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.”
Guest Post: Bringing it Full Circle -A child of immigrants now offers medical care to families detained at the US-Mexico border. Elizabeth Lopez-Murray, DHEd, PA-C, MSPAS, MPH
Photo credit: Jessica Valdez Outlasting Memories.
So proud to introduce you to Elizabeth Lopez-Murray, who has worked as a Physician Assistant for the past 14 years at the Clinica La Familia in Arizona. I had the pleasure of mentoring her in 2002 when she participated in my Short-term Training Program for Minority Students. Back then, I immediately recognized her potential, her work ethic, and her strong desire to help immigrant families, so I assigned her to work in our community-based asthma research projects in Harlem, New York. Inspired by her New York internship and her personal experience as a child of immigrant parents from Mexico, Dr. Lopez now also volunteers to provide medical care to detained immigrant families. She recently published an article for the American Academy of Physician Assistants about her volunteer work with asylum-seeking immigrant families at the US-Mexico border. As a physician assistant with a doctorate degree in health education who is also bilingual in English and Spanish, she exemplifies the many options that students can consider when pursuing careers in science and medicine. Here is Elizabeth's story in her own words.
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:
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.
Guest Blog Post: Amaya Caballero-Wittmaack, Third Year Medical Student and Entrepreneur on How in Retrospect, Her International Research Training Experience Made Sense
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.
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:
Once you preview the application requirements, verify everything as follows:
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.
Celebrating 15 Years of the Mount Sinai International Exchange Program, a Global Health Research Training Program for Minority Students
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:
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.”
As part of our monthly series of guest post, I present to you Nathalie Fuentes. A student from my hometown of Caguas, Puerto Rico, Nathalie is currently pursuing her PhD at Penn State College of Medicine. She was selected from among over 400 applicants to me International Exchange Program for Minority Students. Nathalie reminds me so much of my younger self in her projection of confidence while battling internal insecurities and impostor syndrome. Here she is in her own words.
I was born and raised in Caguas, the heart of Puerto Rico, to humble parents. I was always interested in science. Starting at the age of 5 with my first project presentation at a science fair, my curiosity and urge to know and understand the human body led me to study its function, and the factors that can affect human health. During high school and thanks to the help of a wonderful teacher, Mrs. Lourdes Hernández, I began to visit research laboratories located in the Medical Sciences Campus of the University of Puerto Rico, where I knocked countless doors. While many scientists told me “No”, my patience and perseverance paid off when one researcher, Dr. Carmen L. Cadilla, said “Yes”. Then, at 15 years old, I was selected by Dr. Cadilla as an intern in her NIH-funded Short-term Research Experience for Underrepresented Persons (STEP-UP) I received funding from the National Institutes of Health (NIH) Short-Term Research Experience for Underrepresented Persons (STEP-UP) Program to support my participation in six summer internships.
Despite many accomplishments and the skills and knowledge I have sought out and acquired, my journey as an undergraduate student was not easy. I started my undergraduate studies in Chemistry at the University of Puerto Rico. During my sophomore year, I decided to transfer to a Biochemistry program at Iowa State University. It was clear that this change would bring many challenges, but I did not know all the consequences and responsibilities that would come with this decision. My family had very little financial resources, and to help overcome some costs, I had to work as a research assistant during the day and as a tutor during the night. In addition, I never expected that the English language would be such a hard obstacle for me. I clearly remember how during my first oral presentation, a student asked me if I was truly speaking English because it was incomprehensible. Even though I felt my world crumbling, I used that as motivation to raise my GPA and conquer my dream of becoming a scientist.
Throughout my journey as a student in the United States, I also faced many of the challenges associated with being an underrepresented minority woman in science. However, I always searched, found and created my own opportunities to accomplish my goals by becoming a well-trained and versatile researcher. As an undergraduate student, I was able to explore and conduct research in different scientific topics. For example, during a summer internship at Pennsylvania State University, I studied signal transduction pathways that control tumor suppression, gene expression and chromatin remodeling in leukemia. As an Iowa State McNair scholar, my research about methanotrophic bacteria led to a publication in the Journal of Inorganic Biochemistry. Also, during this time, I obtained independent funding to join a scientific team at Harvard University, where I investigated the role of retinal ganglion cells with the end-goal of developing novel treatment for optic nerve degenerative diseases. Soon after I completed my undergraduate studies in Biochemistry and Linguistics, and had the opportunity to be selected as a fellow of the 2015 Mount Sinai International Exchange Program for Minority Students. This prestigious program allowed me to conduct research at the University Federal of Rio de Janeiro in Brazil, working on genetic engineering microorganisms for bioremediation.
I always knew that graduate school was my next step. The application process was nerve-wracking. I never felt 100% confident that I was going to get into my dream school. During my first interview, I felt so anxious, to the point where I just cried because of how stressed I was. After 5 interviews and 5 acceptance letters, I decided to join the Biomedical Sciences Program at Penn State College of Medicine. I based my decision on the school ranking, type and quality of research, location and mentors with funding available.
My first years as a graduate student were tough. I remember walking through the doors of Penn State College of Medicine with a lot of enthusiasm, bright-eyed and driven to excel in my graduate studies. I felt unstoppable, without knowing that in a matter of days everything was about to change. Feelings of insecurity started to arise. I was feeling suffocated with that pressure of being obligated to excel. For the first time in years of an exciting scientific career, I was feeling like an impostor. I did not know what to do, until I discovered that the key was to find the right mentor. I joined Dr. Patricia Silveyra’s lab, which focuses on respiratory disease. The reason why I chose to study lung disease was because my grandfather, the man who helped raise me, died of a pulmonary disease. I decided at that moment to think outside the box and explore molecular processes that govern the functioning of lung disorders. Dr. Silveyra’s guidance gave me the support that I needed to not only overcome these obstacles, recognizing the existence of “impostor syndrome” and strategies to overcome it, but also to become a well-trained scientist, a leader in the community, and a role model for future scientists.
My main scientific goal now is to understand the immunological basis of the sex differences observed in asthma exacerbation triggered by air pollution. In almost four years of work, I have made significant progress in my experimental work, as well as in career development. I have published two papers as first author, and submitted two additional ones. I have contributed to several other manuscripts, review articles, and book chapters from the lab. I have been recognized with local, national, and international awards. Most importantly, I have focused on mentoring underrepresented students interested in science. Training and working with people from diverse backgrounds is an adventure. Science benefits from diversity! It amazes me how different perspectives can contribute to produce better research.
What have I learned from this journey? First, besides all the knowledge acquired, I have found role models that motivated me, taught me to uncover my true potential and overcame my barriers. Mentors provide knowledge and can see where we need to improve. They always find ways to stimulate our personal and professional growth. My advice to students starting their journey is this: Find someone who you admire and respect, and who has a career path similar to the one you aim to follow. Also, we naturally have the predisposition to get trapped on the negative and think about our failures, instead of counting our victories. Initiative and motivation are indispensable. Successful students not only have brilliant ideas but they take initiative and carry them forward. If you need help, ask. If you have questions, ask. Don’t be afraid! Obstacles are inevitable, but successful people never give up.
Ask your grandmother when she hit puberty. Then ask your mother. Ask other women in your family. Do you notice a pattern?
Yes. In recent years, girls have been developing at younger ages. Today, it is not uncommon to see middle school girls who look like grown women. But why?
Some investigators point to obesity as part of the explanation for this trend. Although that is far from conclusive, it seems to be an important factor. However, we also suspect that exposure to some chemicals in the environment may contribute to earlier puberty in girls.
I was part of a team led by Mary Wolff, PhD, that investigated the relationship between exposure to chemicals found in personal care products and signs of puberty in a group of African-American and Latina girls. In that study, we recruited girls at 6-8 years of age and followed them over time, assessing their exposure to chemicals, their BMI, diet, and puberty development.
A new study published by Dr. Brenda Eskenazi's team assessed whether exposure to these chemicals before birth could also lead to changes in puberty in children. Their study found that exposure to chemicals commonly found in personal care products may cause early signs of puberty in girls, but not in boys. The chemicals that they measured in this new study were phthalates, parabens and triclosan.
I was asked by journalist Lisa Rapaport to comment on this new study for Reuters, the news organization. Here is my quote: “The effects of these chemicals are very complex,” said Dr. Luz Claudio of the Icahn School of Medicine at Mount Sinai in New York City. “Their effects on the hormonal system is different with different chemicals, they have different potencies, their effects can be modulated by other factors such as genetic predisposition, and importantly, their effects can be different depending on the timing of the exposure,” Claudio, who wasn’t involved in the study, said by email. “With that said, this and other studies, together with the laboratory experimental evidence point to potential effects on children.”
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Dr. Luz Claudio is an environmental health scientist, mother and consultant, originally from Puerto Rico. She is a tenured professor of environmental medicine and public health. Luz recently published her first book: How to Write and Publish a Scientific Paper: The Step-by-Step Guide. Dr. Claudio has internship programs and resources for young scientists. Opinions expressed in this blog are solely her own and may not reflect her employer's views.