I'd do anything for my daughter, even a TED Talk!
   When my daughter had the idea of having me apply to the TED Residency, it did not occur to me that I might actually get it.  As a big fan of TED Talks, I have watched many, yet, I've never seen a Talk by someone I know.  All the speakers seem so confident and knowledgeable, and famous.  It all seemed so out of my league.
  To say that I was shocked that I was selected for the TED Residency is an understatement.  Once the shock dissipated, reality kicked in:  How would I find the time to prepare? What is my idea worth spreading? What should I wear?!  Reality check number 1.
   Sure, as an academic research scientist, I have given talks, seminars, lectures, classes, workshops.  I would say that I have been an average speaker giving the average seminar in which every statement is illustrated by a Powerpoint slide.  The purpose of an academic seminar is usually to present data.  It is very much like a scientific paper in oral form: the intro, the methods, the data, the conclusions.  I quickly learned that I wasn't going to get away with that on the TED stage.  Reality check number 2.  
   And as scientists, what do we ever feel sure about?  We are trained to say "the data suggests" in our papers.  We still call evolution a "theory". And we end every research paper with "more studies are needed".  What can I say on the TED stage that I "know for sure", as Oprah would say?  Reality check number 3.
   The TED Residency program helped me check off all those realities.  The program selected a VERY DIVERSE group of professionals and put us together in a pot, raised the heat to simmer, and stirred.  
   Twenty residents were selected, ranging in age from 21 to 70, different races and backgrounds, different areas of expertise, from different countries, working together in open cubicles at the TED Conferences Headquarters for three months.  During this time, I continued working at Mount Sinai, submitting three research proposals to NIH.  I was working 12 hours a day, 7 days a week.  Thanks to my family and a flexible schedule at my job, I was able to do it.
   At TED, I was quickly humbled by how much I needed to learn.  Mostly, I learned from my peers in the Residency. I engaged in conversations with two veteran New York Times reporters about health information and the media, learned from two young African-American men about using technology for social good, and was moved to tears by two LGBT youth about how to tell their stories. The most helpful and surprising learning experience came from an amazing British rapper.  This young red-headed woman taught me the value of every word I say in my Talk. I am forever bonded with all the residents in my group.  It was like going skydiving with strangers, after that experience, you really can't call them strangers anymore.  
   I can honestly tell you that it was very hard for me to do this.  It required a lot of unlearning and learning.  It was truly a humbling experience.  I am still not totally sure that I was deserving, and it took me a while to be willing to share the Talk with all of you.  But I could not let my daughter down.  She kept saying: "Do it Mamami, do it!"  So I tossed the reality checks out the window.  Shook off the impostor syndrome.  And worked my butt off.  
Thank you all for your support during this journey. I really need you to view and share this TED Talk with your contacts.  Now we both can say that we know someone who did a TED Talk. ;) 

Our previous research has shown that exposure to contaminants in outdoor and  indoor air can affect respiratory health, especially in children.  This is important because diseases such as asthma, bronchitis and other conditions are very common and affect many families. 

We have also previously written about how children show exposure to endocrine disrupting chemicals from personal care products and other sources.   Recently, I was interviewed by Kelly Bryant for an article in Reader's Digest.  The article lists 14 ways in which toxins "sneak" into our homes in ways that may be unexpected or surprising for many people.  I was quoted in the article as follows:
It feels good to put dry-cleaned clothing back in your closet, crisp and pressed for your next outing. But the process which made them look brand new could carry some trouble. “Perchloroethylene is a chemical used in dry cleaning,” says Luz Claudio, PhD, professor of environmental medicine at the Icahn School of Medicine in New York. “Although it’s not known how much of it may be released in the home when you bring dry-cleaned clothes in plastic bags, it may be best to open the bags and aerate them outdoors before bringing inside.”
The other 13 sneaky ways toxins may be entering your house, according to the article, are: 

• Through the floorboards in the form of radon, a gas that can lead to lung cancer after prolonged exposure.
• With new carpets that emit volatile organic compounds, especially during the first 72 hours after installation.
• Your mattresses when they are treated with toxic flame retardants.
• Air fresheners as the perfumes and scents can contain toxic chemicals.
• "Natural" products with labels that can be misleading.
• Indoor air products that are intended to perfume or mask odors in the air.
• Household dust can accumulate and concentrate many of the non-volatile toxins that exist in the home.
• Self-care products such as nail polish, shampoo, and others may release formaldehyde, which causes cancer.
• "Safe" ingredients such as polyethylene glycol are very common in cosmetics and cleaning products.  The Environmental Working Group and others question the safety of these ingredients.
• On your shoes you can bring anything that you walked on outdoors including bacteria and other organisms.
• In your walls can be lurking mold which can be an asthma trigger, especially in children.
• From the tap water in as many as 33 states have been found to have unsafe levels of several chemicals.  
• Through your air conditioner, when not well designed or maintained, can contribute to concentrating polluted indoor air. 

To read the full article, visit the Reader's Digest website.  Click below.

Guest Blog Post: Dr. Bahby Banks was one of my first students in the International Training Program.  After completing her doctoral degree, she has become a successful business owner, motivational speaker, and consultant.  She helps other women of color envision their futures and helps businesses evaluate their programs.  She is always a welcome guest speaker for our group of new students.  
Here is Bahby's story in her own words. ​

I participated in the inaugural Mount Sinai School of Medicine (MSSM) Exchange Program for Minority Students in 2006, shortly after I completed the first year of my doctoral studies at UNC Gillings School of Public Health.   My research internship included placements at Fundacão Oswaldo Fiocruz in Rio de Janiero, Brazil and Hospital Alvarez in Buenos Aires, Argentina.  Dr. Claudio did an amazing job of preparing us for our internships, including a week-long orientation in New York City. During this week, we were introduced to local researchers and scientists, provided with instructional language CDs and given literature that detailed the importance of inclusion of underrepresented populations in research.  Every single detail of orientation week wreaked “love” and “investment” from Dr. Claudio and her staff.
After orientation, I made my way to my first placement at Fundacão Oswaldo Fiocruz, where I worked with Drs. Lucia Rotenburg and Rosane Greip to explore gender differences in work ability among Brazilian nurses. My lab consisted of about five young researchers—all women- who investigated various aspects of Dr. Rotenburg’s research.  My work with the Fiocruz team continued after I returned to United States, and resulted in a peer-reviewed publication (Rotenberg L, Portela LF, Banks B, Griep RH, Fischer FM, Landsbergis P. A gender approach to work ability and its relationship to professional and domestic work hours among nursing personnel. Appl Ergon. 2008;39(5):646-52)! The following year, I traveled with Dr. Rotenburg to the 18th International Symposium on Shiftwork and Working Time in Australia—where I was the only delegate from the United States.  Quite an honor!  
My second placement in 2006 was in Buenos Aires with Dr. Diana Gilamberti, director of Obstetrics and Gynecology (OB/GYN) at Hospital Alvarez.  I worked with another Mount Sianai intern to develop a survey to explore the use of petroleum-based lubricants among sex workers receiving services in the OB/GYN department.   This was probably one of the most intriguing experiences that I’d as a budding researcher, as Dr. Gilamberti invited us to share the survey findings with two sex worker union representatives in Buenos Aires.  The representatives responded with such passion and were adamant about prioritizing the safety and health of “their girls”.  The response to raise awareness about the dangers of petroleum-based lubricant use was the quickest I hade seen for any public health effort.  By the end of my internship, the local health department began supplying the hospital with condoms packaged with lubricants.  They also made them available at the local health department.
My journey to become founder and CEO of Pillar Consulting, Inc. was a very non-traditional one.  I knew very early on during my doctoral training that I wanted to serve as a faculty member and independent research consultant.  I did not, however, have a “roadmap” to guide how I could navigate both of these roles successfully.  I had a powerful network of mentors to guide my steps in academia, offering opportunities to contribute to research in historically oppressed communities.  Opportunities did not always present themselves in “traditional” ways, but I was very proactive in seeking leadership and research roles that supplemented my academic training.  Many of my mentors, including Dr. Claudio, were not in my department, but they were invested in my growth as a researcher.
The most powerful shift as a research intern was learning my role as a contributor to research.  The Impostor syndrome is very real, particularly for people navigating industries that have historically excluded women and racial and ethnic minorities.  I did not always feel that I belonged—despite doing all of the work to earn my seat in the room. But, sitting alongside senior women researchers who successfully navigated the academy was priceless.  It was a mirror of sorts for where I wanted to be after I completed my studies. 
Two things I learned over the course of my training: 1) Your work will always speak for you and 2) Think outside of the box.  My applying for the Mount Sinai International Exchange Program for Minority Students was an example of the latter, as this type of training program was not available at my home institution.  I participated in several internships over the course of my studies, and while the variation in topic areas appeared as a “lack of focus” to some faculty, I knew exactly how these opportunities could build my professional portfolio.  I knew that I wanted to add international training to my professional portfolio, and these internships afforded the opportunity to supplement the training I was learning in the classroom. As a result of seizing these opportunities, I was able to conduct research at the World Health Organization, Fundacão Oswaldo Cruz, Hospital Alvarez, and ultimately worked with an amazing research team in rural North Carolina.

My love for program evaluation and mixed-method approaches led to my current career as a business owner and independent research consultant.  During my doctoral studies, I enrolled in courses and took advantage of external training opportunities to develop my research skills (e.g., qualitative methodology, racial and equity training, community-based research).  Business development took a little more work, as I didn’t know any researchers navigating the path of entrepreneurs! I did, however, reach out to several men and women in my network who were entrepreneurs to glean what wisdom I could to position Pillar Consulting as a competitive company.   Networking was key!

I share with my mentees the importance of having a “tangible” when they complete a research internship—something that documents their contribution to the research.  This “tangible” might vary from place to place: a conference poster, oral presentation, brief, video or peer-reviewed publication.  No matter the case, the goal is to share your findings.  Dissemination is key in ensuring your work, and the work of the communities you serve.  As an academician, peer-reviewed publications are essential to building your tenure package.  Scientific writing in essential to sharing your work with the Academy. 
 
Now, as a business owner, I focus most of my work with Pillar Consulting on historically oppressed populations whose voices have not been part of “best practices” shared in the literature. That said, we work with clients to help build their capacity to lead and contribute to the dissemination of their work.  We, as research scientists, continue to partner across the county to disseminate the work of our partners.
 
Participating in Dr. Claudio’s internship helped me achieve my career goals.  There is power in being able to say that part of your academic training included contributions in national and international settings.  By the time I completed my Ph.D., I had co-authored several peer-reviewed publications in national and international journals, presented at conferences around the world and had a vast network of colleagues around the globe. These opportunities laid the foundation for me to become the researcher I am today!
 
I would not be where I am today without mentors who were invested in my success and growth as a public health researcher. As a military dependent, I was accustomed to being in a variety of academic settings—public, private, predominantly White, or predominantly Black—but I was the first (but not last) member of my family to pursue doctoral training.  In more ways than one, there was no a roadmap for me to follow.  My mentors, near and far, were open and transparent about their journeys in research, and pushed me to raise the bar for myself.  They believed in me when I didn’t believe in myself and challenged me to (literally) use my voice at the decision-making table.  They helped me see my dual role as a trainee and contributor to research.
I continue to grow as a leader and evaluation researcher every day.  My goal of building community capacity in research has not changed, but my approach has.   My team is committed to working with an equity-based lens. We are working with partners whose approaches include social determinants of health and structural-based approaches to improving the human condition.

What I say to new students in these internship programs is this: Use your voice.  In the words of the late Shirley Chisholm, “If they don't give you a seat at the table, bring a folding chair.”

Photo credit: Jessica Valdez Outlasting Memories.

I am the proud daughter of two amazing parents who emigrated from Mexico in pursuit of the American dream and the hope for a better future for their children.  Despite their long work hours, my father as a factory worker and my mother as a seamstress, they always stressed the importance of education.  We learned through their hard work and motivation that good grades and college were the only option for a better future. 

I was the first person in my family to attend college.  I earned a Bachelor of Science degree in health education at California State University, Northridge and furthered my passion for health education at New Mexico State University (NMSU), where I obtained a Master of Public Health (MPH) degree.  But it was the opportunity, mentorship and influence of Dr. Luz Claudio that inspired me to obtain my Doctorate in Health Education after completing a physician assistant degree.  Little did I know my pursuit of a doctorate would serve as the catalyst to that which makes me most proud: the opportunity and experiences of serving individuals and families in underserved communities.  These opportunities have fulfilled my moral desire and innate obligation to give back.

While obtaining my MPH at NMSU in Las Cruces, I worked for the New Mexico Department of Health.  Much of that work was spent investigating the indoor toxic pollutants that exacerbate asthma, specifically in the rural communities in and around Las Cruces.  This work was so impactful to my life that I continued to conduct research on childhood asthma in vulnerable populations.  It was during that time I learned of Dr. Luz Claudio’s Environmental Research Program.  So after completing my first year at NMSU, I applied to the program and was subsequently selected as a participant for the Summer 2002 program.  

This opportunity allowed me to further research childhood asthma as a participant of the Environmental and Occupational Fellowship Program at the Department of Environmental Medicine and Public Health at Mount Sinai in New York.  This experience forever shaped my life as a health care provider and advocate for our most vulnerable populations.  I attribute the success of this experience in large measure to the leadership and mentoring of Dr. Luz Claudio and to the other remarkable program participants.

As part of the program, my research involved developing and disseminating materials to families who repeatedly experienced asthma exacerbations and included developing and evaluating culturally effective asthma education programs for communities in and around Harlem, New York.  Given the prevalence rate of childhood asthma, which was strikingly high, we noted alarming hospitalization rates in this population when compared with those living in affluent communities.  We attributed much of these results to a lack of health care resources and information within these communities.  Given the many families using the emergency room for medical care services coupled with the limited time emergency room physicians have to treat patients, we determined that this population had significantly limited comprehensive health care, which is necessary for treating chronic conditions like asthma, and required better patient education about the condition and preventing exacerbations.
​
My role in mitigating the disparities between the social determinants and inequalities of health and these vulnerable populations would be the beginning of a much greater task.  For instance, many of the children lived in poverty-stricken areas with poor housing conditions, which exposed them to asthma triggers that often worsened their condition.  Most families were completely unaware that environmental factors, outdoor and indoor, could trigger an asthma attack.  Because of the knowledge-based perspective of research Dr. Claudio and the program experience provided, the other students and I were able to identify and provide solutions to problems.

The opportunity to work with these families and contribute to the overall improvement in the health of children with asthma in Harlem, New York, was an honor.  Further, this experience served as a stepping-stone for the continuation of my research in the area of childhood asthma and investigations into the health disparities among children diagnosed with asthma living in underserved rural areas of New Mexico and Arizona.

As a physician assistant for the last 14 years, I continue my commitment to working with vulnerable populations and providing medical care to those with the most need.  Although I mainly work in a family practice in a predominately Latino underserved community, during the past year I have been volunteering at various churches throughout Arizona to provide medical care for immigrant families seeking asylum.  Every day, over 100 detained families are dropped off at these churches by US Immigration and Customs Enforcement officials.  Many immigrants have been given no instructions on where to go or how to find relatives living in the US.  Others are dropped off at bus stops, leaving them homeless and helpless in an unfamiliar country without money, cell phones, or information on where to go.
As the daughter of immigrants, I am privileged and honored to be part of this group of volunteers providing humanitarian assistance to these individuals and I recently wrote about this experience in an article published by the American Academy of Physician Assistants.  I am also thankful that these churches have opened their doors and provided humanitarian assistance by allowing us to establish volunteer-run free clinics for these vulnerable immigrant families.  Many of our medications are donated, but too often supplies run short for treating even the most common illnesses.  Common conditions we frequently treat are upper respiratory infections, fevers, otitis media, fungal infections, and wound care.  Because of the scarce medical resources, I have raised funds to help purchase medications and other medical supplies.  In addition to bringing awareness to the current humanitarian situation with asylum-seeking immigrants, I have used social media to recruit medical volunteers.  The largest challenges in this humanitarian relief effort are the political and social determinants that have further complicated their access to medical care and continuity of care. 

As a physician assistant, the combination of delivering health care to patients and conducting research to identify factors that lead to health disparities and find solutions for those disparities is the most fulfilling and gratifying aspect of my career and is a way to better serve my patients.  We live in a world where there are many impoverished communities that lack access to medical care.  As a practicing physician assistant, I want to continue devoting my time to assist those who are most in need, and I hope that more physician assistants will be inspired to conduct research and develop effective educational interventions for underserved communities.

Over the last 22 years, I have been the director of training programs in which I mentor undergraduate, graduate and postgraduate students.  Mentoring and guiding students is my favorite thing to do at work.  I have served as mentor to hundreds of students over the years.   
Many college students ask me whether they should go to grad school.  I never answer that question.  It is a big decision for them to make.  I do tell them what they can expect in grad school that will be different from college.  This can help take some of the shock out of this transition and help students prepare for what's to come in graduate school, for those who decide to go that route. 
Here are 7 differences between the college and grad school experience:

1. You have to be self-motivated:  There's generally no "homework", quizzes, and few exams in grad school classes.  Some classes may only require a final paper or exam.  Although that may sound good to you, it is a major adjustment for college students. Because there is less interim feedback, some students find it difficult to gauge whether they are learning at the right pace in a course – until it is too late.  To succeed in grad school courses, you must find your own self-awareness of how much you are learning every day without the external pressure of frequent exams.
2. You must learn how to learn: Although some graduate courses may use textbooks, many also include original materials such as peer-reviewed articles as the main information sources.  To be able to extract the relevant knowledge from original research articles can be difficult for college students who may not be very familiar with this type of source.     
3. Learning from experts rather than teachers: Seminar-style courses can be tricky for students transitioning from college to graduate school.  These kinds of courses may have a course director who may teach a few of the lectures, but then schedules presenters who are experts in specific topics to give lectures as guest speakers.  Students need to adjust to this because the series of lectures and seminars can feel disjointed and discontinuous.  Another common difficulty that students face with this kind of course is that lecturers vary in their style and the presentations can vary in didactic value. It is up to you, the student, to piece it all together.  
4. Fewer classes per semester: I have reviewed some undergraduate transcripts that make your head spin.  There was the student who double-majored in Africana Studies and Fermentation Science, and the young woman who attempted to improve her low GPA in the sciences by taking credit classes in aerobic exercise.  You don’t get to do this in grad school.  In graduate school, you take fewer classes per semester and the classes are more focused towards training you with the knowledge and skills you need for your specific career.
5.  Digging deeper: Fewer classes doesn't mean more idle time.  In graduate school, classes tend to focus on more specialized topics, like anthropology or microbiology and get into the more intricate details of the theme.  If in college you did a flyby, in grad school you do a deep dive exploration.
6. One big huge project: Most graduate programs require a long-term scholarly project that students must complete before the degree is granted.  This can be a thesis, dissertation, scholarly paper, research project, etc.  Completing a dissertation requires a different kind of relationship with a professor.  The teacher becomes more like a mentor who guides the student through the process of inquiry.  The student then becomes more like an apprentice, working on some aspect of the mentor’s research.  Some college students never experience a mentor relationship until they get to graduate school and this can be a very difficult transition.  
7. A different kind of fun: The graduate experience can be very different (more subdued, less say...) than college life.  You will find that most students in grad school have a strong purpose to learn and less time to party.  It may not only be because the students are older, or that they are all nerds.  It is also because in grad school it is nearly impossible to cram for an exam the night before a test or to come hungover or sleepy to a graduate class or to a meeting with a thesis mentor.  The learning needed to succeed in grad school requires consistent discipline and self-directed study.  Although you can still have fun in grad school, the stakes are high and it is very difficult to get away with just a passing grade because you will need to acquire this knowledge for a job or a career.

The bottom line is, successful graduate students need to be motivated and driven from within.  It can be hard to transition into this model because students may be used to periodic assessments and short deadlines where they know how they are doing along the way.  In graduate school, a long time can pass before you realize that you are not learning all you need to learn or that you have not done all the work needed to complete a dissertation.  That is a rude awakening to have after years in grad school.

Graduate level education is certainly not right for everyone.  It is definitely not right for students who simply go to graduate school as a way to delay a career decision.  Graduate school is a huge investment in time and money, so students need to be aware of what to expect.  If you are not sure, work for a year or two and then decide and prepare for a very different school experience.  

An alumnus of Stanford University and the London School of Hygiene & Tropical Medicine, Amaya Caballero Wittmaack is now a 3rd-year medical student at the University of Virginia School of Medicine and Co-Founder of a data science company, A/B Data Doctors (www.abdatadoctors.com). She was a participant in the 2012 Mount Sinai International Exchange Program that I direct.  I placed her to do her internship at the Pediatric Environmental Health Specialty Unit in Murcia, Spain with my colleague Dr. Juan Antonio Ortega. This is the story of how a series of international experiences and the research training that we provided led her to go to medical school and start a data services company.  ​

My undergraduate adviser once said to me “it is not just what you do, it is how you do it.” She certainly applied these words to her own life as a proponent of equal rights, founder of the Global Fund for Women, and Nobel Peace Prize Nominee. Her advice helped me go from an 18-year-old idealistic college student to a forward-thinking 28-year-old medical student and business owner of a data science company.
I founded A/B Data Doctors with my husband in 2018 to provide data science expertise to individuals and organizations. We have worked with companies such as Zocdoc.Com, suitX, Skye Biologics, The Khana Group, and others around the world to leverage health-related data to support the design and implementation of evidence-based approaches to improving health interventions and access to healthcare resources. Currently, our organization also provides support to other sectors including private companies conducting market research, education-related organizations, and eHealth start-ups. Our services include data analysis, biostatistics, data visualizations, survey design and dissemination, study design and ethical approval support, and other data science needs.  Our long-term vision is to develop our own projects and proposals as well as apply the concept of leveraging healthcare data to improve health systems in the developing world.
My experiences thus far have taught me a few lessons.

• Firstly, you never know what opportunities life will throw your way—when they come, use the opportunity to strengthen yourself as much as possible and live out the experience to the fullest.
• Secondly, in retrospect, everything happens for a reason. It will all make sense later.
• Thirdly, remain open to learning from supervisors, mentors, and colleagues.
• Lastly, remember that “it is not just what you do, it is how you do it”.

I will tell you how I have learned these lessons.
My roots as an entrepreneur and healthcare worker began when I was a volunteer and non-profit worker. As a premedical student at Stanford University, I spent my free time volunteering with nonprofit organizations such as TeachAIDS, where I helped develop and disseminate HIV prevention education tutorials to youth in low income countries. When I graduated, I remained committed to participating in transformative initiatives, and I was interested in gaining more research experience. I learned about the Dr. Claudio’s International Exchange Program from a classmate at Stanford and decided to submit an application. A few weeks later, I learned that I was selected as a participant for the summer of 2012 in Spain. While at the time I had hoped to be assigned to a project in a low-income country, I later realized that my assignment was an ideal personal and professional development opportunity.
As a participant, I traveled to New York City to visit the School of Medicine at Mount Sinai for the program’s orientation. I met with other like-minded students, gained mentorship from Dr. Claudio and alumni of the program, and learned more about health disparities. Then, I flew to Murcia, Spain, where I began my summer research internship at the Hospital of the Virgin of Arrixaca working in the Pediatric Environmental Health Specialty Unit. My project focused on whether maternal breastfeeding habits predicted childhood obesity indicators. I shadowed clinicians, entered data from surveys, collected survey data using phone interviews, analyzed data using SPSS, and presented my results in a manuscript and presentation to my mentor. My experiences in Spain and the opportunity provided by the program shaped my career immediately following my time in Spain and to this day. Conducting research in an international context was invaluable both in developing my professional Spanish language skills and learning how to work in a cross-cultural environment. Having the opportunity to explore Spanish culture on the weekends, completing the famous “Camino de Santiago” pilgrimage, and spending three weeks following the completion of my project traveling around Europe enriched my worldview.
Immediately following the program, I was hired by USAID-funded nonprofit organization based in Washington D.C. that promoted family planning, community health, and gender-norm transformation interventions in India, Rwanda, Uganda, and Guatemala. Due to my hands-on experience conducting research in Spain, I pursued training in data analysis and qualitative research—fortunately, Georgetown University’s Institute for Reproductive Health had numerous individuals committed to teaching in these areas. Through this position, I saw the importance of leveraging data to appeal to stakeholders, to obtain funding for critical development programs, and to support initiatives that were both effective and cost-efficient. My passion for evidence-based healthcare continued to grow. Having loved my experiences in Europe, I ultimately decided to return one year later to pursue a master’s degree.
I pursued my MS in Epidemiology at the London School of Hygiene & Tropical Medicine to acquire skills in healthcare data analytics. Later, I applied to medical school and am currently finishing my third year as a medical student at the University of Virginia. As a medical student, I continued to pursue opportunities to serve my community. I became a community health organizer where I organized screening programs for homeless residents. I was appointed as the president of the International Medicine Club and promoted our mission to encourage our best and brightest to use their skills in regions with limited healthcare resources. Personally, I was awarded the Center for Global Health Scholars Award to do research and healthcare in a rural center in Tanzania. I also worked for two years doing clinical research, where I helped found my University’s first pregnancy cohort and traveled across the country presenting my research. During my third year of medical school, I founded A/B Data Doctors and am currently applying for the MD/MBA program at the Darden School of Business at the University of Virginia. I aspire to utilize my expertise as a future medical doctor, researcher, and entrepreneur to develop my business into an organization that leverages healthcare data to support initiatives that are both efficacious and cost-efficient. I aim to promote this mission both within the United States and also within developing regions.
So this is how I have learned these lessons, through making sense of these experiences to create my own story.  Firstly, you never know what opportunities life will throw your way—when they come, use the opportunity to strengthen yourself as much as possible and live out the experience to the fullest. Secondly, in retrospect, everything happens for a reason. I see now how being assigned to the project in Spain with Dr. Claudio’s International Exchange Program was the perfect experience for me, ultimately leading me to pursue other research opportunities, obtain my MS in the UK, become more involved in mitigating health disparities among Spanish-speaking patients, and most likely lead me to apply my skills in founding A/B Data Doctors. Thirdly, remain open to learning from supervisors, mentors, and colleagues—not only will their connections further your long-term goals, but learning from their experiences will enrich your own. Lastly, remember that “it is not just what you do, it is how you do it”—behaving professionally, with integrity, and being well-intentioned are essential aspects to being an inspirational leader. In my experience, adopting this philosophy has helped carve a professional and personal trajectory that excites me more and more as the days go by. 

I have been the director of several internship programs for more than 20 years now. I have reviewed thousands of applications from students at all academic levels.  What is striking to me is that I see the same mistakes year after year.  Different applicants, same mistakes. 
Here are three actions students should take when applying for internship programs.
1. QUALIFY- Read all qualification criteria carefully. Do not apply for internships for which you clearly do not qualify. If you are not sure if you qualify, read additional materials or contact the internship organizers. Applying to internships requires a lot of time and effort.  Don't waste your time if you do not fit ALL the criteria for acceptance into a program.  Rarely, if ever, do programs make exceptions to their entry criteria.  Here are some examples of entry criteria that applicants often try to sidestep or ignore:

• GPA- Many programs, such as those funded by the National Institutes of Health, require that interns have a grade point average of 3.0 or above.  This is non-negotiable.  Some programs even require a 3.0 GPA in the student's major, so trying to increase your GPA by taking irrelevant classes does not get you closer to being accepted into these programs.  If your GPA is lower than 3.0 and you want to qualify for these kinds of internship programs, consider receiving tutoring or repeating some courses in the summer and try again the following year.
• Start/End Dates- Summer programs can have firm start/end dates that do not necessarily fit with your school's schedule.  This is important because summer programs may require commitment to specific dates for important reasons such the need for interns to attend orientation, group training sessions, or a need for coordination with mentors' schedules.  Understandably, this is very frustrating for potential applicants whose home institutions require summer activities.  However, accepting a scholarship or internship, especially those that are paid or particularly competitive, require a commitment from participants.  Before applying, review your calendar and make sure that you can actually be available for the dates required in the internship program. If not, check with your school advisers to see if they can give you special permission to attend the internship, if you are accepted.  If so, get their agreement in writing.
• Previous Training Requirements- Some internships may require that you already have certain skills.  For example, if you are applying for a summer program on big data, do you need to have certain computer programming skills before attending?  If you don't have those skills yet, will you be enrolled in a course prior to the start of the program?  Are you likely to learn the skills required before the summer?  Be honest with yourself about your strengths and weaknesses. Misrepresenting or exaggerating your level of training can seriously backfire if you are accepted into a program and don't do well. Strive to enter internship programs that are challenging, but within reach for you based on your current training level.
• Socioeconomic Status Requirements- A few programs are intended to address issues of under-representation of individuals that are socioeconomically disadvantaged on the basis of race, ethnicity, income, gender, citizenship status or other criteria.  Some of these socioeconomic criteria may only require self-identification while others may require documentation such as tax returns or passport.  If you are in doubt as to whether you fit these kinds of criteria, you may want to contact the program organizers for clarification.  

2. VERIFY- Application forms for internship programs can be brief with only a few documents to submit, or extensive with requirements for essays, transcripts, letters of recommendation, etc.  If the application platform allows, preview all forms and documents needed before you start the application process.  This will allow you to estimate how much time it will take you to fill the application and verify what documents you may need to request or find before you start.  If the application requires letters of recommendation or documents that you need to get from other people, make those requests first. That way, those documents will be in process, while you work on the application forms.  No professor likes to get a call or email from a student requesting a letter of recommendation that is "due tomorrow"!  Let them know with plenty of time that you will need their letters by a certain deadline. 
Once you preview the application requirements, verify everything as follows:

• Verify That Your Responses Are Accurate- Make sure that all of your responses are accurate.  Some common questions in which I have seen students not be quite accurate in their application forms are current GPA, the courses completed, dates of previous experiences, names of awards, etc. Inaccurate or false statements may get you in the door, as a finalist for a program, but nowadays many programs use verification services to check the information that you provide.  You don't want to be the one that is caught in a lie, whether intentional or not.
• Check and Double-Check- Review your resume, responses, and essays for typos and grammar.  Don't only check for misspellings, but also for grammatical errors and accurate names. It helps to run your application through a grammar and spelling program before pasting it onto the application forms.  It can also help to read it out loud to yourself or ask a friend to check it for you.  It seems like a no-brainer, but I assure you it's not.  I have received applications in which students misspelled their own name.  I have received applications with sidebar comments or reminders that students intended to fix later, but forgot. And, my personal favorite error, applications directed to other programs.  Every year, I get a few applicants that talk about how much they want to enter the program at Columbia or Yale, which would be fine, except that they are applying to my program at Mount Sinai.  This happens because students cut/paste the same responses into different application forms.  It is fine if you do that, but please, verify before you apply. 
• Answer the Questions- Strive to be clear and direct in your responses.  Remember, selection committees are trying to find out whether you are likely to succeed in their program.  Make it easy for them to read and understand your responses. For example, if you are asked to write an essay detailing your career interests, then talk about YOUR career interests.  I have received many essays that read like a thesis on the subject with paragraph after paragraph on generalities about the topic of the internship.  They tell me things that I already know.  Instead, I want you to tell me why YOU are interested in this topic, what makes YOU good at this, what has been your experience in this area of work, and how you plan to pursue a career in this area in the future.  Tell me how this internship will help you achieve your goals, and what you will bring to the program.  Prove to me that you will succeed in the internship.  Provide evidence and examples.  Details like these make for a winning essay rather than one that sounds generic or like a page ripped out of any textbook.

3. APPLY- Once you have determined that you qualify and you have verified that all your information is accurate, do not hesitate to apply.  Don't be intimidated.  Don't run out of steam.  Although many internship programs are very competitive, you will not get 100% of the programs for which you don't apply.  Send your complete application forms and all documentation on time before the deadline and you will have a chance.

Our previous research has shown that exposure to contaminants in outdoor and  indoor air can affect respiratory health, especially in children.  This is important because diseases such as asthma, bronchitis and other conditions are very common and affect many families. 
We have also previously written about the discovery that houseplants could potentially improve the quality of indoor air by filtering some common pollutants.  Different kinds of plants may be able to absorb different kinds of pollutants from the air and from soil.
More recently, I was interviewed by Julia Ries for an article on Healthline.  The article is about a recent study by researchers from the University of Washington in which they show that genetically-modified pothos ivy can absorb benzene and chloroform from the air.  For the article, I was quoted as follows:
   “Air pollution is a major contributing factor in diseases, including cardiovascular disease, respiratory diseases such as asthma, and potentially brain development in children,” said Luz Claudio, PhD, a tenured professor of environmental medicine and public health at the Mount Sinai School of Medicine in New York City.
“We have better control of the environment inside our homes, so it’s worth having clean air indoors as much as possible,” Claudio said.
The original scientific article from the laboratory of Dr. Stuart E. Strand was published in the journal Environmental Science and Technology and can be found HERE.  In their study, the Strand team showed that introducing a detoxifying gene that is normally expressed in mammals (a cytochrome called P450 2e1) into pothos ivy plants not only made the plant express the gene, but also made the plant able to detoxify benzene and chloroform from the air. 
Although this type of research holds promise as a way to improve our environment, genetically-modifying plants is a controversial approach.   We don't know if adding or modifying a gene in an organism can affect other properties beyond the characteristic intended for modification.  In spite of those concerns, genetic engineering holds immense promise as part of the arsenal of approaches towards improving environmental health.  

Global environmental health is recognized as the most pressing challenge of our time. A recent report by The Lancet estimated that environmental pollution causes three times more deaths from non-communicable diseases than AIDS, tuberculosis and malaria combined, and that 92% of pollution-related deaths and diseases occur in low and middle income countries.  Yet, there are few opportunities for the scientific research workforce is receive training in this area of work.
 
I have been the director of the Mount Sinai Division of International Health since 2004.   Our mission is to partner with scientists in other countries to enhance capacity to identify, document, prevent and mitigate environmental health problems that have the potential to affect morbidity in vulnerable populations, especially children. To do this, we initially trained and nurtured the careers of 52 international scholars in Mexico, Brazil and Chile through the Fogarty-supported ITREOH Program - International Training in Research in Environmental & Occupational Health.  We have now expanded our collaborations to 5 additional countries: Argentina, Costa Rica, Spain, South Africa, and Ireland.

My collaborations have developed into close friendships with many international scholars.  Now, after so many years, we have collaborated on many research projects and joined forces to mentor a new generation of researchers.  Through funding from the National Institute for Minority Health and Health Disparities, my former international fellows and I have provided research training to 140 minority students from the US.  Every year, we select 10 students from a national pool of hundreds of amazing applicants, bring them to New York for an intense orientation period and match them with international mentors.  The students then spend 11 weeks conducting research in those countries.  Upon their return to the US, the students continue to receive support to complete research reports worthy of publication.  An astounding number of students, about a third, publish their research in peer-reviewed journals, while others have their manuscripts at different stages of review.   Yet others, present their work at international professional conferences and receive recognition for their work through awards, fellowships, and acceptance to other prestigious programs.

Features of our International Exchange Program that have made it so successful over the last 15 years are:

• Multi-tiered selection process- students are not only selected based on their academic achievements, but also potential demonstrated through perseverance, interests, enthusiasm, and other abilities.  An experienced selection committee that includes alumni of the program reviews the applications and conducts in-depth interviews in order to select the right participants for the program.
• Thorough pre-travel training - Selected students participate in an intense training program prior to being deployed to their international sites.  The training includes an introduction to scientific writing based on the book: How to Write and Publish a Scientific Paper: The Step-by-Step Guide.  This greatly clarifies expectations and provides selected students the tools they need to succeed in the program. 
• Close relationship with mentors - careful matching of student-mentor pairs is possible because of our familiarity with mentors' research projects, relevant skills, and training environment at the host institutions.  
• Quality of the applicant pool - Minority students from all over the US compete for the 10 positions available.  This results in a diverse applicant pool and increases the opportunity to select the best student-mentor pairs.  Given the high level of interest in this program, we would like to expand the number of positions and add a broader international mentor training program.
• Continued long-term mentoring- ​We are available for consultation and mentoring to all students who have participated in the program over the years.  We also support and encourage peer-to-peer mentoring between alumni of the various programs.  Many alumni of the program are now in high-level academic positions and serve as inspiration to current students.

This program has been one of the most satisfying experiences of my career.  I hear students say that the experience of conducting mentored research abroad changed their lives.  It fills me with pride to see students from this program achieve amazing things.  Some are doing important work at the United Nations, National Academies of Sciences, Departments of Health, and other prestigious institutions.  Some alumni are doctors and scientists at hospitals and medical centers, others are caring for people in the poorest corners of the world.  Some are training other students at medical schools, others have started their own businesses.  I like to hear from them all.  It brightens my day to open an email from a former student or to get a card in the mail.  Alumni tell me about their successes, they seek advice, they tell me about their experiences trying to get to their next level.  It is a thrill and a joy to hear their stories, some I have published as Guest Blog Posts.   
I think this program has opened their eyes to a world of possibilities, literally.  It is worthwhile. 

Valencia Lyle was a fellow in both my Short-term Training Program and also in my International Exchange Program, during which she reaffirmed her love for working with underserved populations in other countries.  Through a series of deployments in Tanzania, South Africa and Uganda, Valencia has gained a broad range of amazing experiences that illustrate how to piece together a career in global health by following 5 steps.  Here is Valencia's story in her own words.  

​A well-recognized tradition in U.S. elementary, middle, and high schools following students’ completion of each major educational milestone is for students to write letters to their “future selves.”
 
I intermittently revisit these letters to informally tally the instances in which my career goals drastically evolved. My middle school letter to myself demanded that, by the age 25, I be married, have two children, and work as a pediatrician at a hospital in Michigan.
 
Now, five years past my deadline for accomplishing these major life events, it’s clear that I have abandoned them – at least for now. There were two major work and learning opportunities that led to a major shift in my career goals: my Peace Corps service and the Mount Sinai School of Medicine International Exchange program.  These experiences solidified my ambitions in pursuing a career in global health.
 
In recognition of my long, arduous journey to feeling comfortable describing myself as a global health practitioner, I would like to pass down some of my lessons learned to my fellow young professionals aspiring to work in the field of global health outside of their countries of residence.
 
1.    Take a step out of your comfort zone 
In October 2011, I embarked on my first global health experience as a Peace Corps Volunteer in Tanzania. I was placed in a small, rural village situated within the picturesque Livingstone mountains of the Southern Highlands of Tanzania.  With this being the first time I not only lived out of state, but lived out of the country- unaccompanied- I faced an everyday battle between “toughing it out” and returning to the familiarity and comfort of the place I called home for the first 21 years of my life.
 
Despite the aforementioned inconveniences, Peace Corps was one of the most amazing work experiences I have ever obtained. Developing strong bonds with a community in an unfamiliar culture, mastering a new language, and working with diverse community leaders to find solutions to issues plaguing the residents of our village was rewarding beyond belief. 
 
I ultimately decided to move forward with option number one: toughing it out. This afforded me extensive work experiences in supplying antiretroviral therapies to adults and children living with HIV and ensuring these populations had access to care.  My Peace Corps service served as a catalyst for my interest in pursuing a career in public health which is why, following the close of my Peace Corps service, I pursued a master’s degree in public health from Columbia University’s Mailman School of Public Health.
 
 2.    Don’t endure the journey alone – seek mentorship 
During my graduate studies at Columbia University, I vacillated between building a career in the U.S. and working abroad. It was not until I joined the 2015 cohort of the Mount Sinai School of Medicine International Exchange program that I realized I did not want to start my global health career off in the U.S.
 
While a participant of the Mount Sinai School of Medicine International Exchange program, I was fortunate to receive two mentors: Dr. Luz Claudio, who assisted me in identifying a potential career trajectory in global health, and Professor Rodney Ehrlich, my research mentor at the University of Cape Town (UCT) in South Africa. Under Professor Ehrlich’s supervision, we conducted a study assessing the incidence of tuberculosis in South African gold miners. We aspired to use the results of our study to strengthen occupational health guidelines in gold mining companies and policies in South Africa.
 
The research I conducted at UCT and my overall experience in the International Exchange Program elicited two major revelations about my career trajectory: 1) if I conduct research, it should be research that will propel data driven policy making, and 2) I enjoy careers in which there is a combination of program implementation and research.

3.    Explore different professions in global health through internships, fellowships, and short term positions 
The critical revelation about my ideal working environment that I acquired from completing the Mount Sinai School of Medicine International Exchange Program incited my eagerness to explore the wide range of professional opportunities within the field of global health. This led me to acquiring internships and short term positions in an assortment of areas in global health and policy ranging from marketing writing at the Clinton Global Initiative to policy research at UN Women during my graduate studies at Columbia University. 
 
Immediately after obtaining my MPH, I received an opportunity to manage a fresh food voucher program for South Sudanese refugees in Uganda. While I feel privileged to have received the unique and humbling opportunity to work in refugee settlements in a high impact area – nutrition, the position opened my eyes to the necessity of research in this field. I began to grow interested in assessing the cost-effectiveness of various nutrition programs, discovering innovative ways to build the capacity of the health workers and various stakeholders we trained, and investigating the manners in which diverse health policies affected the outcomes of the programs we implemented.

4.    Once you think you have everything figured out, embark on a purposeful career search 
The professional revelation I acquired from working in Uganda resulted in me scouting out a work experience that combined both of my passions – program implementation and research. I began supporting the Rwanda Ministry of Health as a Monitoring, Evaluation, and Research Officer through the Global Health Corps. This position offered me experience in both supporting the implementation of programs at the national level and conducting research to further support data driven decision making.
 
This position was such a great fit that even after the end of my Global Health Corps fellowship, I have continued supporting the Rwanda Ministry of Health as a consultant. From conducting research on surgical outcomes to assessing the implementation of civil registration and vital statistics procedures, my work at the Rwanda Ministry of Health has challenged me to think outside the box with regard to program implementation and strengthened my ability to conduct health services research under the mentorship of well-established experts in health service delivery, research, and policy making.

5.    Take your time – don’t let anyone rush you into zeroing in on a career path you are not certain you would like to pursue 
While I am acquiring my short term career aspirations, I am still far from obtaining the work experiences and educational credentials needed to fulfill my long term career aspirations.
 
Although I had a path to success spelled out for myself by the age of 12, I decided to deviate from that path through taking my time and exploring career opportunities outside of medicine. Exploring careers outside of medicine was the best decision I could have made for myself as working in global health has empowered me to collaborate with global health experts around the world to improve the health and well-being of populations both in the U.S. and abroad.
 
As a young professional, I know that there is so much pressure for us to have it all figured out by the time we graduate from college. I am taking my time to explore the different professional opportunities in global health and I will admit that I still have not figured everything out. My advice to you, my fellow young professionals, is to take your time and do not settle on a career that seems comfortable, easy to obtain, and familiar. Whenever I begin to doubt my decision to take my time and explore different careers, I call to mind a quote from Steve Jobs: “the only way to do great work is to love what you do. If you haven’t found it yet, keep looking. Don’t settle.”

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