Global Health Careers: Part II

Ok, so here’s part 2 for global health career paths… I am a physician so this is pretty physician-geared, but I want to re-emphasize that there are tons of areas of work in global health, many of which don’t require any sort of clinical degree. I just wanted to share some of the resources I’ve accrued in case anyone else is interested in this kind of work. These ideas are by no means an exhaustive list. I sorted these out chronologically/by career stage so it should feel like a sort of pathway into global health from start to finish, but if I’ve learned anything in the last couple of years its that there are probably dozens of ways you could go about doing this and there’s no ‘right’ way to pursue a career in global health. Hopefully its helpful to someone interested in getting involved in this field :)

Undergraduate/pre-med. With some exceptions, I would not rush into field work at this stage. Unless you have something concrete to offer such as EMS skills or language proficiency, I really would spend this time learning, reading, and absorbing everything you can from the field of global health. Work experience overseas is great, but be selective about the programs you choose to become involved with. You never want to be in a position where your presence is causing more harm than good. For me working through a Fulbright grant offered a great opportunity to work overseas doing research without becoming involved in direct medical care. It was easily one of the coolest things I’ve ever done. For more information on how to apply for a Fulbright Grant, see their website here. 

In the meantime there are plenty of great resources you can explore to continue learning about the field- you can follow mailing lists such as NPR’s Goats and Soda, Johns Hopkins’ Global Health NOW and the Center for Global Development. There are also many great books- too many to list, but Mountains Beyond Mountains and The Spirit Catches You and You Fall Down are two that I was recommended again and again.

Right after undergrad is also not a bad time to pursue an MPH, especially if you’re still not sure if clinical medicine is for you, or you’re not sure your application for medical school is strong enough yet. If this isn’t you, I’d strongly consider waiting until during or after medical school. The reason for this is twofold: one, if you hold off on getting your MPH until residency or fellowship, there’s a good chance someone will pay for it for you- yay! Secondly, a master’s degree in public health is the kind of graduate training where it kind of does matter where you go. While you don’t have to go to a top 10 program, you should definitely aim to go somewhere with a robust global health curriculum and reputation, as networking is one of the key reasons to get an MPH. Here’s a list of some of the top master’s programs when it comes to global health. 

Medical School. Ok so first off, just learn how to survive and thrive in the insanely rigorous environment that is medical school. If you plan to practice clinical medicine, the best thing you can do to prepare yourself for a job in global health is to learn great clinical medicine. Once you feel you’ve found your footing in medical school, you can start to seek out opportunities and experiences in global health. This may take the form of a rotation overseas or online, an interest group, a spring break trip or lecture series. Whatever you do, I still think you should prioritize quality over quantity- make sure if you are going to work overseas your have adequate supervision, and your presence is not causing more harm than good. This may mean an ‘away’ rotation with a medical school that has a well-established, positive relationship with a hospital overseas rather than an experience with your own school.

Medical School is also a great time to consider an MPH; some people take time to do it before clinical medicine rotations begin, or before they apply for residencies. You’re already going into a ton of debt so it will be a balance of finding the best program for global health you can get accepted into and the program that won’t cost you an arm and a leg (this is key! It’s a lot harder to work in this field if you accrue a ton of loans.) On that note, while virtually everyone takes on loans for medical school, if you truly want to pursue a career in global health, you want to know all your options, and consider things like scholarships and the public service loan forgiveness programs.

Residency. Again, step 1 is focusing on becoming a strong clinician. But before you submit your rank order list, if you are considering a career in global health, I would strongly, strongly recommend ranking programs with global health tracks. These tracks vary widely, from a few courses with a short project assignment to an entire extra year sent at a site overseas. In pediatrics the programs doing the most in global health are generally Boston Children’s, CHOP, UCSF and Baylor School of Medicine, but there are plenty of small and mid-sized programs with great opportunities as well. A quick google search will give you pages and pages of info, and the ABP guide (linked here) is also a great resource and guide for trainees interested in global health tracks and pathways.

If you aren’t at a program with a strong global health track or presence, don’t worry. There are definitely still options to stay involved in global health. Baylor’s International Pediatric AIDS Initiative offers 4-6 week rotations to outside residents. I also did nearly all my mandatory presentations on global health topics, from journal clubs on hand-held echo use in diagnosis rheumatic heart disease to resident as teacher talks on HIV/TB. Staying involved in global health societies, such as the Consortium of Universities in Global Health, and the AAP’s SOICH (if you are in pediatrics) other ways to continue to network as you complete your training.

Everything else. Once you’re an attending, the world really is your oyster. If you are truly passionate about a subspecialty field, now is a great time to become involved in global health as a fellow, as there’s huge need for specialty care in low and middle-income countries worldwide. ID, critical care, neonatology and emergency medicine tend to be subspecialties with a decent amount of overlap with global health, but it does vary A LOT from program to program.

I was somewhat undecided about subspecialties, and wanted more on the ground clinical experience, so I went for a global health fellowship. Only a handful of pediatric programs offer an entire fellowship for global health (At the time that I was researching options last year it was UCSF’s HEAL program, Utah, CHOP and Boston Children’s Hospital.) Some are more research driven and require NIH K-grant funding, while others (like mine) are funded through the fellows working as gen peds clinicians in community hospitals for half the year to fund the other half of your time being spent working abroad. A big driver for me was that I am getting part of my MPH funded (yep! Another reason waiting to get your MPH isn’t always a bad idea) but I also feel very, very lucky to be able to work with and learn from the network of people here who are doing amazing things in global health.

I will also say many people just get out there and practice global health. This may be through a U.S.-based program (BIPAI hires general pediatricians for their HIV clinics, and Seed Global Health hires physicians to teach Helping Babies Breathe Curricula in resource-poor settings) or through an international NGO (MSF is very competitive and offers only longer stints unless you work in certain specialties, but there are many smaller organizations looking for physicians to assist with various projects.)

One extra option I’ll throw out there- the CDC has a field epidemiologist training program that basically trains both physicians and non-physicians to address epidemics in the field and is another great way to get on the ground experience and training. The UK and EU also have a similar track.

Hope this has been a helpful guide to anyone who is interested :) Feel free to message me or comment if there's anything you're particularly curious about.