Epidemic intelligence service officer: How I got my job and where I'm going

So, my mom played a huge roll in getting me to where I am today. She worked about once a year abroad providing surgical care in developing countries, and she would bring me along occasionally. So, by the time I was 12, I had already been with her to Kenya, to Cuba, to Jamaica on her surgical trips. And it just kind of instilled in me you know, a passion for not only medical care, but just going abroad, being with other people, and being in these sorts of environments. I actually started medical school right out of high school in a six year program at the University of Missouri, Kansas City. And throughout that experience, I was in different student organizations that got me opportunities to work in public health and global health. One group in particular was called GlobeMed, and they connected us with clinics in developing countries and got us involved in different types of projects such as water sanitation, so well digging, but also getting us in nutrition programs and community health workers going. I also worked in the free health clinics, and so that sort of thing fostered my passion for public health and also internal medicine where I could work one on one with patients. So, I went through internal medicine training at the University of Minnesota and joined their global health program. As a result I got to be a clinician, basically a primary care doctor for relocated refugees in the Twin Cities, Minneapolis and St. Paul, but I also got to do international rotations in refugee camps actually in Uganda working with Congolese refugees. And then after my training I actually signed on for a chief year as chief resident in the internal medicine program as the Global Health Chief Resident, and spent half my year in the United States training residents, and the other half of my year in Tanzania training students there. As a doctor, I not only had training in internal medicine, but I've also kind of in a way focused on global health and tropical medicine. I'm certified in tropical medicine through the American Society of Tropical Medicine and Hygiene. And I've kind of used that to inform a lot of my passion for public health. So, after residency, after my chief year, I joined the Epidemic Intelligence Service, kind of formalized my career in more of a public health role and become an epidemiologist, but I also applied my medical training to more of a populational level rather than one on one patients at a time. I found out about EIS while I was doing a residency rotation in Uganda, so I was working in Congolese refugee camps, and I was working with a division here at the CDC, the division for Global Migration and Quarantine on evaluating splenomegaly in Congolese refugees. So that experience gave me the passion for what I wanted to do. I loved it. And when I came back to the United States, I had a one month global health class at the University of Minnesota where EIS officers would come in and talk about their experiences, what they've gotten to do. So, people would come in, and they'd tell us how they investigated a fungal outbreak down in Ohio, how they were involved in the Ebola response, and it was just amazing. And one person literally said to me like if what you did in Uganda is what you want to do with the rest of your life, apply to this program. And so I had to. And I started the application process starts, let's see, that would have been in summer to fall of the year. They accept a certain number of applications for interviews. You come down to Atlanta, you meet with a couple of people at the CDC and interview, and at the end of the interview process, they accept about 60 to 80 people every year. So it was a pretty rigorous experience because they want the best, and they want people with a passion for these sort of things. But it was rewarding, and you get to meet people that even if you don't work with them, you'll continue to know them and continue to foster relationships with them. I had to interview for this very specific position at the CDC, and the other people that I interviewed with, I still talk to. So it's about relationship building, and if you don't get in the first time, try again because there's a lot of people who get in their second time. You get to tell them up front in your interviews: I'm interested in working in global health, or I'm interested in working in occupational injuries or chronic diseases, and they'll actually pair you with interviewers who are kind of in that area, so you can speak about what your interests are in that subject matter. So, the training once you get the job is about 10% in the classroom, 90% in the field. You've got about a month whenever you get here over at Emory campus learning basic epidemiology. And you're alongside as a physician, PHDs who have learned this over years of training, and so they're kind of helping you and working with you while you're teaching them various things about medical care. And so once you're in your division, once you're in your job, you start getting deployed to the field, and that's where you really start to learn. You're working with supervisors and mentors who have been doing this for years, who are former EIS officers themselves, and their kind of training you as you're going on how to start writing up all these questionnaires that you're gonna be asking people in the field about getting the right supplies to the right area, about writing up your report and talking to the public, about really becoming an epidemiologist. And so the training is more hands on rather than just taking notes in the classroom. Whenever I was applying to the Epidemic Intelligence Service, you have the option once you get in, to either remain as a civilian or to join the United States Public Health Service. So when you apply to the Public Health Service, you're given multiple screenings. So not only are you given a background check, and you have to apply, you have to actually interview over the phone and submit an application. You're even screened medically because they want you to be fit for service. And so there are very strict criteria to that as well. So, for example, I know that there are certain disqualifying conditions like asthma. So there's a lot of people who still serve at the CDC as civilians who have applied for Public Health Service, but because they're so rigorous, have gone on to just work as citizens instead. In the Public Health Service, I am expected to always stay in some sort of federal role. So my plan is to stay at the CDC if I can, just because this is a subject matter that I really enjoy, and I love working on kind of the larger scale of things. So, a lot of people after EIS stay on at CDC. Other people have gone on, actually, back to their specific subject matter issues. I know many friends who have just gone on to go back to clinical care and continue to be doctors, but also work in maybe research or public health on the side. And then there's other people who do the opposite. They stay on at CDC, but maybe they have a clinic once a week that they keep up and keep going to keep up their medical training. As far as kind of movement and what you can do as you progress through the Public Health Service, there's certain intervals when you can apply for promotion basically, and you go up in pay grade, but also in opportunities. And right now I'm a lieutenant commander, so I need to wait about five years before I can apply to become a commander. Other people can move quicker depending on if they start off on a lower rank. And that gives you more opportunities financially, but then professionally once you're done with EIS, you can apply for different jobs throughout the CDC. I guess I can't really speak to people who do other things, but usually like we talked about, you've fostered a relationship with other divisions either because you've interviewed with them before, you've met them, or you worked with them with field response. A lot of time that we go abroad or go into the field, we're not alone, we're working with other divisions. If we are working, if there's a State Health Department person who needs some help on flu, they'll call up the flu person here. And through that you foster relationships. And so when it comes to applying for a job, you might already kind of know some people in certain divisions. So students, probably if they want a career in public health, or working really anywhere, even at the CDC, I think should get involved in not only in their communities, but also find out what they're really passionate about, because a lot of things make inroads to public health. You can be a doctor and be providing care one on one. You can be a veterinarian and be putting out diseases that occur in animals that can spread to human beings. You can be a journalist and just wanna promote good public health action by speaking to what works in your community. But I think finding a passion and getting involved is important, and I think that's something that you should foster first before putting down any ground work, because you need that passion to keep going. And if you're just doing this for a job, it's not gonna work. I think for more practical steps, if you wanna get involved in public health early, if you're in the United States you can start getting involved in different student groups like GlobeMed. And if you're at a different medical school, you can get involved in certain advisory groups like public health interest groups. If you're abroad you can probably apply for the Field Epidemiology Lab Training Program, FELTP program, which is like EIS, but for individual countries. And I know at least in Nigeria they're pretty great. So I think there's a lot of opportunities to start and make inroads, to start getting up to EIS, but EIS takes all groups of people. They take doctors, they take nurses, they take pharmacists, they take PHDs, so I think whatever you're fostering your passion in, as long as you're moving forward in your career working to a stronger academic position, you can eventually apply to EIS, and they'd welcome you with open arms if you had this background, already a passion for working in these areas, and proof of that. Because I think when you apply to these positions they wanna know, you're gonna learn epidemiology here. You don't need to know that ahead of time. I think what they wanna see is your passion, that you've had experiences in these areas, and that you're open to it.