use of those experiences and being available and taking risks, you know, because honestly, just p boarding in, or transitioning into public what the risk really, but being willing to take risks, sometimes well thought out risks, you know, well informed risks can give you a good outcome at the end of the day versus not even trying, right? Yeah, yeah, you would never know, except you, you know, step your foot out, you know, take that first step. And you’re like, Okay, this is not as bad as it seems, you know?
Exactly. When you think about the future, what are you kind of most excited about, or what are some goals that you’re working towards?
I would say, just growing in my field, right. Being able to contribute more to research, building a strong research portfolio is something I’m really interested in working on, by then, also giving back to the community and to the field, very active in the American Public Health Association. That is my way of contributing to the field in general, right, I always encourage students or you know, any college career professionals, to find a relevant organization and be part of it, you know, and they will help you grow your helping them work, you know, to meet more people in your field, right, and really be able to share your research as well, you know, during conferences and all that. So, yeah, grow more in my field and give back as much as possible, as well as something I’m interested in to have more mentoring relationships with students that are interested in my field, or, you know, just want to talk about public health and their career in public health. You know, it’s something they’re interested in doing. And also specific student parents as well, because I’ve walked- I’ve walked that path, you know, parents, being a student, as well as reading a family as well. So I’m always happy to contribute or, you know, speak with students that are in this similar situation, and encourage them and say, hey, it can be done, it can be done.
Yeah that’s excellent. Well, thank you for the amazing work that you do. And we can’t wait to, you know, see and learn about all the amazing work that you’re about to do in this field. So, once again, thanks so much for being on the podcast and for sharing your journey. And yeah, we hope to hear from you again.
Thank you so much, Sujani, for having me, I enjoyed chatting with you. And it really did bring back a lot of memories.
Good. Thank you so much. It was such a pleasure.
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