The different flavors of epidemiology careers

[MolBio]

There were a few posts recently wondering what exactly an epidemiologist does. I am currently procrastinating and I thought I would answer this question with (unnecessary?) detail. Note, this includes a lot of anecdote/opinion, I don't have references to support everything I describe here. Without further ado.

Academic Research epidemiologist
- Works in universities and academic centers
- Day-to-day: research the underlying etiologic factors causing a disease or condition
- Research is usually majority working with data; fieldwork may include collecting data (interviews, blood draws etc)
- Can be genetic, environmental, infectious disease, chronic disease, or even behaviorally focused
- Usually just knowledge for knowledge's sake, but can advise policymakers (some professors testify before congress)
- Salary and career track very similar to other other academic departments
- Funding comes from grants, and is never enough
- Highest level would probably be professor
- Jobs posted on university career web sites

Applied epidemiologist
- Works in city, state, or national (CDC, FDA) health departments and agencies
- Day-to-day: investigating the distribution of diseases and its risk factors for your geographic area and disease area
(including temporal and geographic distribution). Surveillance of disease.
- Emphasis is on accurately describing the health situation and trends for your jurisdiction
- The other half of your work is recommending the direct public health response(s), including advising policymakers
- Funding comes from the government budget, and is never enough
- Highest level would probably be senior epidemiologist/scientist (PhD) or health commissioner (MD/MPH or MD/PhD)
- Jobs posted at health department websites, usajobs.gov

Clinical trial research epidemiologist (much less familiar with this type)
- Works for pharmaceutical companies or health care organizations
- Day-to-day: clinical trial of a drug or a medical procedure, enrolling patients, monitoring adverse side effects
- Research is usually oriented toward the structure of the trial, quality control, reliability, validity, careful documentation
- Salary usually higher, possibility of some ethical dilemmas
- Funding comes from the company, may depend on performance of drug (?)
- Highest level would probobaly be MD/MPH or MD/PhD clinical trial director (??)
- Jobs posted on pharmaceutical company websites

Infection control epidemiologist
- works for a hospital
- Day-to-day: tracking hospital-acquired infections; often highly related to antibiotic resistance, MRSA, VRE etc., and/or
post-operative infections, but can also link with academic or applied epidemiologists to share data on current outbreaks
for example H1N1; hospital-based surveillance
- Can enact policy at the hospital level- for example, enforcing hand hygiene on the wards
- Can do some publishable research, for example association between a specific procedure and reduction in infections
- In some cases, can get a reputation for making the lives of clinicians harder
- Usually, but not always, a clinician with public health training (usually RN/MPH or infectious disease specialist MD/MPH)
- Jobs posted by hospitals on various websites

Field epidemiologist / "outbreak investgation"
- Works in health departments and agencies, also certain NGOs like doctors without borders
- Day-to-day: in the field investigating outbreaks, including interviewing, case-finding, gathering specimens, etc.
- Restricted/concentrated to a specific time and place
- Can be often international (e.g. cholera outbreak in Haiti)
- Usually the work is in response to specific outbreaks only, not a dedicated position - i.e., contract/consulting work
- Usually works on a team including clinical, epi, lab, policy
- The goal is to identify the primary source(s) of the outbreak, and then find the best way to contain it if possible
- Often applied epidemiologists are called off their normal duties into the field for an outbreak

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[swaffles]

Nice work!

 

[IndyMT]

Thanks SO much for posting this! Exactly what I was looking for. Is it easy to find jobs with just an MPH (no md or phd) in applied epidemiology?

 

[MolBio]

Thanks SO much for posting this! Exactly what I was looking for. Is it easy to find jobs with just an MPH (no md or phd) in applied epidemiology?

In general, yes: there is still a big shortage of skilled epidemiologists especially at the local (city) government level, also at the state level, the main problem is not the demand it is the funding. However you should still be able to find a lot of different positions with health departments throughout the country at various times, just maybe not always in the exact geographic location you want... There is also an applied epi CDC/CSTE fellowship specifically intended to recruit masters level grads into various health departments. http://www.asph.org/document.cfm?page=751&JobProg_ID=15

The other caveat, not to burst your bubble, is that the pay in most of these positions at the master's level isn't blockbuster... at the entry level, it's probably equivalent or slightly lower to what you were making as a medical laboratory technologist. PhD level would pay higher but also overqualify you for certain positions and of course they would be more competitive.

hth

 

[mezmerized7]

I definitely agree with the sentiment below. Thank you for this thread...it's great to see your first post with all the information in one place.

In general, yes: there is still a big shortage of skilled epidemiologists especially at the local (city) government level, also at the state level, the main problem is not the demand it is the funding. However you should still be able to find a lot of different positions with health departments throughout the country at various times, just maybe not always in the exact geographic location you want... There is also an applied epi CDC/CSTE fellowship specifically intended to recruit masters level grads into various health departments. http://www.asph.org/document.cfm?page=751&JobProg_ID=15

The other caveat, not to burst your bubble, is that the pay in most of these positions at the master's level isn't blockbuster... at the entry level, it's probably equivalent or slightly lower to what you were making as a medical laboratory technologist. PhD level would pay higher but also overqualify you for certain positions and of course they would be more competitive.

hth

 

[onecountry1]

Hey! Thanks for this guide. Just wondering, what exactly does "surveillance" mean? Does that mean compiling data collected by other people or do applied epidemiologists get to collect data themselves. how much time do applied epidemiologists spend in front of a computer "crunching numbers"?

 

[mezmerized7]

Also, for applied epidemiologists, you do not have to have a MD to be health commissioner. My current health commissioner has a PhD and two Masters degrees. I know the list isn't set in stone, but just thought I'd share.

 

[mezmerized7]

Well "surveillance" is basically the continuous collection and analysis of data. And applied epidemiologists can be a part of the data collection process or depending on the structure of an institution, they can also be excluded from that process and rely on others to collect the data. To answer your third question, once again depending on the structure of the organization/institution in which you work, applied epidemiologists can spend their entire lives crunching numbers in front of a computer, or they could also do field work, going out into the field to collect data or also writing health reports (or a combination of all listed). If you are at a much higher level, for example, Health Commissioner, obviously, there would be other epidemiologists who would do this work for you and you would be more involved with policy and planning.

Hey! Thanks for this guide. Just wondering, what exactly does "surveillance" mean? Does that mean compiling data collected by other people or do applied epidemiologists get to collect data themselves. how much time do applied epidemiologists spend in front of a computer "crunching numbers"?

 

[cerealrhapsody]

Cheers MolBio, this is a really excellent thread.

Does anyone have any knowledge of the differences between specific fields in epi, such as infectious diseases, chronic diseases, maternal/child epi, social epi, etc. as well as epidemiology of specific issues like HIV/AIDS, cancer, cardiovascular disease, etc? Specifically I am wondering if there is any significant difference in the size, demand, career outlook/job market, salary, working conditions, opportunities, or any other aspect within these different fields.

I'm starting my MPH in epidemiology this fall and still have no idea what I want to specialize in. And I'm starting to feel the pressure to commit to something...

 

[CopperStripes]

In a governmental position, what is the difference between a health commissioner and a medical officer?

 

[MolBio]

Cheers MolBio, this is a really excellent thread.

Does anyone have any knowledge of the differences between specific fields in epi, such as infectious diseases, chronic diseases, maternal/child epi, social epi, etc. as well as epidemiology of specific issues like HIV/AIDS, cancer, cardiovascular disease, etc? Specifically I am wondering if there is any significant difference in the size, demand, career outlook/job market, salary, working conditions, opportunities, or any other aspect within these different fields.

I'm starting my MPH in epidemiology this fall and still have no idea what I want to specialize in. And I'm starting to feel the pressure to commit to something...

It's been often said that PH is not a field that we go into for the money. With that philosophy in mind, my suggestion would be to select the sub-field that really interests you, or wait a bit until you can make that distinction. Said in another way, I think the pay, the job market and the core epi skills you would learn are similar enough, that they would not be the deciding factor.

That being said, I'm also going to contradict myself a little bit with the observation that from what I've seen, you would have less competition for jobs in non-communicable disease epi and injury epi. (compared to commmunicable, which is sometimes seen as more exciting)

A couple considerations in making this decision:
- What is your background, and is your previous experience something you hope to use in your future career?
- Do you want to work domestically or internationally?

 

[CMVMPH]

A couple things to consider:

1.) "Infection Control" Epidemiologists, as you had put them, more often than not are not really classically trained epidemiologists. They are often nurses or strictly clinically trained (without an MD, usually) that track the rate of nozocomial infections and report back to the appropriate boards and the governing bodies that are interested in them (in my state, the NYCDOHMH, NYSDOH and the CDC). Don't specifically look into this without reading between the fine lines or you'll get very dissapointed more often than not. A quick "indeed.com" search will show you that a lot of "Infection Control Epidemiologist" job positions want people with at least an RN (but no mention of the MPH.

2.) Epidemiologists work great in statistical analysis when coupled with study design projects. You might not be the biostatistician that works for a pharmaceutical company crunching numbers with SAS strictly, but people with training in Epidemiology are invaluable assets not just to nonprofit and government institutions looking for a valid and reliable way to spend grant money, but also health systems looking to dive a little deeper into "academic" research. And I wouldn't call an epidemiologist working on this an academic Epidemiologist.

It's hard for someone first coming into this to realize everything you can do with an MPH in Epidemiology, but let me tell you this as someone who is a 2nd year Doctor of Public Health student in Epidemiology and as someone who has had their MPH in Epidemiology for 4 years so far. (And this is only an opinion so don't bite my head off!!)

The Epidemiology concentration is the most marketable concentration in the realm of MPH degree concentrations. If you get enough experience, you can be a part in management and administration of various levels of health systems (I did this for 3 years fresh out of grad school with an MPH in Epidemiology).
I have a few friends focusing on occupational and environmental epi as it relates to the WTC disaster, so there's a lot of overlap in that field and in epi. Also, most of the time, someone with an MPH in Epi qualifies for further training to dive deeper into environmental related work (like being a sanitarian for a local health dept.) if they want.
In regards to any social and behavioral science-related concentrations, the "latest" craze in Epidemiology is focusing on the larger eco-epidemiology model of disease causation. This means that not only are you looking at smoking causing lung cancer, but someone's socioeconomic status, the place where they live, etc. I would say if you want to go into sociology at this level with an MPH, concentrate in Epidemiology with a focus on social epi and you'll go far.

I hope I haven't made anyone mad by my abovementioned opinion, but the truth is that it all comes from experience that I've had, which I feel is more valuable than google general job descriptions for epidemiologists (which is what I did when I first thought about getting into all this mess in 2005 ).

 

[CMVMPH]

It's been often said that PH is not a field that we go into for the money.

Just a comment on that.... I think they mean it's not the field to go into for "the money" compared to being in financial services.

With 5 years experience and an MPH under your belt, an Epidemiologist in NYS pays a minimum of $80k.
I only have 3 years experience and most of the jobs I've been offered as of late (program coordinator and evaluator, clinical research coordinator, grant chapter evaluator) pay in the mid $60ks.
Of course, different areas of the country are going to pay less or more depending on the standard of living (I live an hour north of NYC and work and go to school in NYC), but PH, and especially epidemiology, pay far more than a lot of other disciplines and careers.

 

[CMVMPH]

In a governmental position, what is the difference between a health commissioner and a medical officer?

Depends on the municipal guidelines...

In NYS, not every county needs a health commissioner (this is determined by the county legislature and/or by the county's population), but every county needs a Deputy Director. A Deputy Director in NYS can have a doctoral degree in public health or a PhD, but I have never seen a health commissioner in NYS not at least have an MD too.

Just out of curiosity, where did you see the position of 'medical officer'? I know every state structures their health departments differently and I'm just curious where you saw that....

 

[MolBio]

In a governmental position, what is the difference between a health commissioner and a medical officer?

Usually health commissioners are in charge of the entire department of health of a city (not sure about county level?). At this highest level you usually focus on policy decisions, budget, etc. You have to be able to understand epi data and studies coming from your dept, but commissioners can have different types of health and public health backgrounds besides epi.

Medical officers are usually MD's trained and hired through the CDC or the public health service (USPHS) and put into various posts, including the sub-national level. Medical officers are expected to be able to interpret epi data and conduct applied epi research in their field/area.

Some info here - http://www.cdc.gov/employment/menu_mopp.html
Salary info here - http://apps.opm.gov/ssr/tables/index.cfm?action=pickDate&SrTable_nr=0524

 

[CMVMPH]

Usually health commissioners are in charge of the entire department of health of a city (not sure about county level?). At this highest level you usually focus on policy decisions, budget, etc. You have to be able to understand epi data and studies coming from your dept, but commissioners can have different types of health and public health backgrounds besides epi.

Just wanted to make it clear from what I said earlier that states with structured county health departments have health commissioners, generally. There is also generally a state health commissioner as well, but I'm also going to go one step above what MolBio said. Health commissioners have to "understand" public health, but they're really just a politician in public health clothing. Health commissioners are the decision makers, the contract signers... not really individuals that work too closely with people beyond the senior associate commissioners and the PIO (public information officer).

Many city health departments have numerous associate and/or assistant health commissioners that are heads of departments, and many of these people can hold these titles with or without a doctorate, an MD or even an MPH by itself (with a load of experience). Just because you hear the term "commissioner", different cities and states interpret this differently, but it usually requires a buttload of experience or a prestiguous degree.

 

[CMVMPH]

Hello , Pantouka, you requested a response from me so I hope you don't mind me posting it here
One of the biggest problems that I see with people coming into public health from undergrad is that they look more into what a ______ does and not so much about what they want to do once they get a particular degree. The reality of the situation is that you could theoretically do much of what an epidemiologist does with an MPH in biostatistics and do much of what a biostatistician does with an MPH in epidemiology (especially if you've had some substantial SAS experience, which both epi and biostats people often do now).
You will generally see biostatisticans finding employment at pharmaceutical companies, but a lot of big name companies, like IBM, are going more into human services and social epi-like applications. (IBM has a lot of interesting post-doc opportunities in Armonk, NY if you're interested in reading more about what I'm talking about).
Here's what you have to ask yourself---if you're looking into getting an MD/MPH, are you looking for the MPH to supplement clinical-based research or to get more involved in publishing journal articles? If so, it might be more advantageous for you to focus on biostatistics. If you're looking to get into public health, (ex: work in the community, head a nonprofit, work as an associate commissioner), it would serve you better to get an MPH in epidemiology.
The other thing that I'll say is that many schools often only have an MS degree program for biostatistics, and offer either an MS or MPH option for epidemiology. Keep in mind that you can generally achieve the MS a little quicker than MPH because with an MS, you're only taking classes in your specialty. Concentrating on an MPH in epi, you'll also be taking a health policy class, an environmental health class, etc. so it might take a little longer but it would offer a little more diversity and compliment the MD.

In the end, you know what interests you and what types of things you'd like to go into for a career, so let that guide you in regards to picking a degree program before worrying about what the degree will do for you.
Best of luck

 

[MolBio]

I don't know how research-intensive (versus policy-intensive) the field of genetic epidemiology is, but using it as an example, I feel like the emphasis on identifying potential genetic risk factors for certain diseases only has the potential goal of increasing awareness within the population, as opposed to actively looking for treatments based on those genetic discoveries (where the biochemists would take over, anyway).

snip

This is getting a bit philosophical, but perhaps another way of looking at it is that after biochemists have taken over to find potential candidate cure molecules, then the epidemiologist then takes over again to see whether or not the cure actually works in a human being (and then potentially again, to see whether or not it works in real-world populations).

I think the other point here is that public health places a heavy emphasis on the prevention side (diet, exercise, immunization, risk behavior, environmental exposure) ...which could be considered a more proactive approach than medicine, in a sense. "Acting" on information can be to cure a disease clinically but it can also be to prevent it or reduce its likelihood. Yes, some individuals may choose not to listen to your prevention program, but the goal is for enough people to listen and act that it makes a difference at the population level. (Some people don't listen to their doctors either, and come back two months later for the exact same curative medicine you gave them before).

Again, the higher up you get, the more of a manager/bureaucrat you become, but you also get more authority to approve or cancel programs or policies. Whereas at the lower levels, you gather the evidence (data+analysis) before and after the program/policy. Either way you are stil involved in the overall process.

MS/PhD track in epi is intended for academic research but doesn't bind you to that track, you can always do applied research and do an internship or two if you want to work outside of academia. I think it's rarer for people to do the applied MPH/DrPH track in biostats (what is a DrPH in biostats? Even biostats departments are struggling with this question), you can do lots of consulting or other work in the private sector as mentioned, with a MS/PhD in biostats.

 

[E24Gose]

Hi everyone!

I don't have much to add to this conversation, but I wanted to say thank you to everyone involved. Its really informative and is exactly the type of conversation I need to see (and maybe add my two cents after more experience and research) in order to make better decisions about my future in public health.

So, thank you all!

 

[EPIMSstudent]

Hi.

Glancing through this thread has been very informative, thanks to all who've contributed. If this has been mentioned I apologize, but I did not seem to see any distinction between a MPH in EPI, and a MS in EPI. As a current MS student in EPI, I am curious to know what the distinction between the two are, as this is the first time I have even heard the identification of a MPH in EPI mentioned.

Thanks.

 

[Stories]

Hi.

Glancing through this thread has been very informative, thanks to all who've contributed. If this has been mentioned I apologize, but I did not seem to see any distinction between a MPH in EPI, and a MS in EPI. As a current MS student in EPI, I am curious to know what the distinction between the two are, as this is the first time I have even heard the identification of a MPH in EPI mentioned.

Thanks.

MPH requires core public health classes.

MS does not.

Further differences are posted in the sticky at the top of the forum (http://forums.studentdoctor.net/showthread.php?t=644314).

 

[Porcupine]

Thanks all the contributors for the valuable discussion. I am going to enter the MPH route and still undecided about where to go after graduation. Can I extend the discussion a little bit by asking for your opinions about employment opportunities for international MPH (Epi) graduates at:
- Government health agencies (I guess it would be difficult since government should be the first one who prioritizes their job vacancies to citizens, especially in times of crisis)
- Non-government/non-profit health organizations (I am leaning towards this option =) )
- Consulting firms: it seems to me that MPH with concentration on Health Policy and Management are more suitable to apply for positions at consulting firms like Mc Kinsey and BCG. Just seek for some advise if MPH (Epi) are qualified for positions in such firms?

I guess it is academic jobs are more friendly to international students but I know that I want to do something more applied epi than academic epi

Thanks ahead for your opinions =)

 

[epigirl2012]

I definitely want to follow up with Porcupine's last comment: How feasible are consulting jobs for people with an MPH in Epidemiology?
What would their role be in a consulting firm like McKinsey or a smaller public health consulting firm like John Snow?

 

[EpiWin]

I know pharmacoepidemiology for pharmaceutical companies is a definite possibility. When I interviewed with consulting firms last year, I met a few associates with MPH backgrounds at the boutique healthcare consulting firms. My understanding was that they oversaw the analysts on the number crunching and data analysis side of projects. Uncertain about McKinsey and others, though with their reputation for seeking out people with strong quantitative backgrounds, an MPH in epidemiology certainly helps.

 

[Porcupine]

I found something which might be useful for those who wish to work for WHO/UN.

The good thing about WHO is that they report the salary in their job package. In WHO (and perhaps in the UN), their professional track is from P1 to P5, followed by Director (D1 - D2) and National Professional Officer (NPO) ...

Some of the WHO jobs that are based on US are:
https://erecruit.who.int/public/hrd-cl-vac-view.asp?o_c=1000&jobinfo_uid_c=25803&vaclng=en
https://erecruit.who.int/public/hrd-cl-vac-view.asp?o_c=1000&jobinfo_uid_c=25811&vaclng=en
https://erecruit.who.int/public/hrd-cl-vac-view.asp?o_c=1000&jobinfo_uid_c=25820&vaclng=en

According to the job posts, P3 requires about 7 years of working experience and pay 56-60k while P4 asks for 9 years and pays 67-72k. Both said "MPH is desirable".

The UN salary scale can be found here: http://www.un.org/depts/OHRM/salaries_allowances/salary.htm

Any input on NGO's salary/job prospect are welcome

 

[Csassen]

This post has been really helpful, but I'm still a little curious. Ideally I'd like to work in infectious disease eradication, specifically Malaria. Is it necessary to have an MD or RN, or can I find a job close to what I'd like to be doing with a BSPH and an MS in epidemiology? I really can't afford to go to medical school

 

[OneDay81]

Tropical medicine might be good for you.

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[ariyuan]

I am currently a public health major (former pharmacy major) and I am extremely interested in becoming a clinical trial research epidemiologist. What would be the pathway for this career? Do I need a MPH with concentration in epidemiology? Or would I need another degree?

Are there any other careers related to epidemiology that have a pharmaceutical setting?

 

[ratonlaveur]

I am currently a public health major (former pharmacy major) and I am extremely interested in becoming a clinical trial research epidemiologist. What would be the pathway for this career? Do I need a MPH with concentration in epidemiology? Or would I need another degree?

Are there any other careers related to epidemiology that have a pharmaceutical setting?

If you want to actually lead research in any type of epi, aside from working for local or state health agencies, a MD and/or PhD in epi would be the way to go. When I was looking for jobs a few years ago, I saw some pharma companies hiring epidemiologists, though not that often. You could also go into academia with pharmacoepi as your focus.

 

[KayCZero]

Does anyone know an epidemiologist who I can contact for an informational interview? Thanks!

 

[JDGBruin1317]

Is there a way I can job shadow an epidemiologist in a County of Public Health workplace?

I'm currently a 3rd year in college and I'm interested in pursuing a MPH degree in epidemiology. Are there any epidemiology positions offered at CDC or WHO that require a minimum of an MPH degree? I have been told that in order to get a job at CDC, you have to have an MD/Ph D/Dr PH along with a MPH degree.

 

[scribePT]

Bump