Perspective: Bridging Your Research Into Public Health

I started as a traditional “bench” scientist and then moved into the multidisciplinary field known as implementation research. Today, I develop models that elucidate the real-world costs and benefits of interventions including HIV testing, novel drug adoption, and screening programs. During my journey, I discovered some useful strategies. The most important was this: Invest some of your time and energy in the future.

People tend to think about time-management merely as a way to improve efficiency. But how we spend our time reflects — or should reflect — our values and long-term goals, and help us achieve them.

People tend to think about time-management merely as a way to improve efficiency. But how we spend our time reflects — or should reflect — our values and long-term goals, and help us achieve them. To this end, I use the “80:10:10” rule laid out by Science Careers columnist Peter Fiske in 1998: Devote 80% of time to your current work, invest 10% of your time learning something new, and dedicate the remainder of your time to networking. The focus of this essay is on how to spend the 20% of the time you’re investing in your future.

Extend yourself

I’ve always been interested in healthcare, so while I was an undergraduate studying molecular biology I attended seminars on public health, human rights, and infectious disease management, which led directly to my current career path. Similarly, my interest in primary immunodeficiency disorders led me to read papers from outside my field, including papers on HIV/AIDS, which causes similar symptoms. I discovered a T-cell marker assay used to detect HIV/AIDS patients’ immune system that could be modified for use in infants with severe combined immunodeficiency (SCID).

Go beyond your basic responsibilities. Help a lab mate with a project to learn some new science. Attend brown bag seminars in other departments. Help the organizers set up or clean up: You’ll meet the speaker one-on-one and the organizer will be grateful for your help. Those social events at conferences you always skip? They’re really work events, so start attending them.

When I attend a conference, I have three main goals: present my research, learn something new, and meet at least one new colleague with whom I stay in touch. Working relationships take time and effort to build but lead in time to new professional achievements.

Ask hard questions

When I started my Ph.D. program in epidemiology, I knew I wanted to work in science and public health. I didn’t know what I would study, but I was always looking for opportunities. I published my thesis work on the development of a genetic screening test for SCID, but I knew I wasn’t finished. Many questions still needed answers:

• How could I make sure that the new test was implemented?

• What would be the cost and benefit of the intervention for society?

• How does one balance the value and the cost of such an intervention?

All these questions added up to one fundamental question: How could I make my research matter in the real world? I read papers on decision sciences and e-mailed their authors. After several exchanges, one author joined my thesis committee and I added a new specific aim to my thesis.


At first I couldn’t understand why the comprehensive/qualifying examination in my Ph.D. program at Yale University required not one but two proposals. One was on my proposed thesis work, but the other had to be on something completely different. Learning to think rigorously about an area other than the one I was most focused on (and naturally drawn to) made my transition from bench to computer seem much more natural.

While I was at the National Institutes of Health (NIH), I took evening courses at Johns Hopkins University on health policy and the cost-effectiveness of the health care system. Along with my weekly issue of Science, I read books on management, social network analysis, and system-science modeling. I extracted data from the medical literature, conducted interviews with experts, and learned to program models to assess the costs and benefits of science-based public health interventions.

My next publication was a big change from the first one: I used Markov modeling to evaluate the cost-effectiveness of population-based newborn screening for SCID. Today, several U.S states use this test as a part of their newborn screening program.

Since then, my research portfolio has continued to grow. Today I’m working with scientists, physicians, and policy-makers on implementing new HIV testing strategies, evaluating the adoption of new hepatitis medications, and assessing the impact of genome sequencing in society.

Learn new skills

As I tell my students, a career spanning science and public health requires a wide range of skills. Getting things to work in the real world requires a very different set of skills than bench research. Here are some examples of academic disciplines that can help span the gap between science and implementation:

•. As costs fall and throughput rises, should genome sequencing be used in newborn screening? How would it be implemented and managed? What would the long-term health benefits be compared with the status quo? Would routine newborn sequencing be cost-effective?

Implementing any plan in the real world requires choosing among various strategies and managing and balancing goals and costs. Decisions have to be made to allocate resources in ways that maximize the benefit to society. Economic skills such as business-case modeling and budget-impact analysis are essential for making such calculations. If you’re interested in changing your career path, such skills can lead to a career as a project manager, strategic analyst, or finance director at scientific or public health institutions.

•. Bringing new scientific knowledge into the health care system is a complex and dynamic process. Certificate programs at institutions like the University of Pittsburgh and the New England Complex Systems Institute — which take between a week and a semester to complete — could be an option for working professionals.

•. Health and science information can spread virally to millions of people with just a few mouse clicks, so make sure your science is accessible through social media. Tapping into social networks such as Facebook or Twitter will help you generate a base of readers and supporters. Build an online presence. Such skills and networks are increasingly important in a wide range of careers.

Cultivate your own board of advisers

From my years of graduate school at Yale, my training at NIH, and my current position at Boston University, I have assembled, in effect, a board of advisers to advise me on career and other decisions. The board is constantly in flux as new advisers join and others leave.

Find mentors who represent different aspects of your personal and professional life. One mentor can align directly with your research mission. Another can help you tactfully navigate workplace personalities and politics. A third may be especially helpful with grant writing. A fourth may be the one you take to coffee to discuss big ideas. A fifth may help you balance work with family or other personal obligations.

Build it and it will come together

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