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Life After Fellowship: How to Find & Negotiate for a Job in Healthcare Epidemiology · The SHEA Podcast

• 0:05
  SPEAKER_01: Welcome to our Leadership and Management podcast series brought to you by the Society for Healthcare Epidemiology of America, SHA, promoting the prevention of healthcare associated infections and antibiotic resistance and seeking to advance the field of healthcare epidemiology and antibiotic stewardship.
• 0:22
  SPEAKER_01: I'm Dr.
• 0:22
  SPEAKER_01: Jessica Howard Anderson, Assistant Professor of Medicine in the Division of Infectious Diseases at Emory University School of Medicine and the Associate Hospital Epidemiologist at Emory University Hospital Midtown.
• 0:34
  SPEAKER_01: I will serve as your moderator.
• 0:36
  SPEAKER_01: Shay is excited to launch this episode of the podcast series entitled Life After Fellowship: How to Find and Negotiate for a Job in Healthcare Epidemiology.
• 0:45
  SPEAKER_01: This podcast will discuss common issues and questions that arise when individuals are looking for their first job in healthcare epidemiology, including in public health.
• 0:54
  SPEAKER_01: We will address themes, including how to start the job search, what to look for in a job, contract negotiations, and recommended training courses.
• 1:03
  SPEAKER_01: I'm happy to introduce our three speakers for today.
• 1:06
  SPEAKER_01: First, we have Dr.
• 1:07
  SPEAKER_01: Jennifer Hanrahan.
• 1:08
  SPEAKER_01: Dr.
• 1:08
  SPEAKER_01: Hannahan is the chief of Division of Infectious Diseases at the Eastern Virginia Medical Center.
• 1:13
  SPEAKER_01: She was previously the medical director for infection prevention at ProMedica in Toledo.
• 1:18
  SPEAKER_01: And prior to that, at Metro Health Medical Center in Cleveland.
• 1:22
  SPEAKER_01: Our next speaker is Dr.
• 1:24
  SPEAKER_01: Sujan Reddy.
• 1:25
  SPEAKER_01: Dr.
• 1:25
  SPEAKER_01: Reddy is the medical director of the CDC's Prevention Epicenters program in the Division of Healthcare Quality Promotion.
• 1:32
  SPEAKER_01: Prior to joining CDC, he worked as a hospitalist at Grady Memorial Hospital in Atlanta and as an infectious disease doctor at Emory University.
• 1:41
  SPEAKER_01: And finally, we have Dr.
• 1:42
  SPEAKER_01: Claire Rock.
• 1:43
  SPEAKER_01: Dr.
• 1:43
  SPEAKER_01: Rock is an associate professor of medicine at Johns Hopkins University Schools of Medicine and Bloomberg School of Public Health.
• 1:50
  SPEAKER_01: She is an associate hospital epidemiology at the Johns Hopkins Hospital and an academic researcher in the field of healthcare epidemiology.
• 1:57
  SPEAKER_01: Thank you all for joining us today.
• 2:00
  SPEAKER_01: To kick off our discussion, I'd like for each of our speakers to tell us a bit about their career path in healthcare epidemiology and what their current job entails.
• 2:09
  SPEAKER_01: So, Dr.
• 2:10
  SPEAKER_01: Hannahan, I'm going to turn to you first.
• 2:12
  SPEAKER_01: Would you like to start?
• 2:13
  SPEAKER_01: Sure, thank you.
• 2:15
  SPEAKER_02: When I started, basically shortly after I joined faculty at Metro Health Medical Center in 1999, the position for healthcare epidemiol just became available.
• 2:24
  SPEAKER_02: And I volunteered, knowing almost nothing about infection prevention.
• 2:28
  SPEAKER_02: When I started the position, I was told that about 10% of my time was going to be sufficient for the duties of infection prevention.
• 2:36
  SPEAKER_02: And then soon after I started September 11th happened, and we had a lot of hospital outbreaks going on.
• 2:43
  SPEAKER_02: And so there was increased attention to the possibility of bioterrorism and pandemics.
• 2:49
  SPEAKER_02: And pretty soon the job was taking 80% of my time.
• 2:53
  SPEAKER_02: But while it was taking all that time, I couldn't get the support for it.
• 2:56
  SPEAKER_02: So I had to spend a number of years trying to convince the administration that I needed sufficient support in both time and salary for the position.
• 3:07
  SPEAKER_02: And while I would say that I think there is improvement in that area, we still are not where we need to be in terms of having sufficient support for infection prevention.
• 3:19
  SPEAKER_02: And so part of my mission has been to get increased recognition and support for healthcare epidemiology.
• 3:25
  SPEAKER_01: Thank you for telling your story and definitely agree we need to start out at more than 10%.
• 3:30
  SPEAKER_01: So, Dr.
• 3:31
  SPEAKER_01: Reddy, can you tell us a little bit about your career path and experience?
• 3:35
  SPEAKER_00: Sure, thanks.
• 3:36
  SPEAKER_00: I was always interested in trying to make an impact beyond individual interactions with patients, but I hadn't quite figured out what that would look like.
• 3:43
  SPEAKER_00: During ID fellowship, I wanted to develop more Epi skills and did a master's in clinical research.
• 3:49
  SPEAKER_00: And my thesis project actually was utilizing C diff data from the CDC's Emerging Infections Program, or EIP, which performs population-based surveillance in collaboration with health departments and academic medical centers.
• 4:02
  SPEAKER_00: I was drawn to healthcare Epi because by its nature, you're having an impact on the population you're serving.
• 4:07
  SPEAKER_00: Even better, healthcare EPs are always looking at data and to inform real-world actions to improve the health of the population.
• 4:16
  SPEAKER_00: After fellowship, I was drawn to work in the CDC's division of healthcare quality promotion, which is where I'm at right now, because we're very focused on using data for action.
• 4:25
  SPEAKER_00: My current role is leading Epi investigations with our internal scientists as well as with our external partners through the Prevention Epi Centers program, which is basically a network of academic medical centers who are doing collaborative research on HGIs and AR prevention.
• 4:41
  SPEAKER_00: I love it.
• 4:42
  SPEAKER_00: I work with the really bright people and create opportunities to ask and answer questions that are focused on improving patient safety.
• 4:49
  SPEAKER_00: I really enjoy applying the public health lens to healthcare epi because there's always something uniquely challenging and there's always a diversity of activities to pursue.
• 4:59
  SPEAKER_00: Activities are guided to wherever the biggest issues are or wherever we can have the most impact on patient safety.
• 5:06
  SPEAKER_00: This often leads us outside of the hospitals to other healthcare facilities, including like dental clinics and nursing homes, but also requires a wide range of partnerships that I really enjoy.
• 5:18
  SPEAKER_01: Thank you, Dr.
• 5:18
  SPEAKER_01: Reddy.
• 5:19
  SPEAKER_01: Yeah, I'm really excited to hear about your experience in CBC and in public health in general.
• 5:24
  SPEAKER_01: So, Dr.
• 5:25
  SPEAKER_01: Rock, can you tell us about your career pathway?
• 5:28
  SPEAKER_03: Sure.
• 5:29
  SPEAKER_03: Yeah.
• 5:29
  SPEAKER_03: So I did my, I'm originally from Ireland and did all my medical school and a lot of my training there.
• 5:35
  SPEAKER_03: And then myself and my husband came over to the US, to Baltimore, and I came to the University of Maryland and did ID fellowship there.
• 5:44
  SPEAKER_03: And that's where I really came into contact with healthcare epidemiology.
• 5:48
  SPEAKER_03: I'd never really seen it as something that was kind of a viable option or really understood what it was that a hospital or a healthcare epidemiologist would do.
• 5:57
  SPEAKER_03: And so I was really fortunate to work with Anthony Harris and Carrie Tom and really have their mentorship at the University of Maryland and just found what they were working on and the way that they perceived things is really interesting.
• 6:10
  SPEAKER_03: And so I stayed there and did some more research with them after fellowship and did my master's in clinical research, which I thought really helped me to ground in the actual skills of Epi and study design and statistics.
• 6:25
  SPEAKER_03: And it's not now that I do my own statistics, but I'm able to have that conversation with a statistician, right, to really understand and speak the same language and really helps my current research.
• 6:35
  SPEAKER_03: So then when I finished that, I moved over to faculty to Hopkins and I've been there since.
• 6:40
  SPEAKER_03: And my job is predominantly academic research, mainly funded by the CDC through the Prevention Epi Centers, obviously working with Dr.
• 6:50
  SPEAKER_03: Reddy, and then some of the Shepherd opportunities within the CDC for some international work, et cetera.
• 6:57
  SPEAKER_03: And so that's been extremely rewarding.
• 6:58
  SPEAKER_03: I think one of the really nice things about hospital epi research is that a lot of the operational research needs overlap.
• 7:08
  SPEAKER_03: The research that you're doing is really to address a problem that you're seeing within the work that you're doing.
• 7:14
  SPEAKER_03: And so it's very kind of cause and effect and easily able to link.
• 7:17
  SPEAKER_03: And what it means is that the research to me is very rewarding because you can see it make a difference.
• 7:22
  SPEAKER_03: And when you're working as a hospital epidemiologist, you're able to implement the results of your research into the practice.
• 7:27
  SPEAKER_03: And so I think in a different way to other specialties, we have that advantage of really being able to see often the impact of the research that we're doing.
• 7:36
  SPEAKER_01: Yeah, that's great.
• 7:37
  SPEAKER_01: Thank you all for sharing your experiences.
• 7:41
  SPEAKER_01: So now, Dr.
• 7:42
  SPEAKER_01: Hannahan, I'm gonna turn it back to you.
• 7:44
  SPEAKER_01: As the chief of an ID division, what advice do you have for fellows who are just starting to look for a job?
• 7:51
  SPEAKER_01: And do you have any key questions, uh, recommendations that fellows might ask when speaking to a division chief or other faculty members?
• 7:58
  SPEAKER_02: I would say that the single most important thing, regardless of the job that anyone is doing, is to have meaningful work.
• 8:06
  SPEAKER_02: That is, you know, clearly the thing that's gonna make you get up in the morning and that's gonna make you want to go back to work.
• 8:12
  SPEAKER_02: Also, having a supportive environment is really important.
• 8:16
  SPEAKER_02: Many people that I've interviewed for positions ask about salary as one of the first topics.
• 8:22
  SPEAKER_02: And while it's important, obviously you need to be able to pay your bills, it's not the thing that's gonna determine how happy people are.
• 8:30
  SPEAKER_02: And while salaries are surprisingly similar across the country, the cost of living is not.
• 8:35
  SPEAKER_02: It varies a great deal.
• 8:37
  SPEAKER_02: So the number is really meaningless unless you figure out how much it actually costs to live in an area.
• 8:43
  SPEAKER_02: The things that I think are really the most important are whether someone feels valued in their work and whether they like their environment, including the people they work with and report to.
• 8:52
  SPEAKER_02: So I would be asking questions about how the person you are going to be reporting to sees the role of healthcare epidemiology and what kind of support is in place, both in terms of time and salary support.
• 9:05
  SPEAKER_02: Also, it's important to know what is the turnover rate like at the institution that you're going to.
• 9:10
  SPEAKER_02: There is a baseline expected turnover rate, people leave jobs.
• 9:14
  SPEAKER_02: But if people are leaving the institution in much greater than expected numbers, there's a reason for that.
• 9:21
  SPEAKER_02: You need to ask about that.
• 9:23
  SPEAKER_02: That's not always going to be a reason not to take that position, but you really need to do a little bit of research and try to find out why that's going on.
• 9:31
  SPEAKER_02: So ultimately, I would say make sure that you're going to have enough time to do the job, make sure that the clinical productivity is not such that you're not going to be able to fulfill the expectations.
• 9:42
  SPEAKER_02: And so it really comes down to asking a lot of questions.
• 9:45
  SPEAKER_02: And I would say ask those questions of a lot of different people so that you're not just getting the answers that they want you to hear, but really talk to a lot of different people to find out.
• 9:56
  SPEAKER_01: Thanks.
• 9:56
  SPEAKER_01: Yeah, I was going to ask have you had success in in asking about the turnover rate from the division director or from other faculty members or from either?
• 10:06
  SPEAKER_02: It's always surprising to me how candid people are in interviews.
• 10:10
  SPEAKER_02: You would think that people are trying to recruit you, they want to be on good behavior, right?
• 10:14
  SPEAKER_02: Or they want to present a good face, but things come out that are big red flags.
• 10:20
  SPEAKER_02: So just pay attention to what people say.
• 10:23
  SPEAKER_02: And I think you can get that information from a lot of different people.
• 10:26
  SPEAKER_02: It may be administrative, you know, or support staff who are going to give you some of the information.
• 10:31
  SPEAKER_02: So just pay attention to all of your interactions.
• 10:34
  SPEAKER_01: Really great advice.
• 10:36
  SPEAKER_01: So, Dr.
• 10:36
  SPEAKER_01: Reddy, your career has been focused on public health and healthcare epidemiology working at the CDC.
• 10:43
  SPEAKER_01: What advice do you have for fellows who want to pursue a career in public health, including at the CDC or at local health departments?
• 10:50
  SPEAKER_00: I think the biggest thing to realize is that public health is quite vast.
• 10:54
  SPEAKER_00: When I was a fellow, I didn't even know that my current job exists, but here I am now.
• 10:59
  SPEAKER_00: So you don't know what you don't know.
• 11:02
  SPEAKER_00: So you have to start asking open-ended questions to lots of people and start exploring what different entities are doing.
• 11:08
  SPEAKER_00: And I just to give you a primer on some of these different entities.
• 11:11
  SPEAKER_00: So on the federal government side, you know, obviously there's CDC and we're in the Department of Health and Human Services or HHS.
• 11:18
  SPEAKER_00: But even within HHS, there's several other agencies, right?
• 11:22
  SPEAKER_00: There's the FDA, the Food and Drug Administration, there's Centers for Medicare and Medicaid Services, or CMS, obviously NIH, National Institute of Health, has instrumental scientists.
• 11:32
  SPEAKER_00: The Agency of Healthcare Research and Quality, or ARC, AHRQ, also has a lot of research opportunities as well.
• 11:39
  SPEAKER_00: So these agencies have a wide range of activities and they have a critical impact on patient safety.
• 11:45
  SPEAKER_00: As for CDC and what do we do in terms of healthcare EPI, I'm in the division of healthcare quality promotion, whose mission is to protect patients, healthcare personnel, and promote safety at both the national and international healthcare delivery systems.
• 12:00
  SPEAKER_00: Our division does a wide range of activities to achieve this.
• 12:04
  SPEAKER_00: So it could be responding to outbreaks, developing guidelines, whether it's related to HAIs or antibiotic stewardship, and perform surveillance like through our national healthcare safety network or other systems, like I had mentioned EIP earlier.
• 12:16
  SPEAKER_00: There's also lots of training and lots of other epidemiological investigations.
• 12:20
  SPEAKER_00: So there's just lots of activities that we're doing in our division.
• 12:24
  SPEAKER_00: I'd also want to mention that there's lots of opportunities that are not at the federal level.
• 12:29
  SPEAKER_00: So state and local health departments are increasingly doing lots of healthcare epidemiology work.
• 12:35
  SPEAKER_00: Every state and county and most large cities have departments of public health, and many have specific HEI programs that are increasingly also doing antibiotic stewardship work.
• 12:45
  SPEAKER_00: These health departments do many of the same functions as CDC in terms of outbreak investigations, surveillance, and filling prevention approaches, and obviously doing a lot of emergency preparedness and response.
• 12:57
  SPEAKER_00: Many health departments look at practicing ID docs to support their work.
• 13:01
  SPEAKER_00: And there's a lot of activities that you can perform here through a contract.
• 13:05
  SPEAKER_00: You can be based at your local facility, but be contracted out to facilitate an outbreak response or provide expertise in a collaborative that they're doing.
• 13:16
  SPEAKER_00: So there's lots of opportunities at state and local health departments, and they're only expanding, especially when it comes to HAI and AR work.
• 13:23
  SPEAKER_01: Thanks, Dr.
• 13:24
  SPEAKER_01: Reddy.
• 13:24
  SPEAKER_01: I think I'll ask you later on in the podcast about what skill sets or trainings might be useful for fellows interested in that.
• 13:31
  SPEAKER_01: So I'm excited to hear that.
• 13:33
  SPEAKER_01: Dr.
• 13:34
  SPEAKER_01: Rock, I wanted to ask you about how you've incorporated research and healthcare epidemiology into your career.
• 13:40
  SPEAKER_01: And do you have any advice for fellows who want to have a more research-oriented career?
• 13:44
  SPEAKER_03: Yeah, I think this is a great topic.
• 13:47
  SPEAKER_03: And I would say that the main advice I would have for fellows is to recognize the importance of mentorship and sponsorship.
• 13:56
  SPEAKER_03: Without those two things, it's really impossible to really develop a research-oriented career.
• 14:02
  SPEAKER_03: And those two things are not the same.
• 14:16
  SPEAKER_03: And as students said, like you don't know what you don't know.
• 14:19
  SPEAKER_03: And so often you rely on your on your mentor to tell you the things that you should be knowing or should be learning about that will help you to make good decisions to be able to move your career forward.
• 14:31
  SPEAKER_03: And often a mentor is someone that can help with the nitty-gritty, right?
• 14:34
  SPEAKER_03: Of writing one of like, you know, a research proposal, whether that's something to shave for many of the different awards they have for young investigators, et cetera, but really can help give you those skills and really help orientate you and help you strategize to your career.
• 14:49
  SPEAKER_03: And then the other is um sponsorship.
• 14:52
  SPEAKER_03: And sponsorship is really people that are looking out for your interest and they're thinking about you and promoting you and putting your name forward when it comes to, oh, you know, the planning committee for Shay is planning a session on this.
• 15:05
  SPEAKER_03: Oh, you know, wouldn't that person be a great person?
• 15:08
  SPEAKER_03: You need to have try and have people that are in your corner to be able to push your name forward when it comes for these opportunities.
• 15:15
  SPEAKER_03: And then what I would say is as I go on, I recognize more and more that actually gratitude is really, really important because I think when we're at the mentee stage, we often don't recognize that the mentors have a huge portfolio of things going on.
• 15:30
  SPEAKER_03: And the time that they give to mentees and also sponsors, you know, the time that they give just to help people develop and put them forward is really something that's very, very important.
• 15:41
  SPEAKER_03: And so I think, you know, it's very important to recognize that and be thankful.
• 15:46
  SPEAKER_03: I think that really helps to develop a more research-oriented career because it doesn't happen spontaneously.
• 15:52
  SPEAKER_03: It has to happen with something that has a lot of effort and a lot of strategy.
• 15:57
  SPEAKER_03: And that continues.
• 15:58
  SPEAKER_03: It's not something that goes away after the early investigator stage.
• 16:02
  SPEAKER_03: The mentorship continues.
• 16:03
  SPEAKER_03: It just may be that the mentor changes and the sponsorship continues.
• 16:07
  SPEAKER_03: It just may be that the sponsors change and evolve.
• 16:10
  SPEAKER_01: Thanks for highlighting that.
• 16:13
  SPEAKER_01: Do you have thoughts about how many mentors or sponsors that the fellow should seek out, or does it really depend on the individual?
• 16:21
  SPEAKER_03: I think the concept of a mentoring committee is a really nice one.
• 16:26
  SPEAKER_03: But I think that to really be successful, you need to have one primary mentor.
• 16:29
  SPEAKER_03: And that's someone that's really invested in you and really helping you when it comes to strategy.
• 16:35
  SPEAKER_03: But you also need additional inputs from other people.
• 16:38
  SPEAKER_03: And that's how I know for our fellows, we have like mentoring committees, right?
• 16:42
  SPEAKER_03: So there's one primary mentor, but then every quarter or whatever frequency, there'll be a meeting of a mentorship committee to be able to give kind of additional inputs and to give additional advice and make sure that the mentee is being connected with all the availability that is within the university to help them kind of move their research forward.
• 17:02
  SPEAKER_03: So I think that type of model works well.
• 17:04
  SPEAKER_03: And then I think sponsors, you can never have enough sponsors, right?
• 17:08
  SPEAKER_03: Because there can never be enough opportunities.
• 17:10
  SPEAKER_03: And it's not necessarily that you need to say yes to all those opportunities, but it's good to have the opportunities to avail of.
• 17:16
  SPEAKER_03: And often it's the mentors that even as they're discussing opportunities with other people that they're coming across with, that sponsorship opportunities can come up.
• 17:25
  SPEAKER_03: So they may not necessarily be mutually exclusive.
• 17:28
  SPEAKER_03: Lastly, I would say that Shea, there's lots of mentoring opportunities through Shay, right?
• 17:33
  SPEAKER_03: We have the Women in Breakfast meeting, you know, during the spring meeting, and there's lots of other opportunities to broaden your potential mentorship and sponsoring network within Shea, where there's many people that are willing to give their time and energy to help some of the junior investigators.
• 17:51
  SPEAKER_03: Thanks, Dr.
• 17:52
  SPEAKER_03: Rock.
• 17:52
  SPEAKER_01: All right.
• 17:53
  SPEAKER_01: So for many of our listeners, this may be the first time they've had to think about job contracts and negotiations.
• 18:01
  SPEAKER_01: And so I want to ask now what advice you all have about reviewing job contracts.
• 18:06
  SPEAKER_01: And maybe if you have one or two items you think that's really important for the fellow or trainee to negotiate for.
• 18:13
  SPEAKER_01: So, Dr.
• 18:14
  SPEAKER_01: Hannahan, could you start?
• 18:16
  SPEAKER_02: What's most important to negotiate for is obviously going to depend entirely on someone's life and career goals.
• 18:22
  SPEAKER_02: And so, while I can't say what's most important for an individual, I can give some general advice on contracts.
• 18:28
  SPEAKER_02: First of all, read the contract in its entirety and make sure you understand what it says.
• 18:33
  SPEAKER_02: I think a lot of people think, oh, you know, it's a contract.
• 18:36
  SPEAKER_02: It's kind of like those user agreements that we constantly sign.
• 18:39
  SPEAKER_02: You figure that it maybe you don't have to read it thoroughly.
• 18:42
  SPEAKER_02: Trust me, you should read it thoroughly.
• 18:45
  SPEAKER_02: And again, make sure you understand what it says.
• 18:47
  SPEAKER_02: A lot of people will have their contracts reviewed by lawyers.
• 18:50
  SPEAKER_02: If the lawyer is not familiar with healthcare, they're going to give you advice that may not be particularly helpful.
• 18:57
  SPEAKER_02: And I have actually seen that quite a bit.
• 18:58
  SPEAKER_02: I've seen people come back and ask for things to be changed that are meaningless.
• 19:03
  SPEAKER_02: The things I would pay a lot of attention to are non-compete clauses.
• 19:08
  SPEAKER_02: Non-compete clauses are now fairly standard.
• 19:10
  SPEAKER_02: You're not usually thinking about what happens if you would want to leave the job you're currently contemplating, but you should be thinking about that because if people are not necessarily staying in jobs like they did 20, 30 years ago for their entire lives, people do change jobs.
• 19:27
  SPEAKER_02: And you need to know if the non-compete clause is large, it may mean that you actually have to move out of the area to be able to take a new position.
• 19:37
  SPEAKER_02: So just make sure you understand that pretty clearly.
• 19:39
  SPEAKER_02: If you can negotiate to have the non-compete clause removed, I would definitely do that.
• 19:44
  SPEAKER_02: That can make your life easier in the future, but that's not always negotiable.
• 19:49
  SPEAKER_02: The other thing I think people just really need to be aware of is how long it actually takes to get a job and then to start that job.
• 19:58
  SPEAKER_02: Make sure that you give yourself plenty of time to do that.
• 20:01
  SPEAKER_02: It takes about three to four months to get credentialed at most places.
• 20:05
  SPEAKER_02: And if you're going to be working at more than one hospital, that credentialing may be sequential.
• 20:10
  SPEAKER_02: So you may not be able to actually start your work until all of that credentialing has taken place.
• 20:16
  SPEAKER_02: And also you got to build in time for actually doing the interviewing and the negotiation about the contract.
• 20:22
  SPEAKER_02: So make sure that you are starting your job search at least six months in advance.
• 20:27
  SPEAKER_02: Give yourself enough time to make sure that you're going to be able to find a position.
• 20:31
  SPEAKER_02: I think that's very important.
• 20:32
  SPEAKER_02: People are sometimes surprised by how long all of that paperwork takes.
• 20:37
  SPEAKER_02: Thanks.
• 20:38
  SPEAKER_02: Great advice.
• 20:39
  SPEAKER_02: Dr.
• 20:39
  SPEAKER_01: Rock, do you have anything to add?
• 20:41
  SPEAKER_03: Yeah, I think that's all terrific advice.
• 20:43
  SPEAKER_03: I do think it's really sitting down and understanding what are the important things to you.
• 20:48
  SPEAKER_03: For example, from my perspective, which would be somewhat unique, one of the really important things was visa aspect and being able to have a sponsorship path that would get me to a green card.
• 20:58
  SPEAKER_03: And so that was one of the critical essential things for me.
• 21:02
  SPEAKER_03: But they may be obviously different for different people, but there are some essential things, like the non-compete clause, for example, like what Dr.
• 21:09
  SPEAKER_03: Hanwin was mentioning, or some other things that really are going to be some deal breakers for you.
• 21:14
  SPEAKER_03: And so really having an idea about what those things are before you start any negotiation, I think is very important.
• 21:23
  SPEAKER_03: And then what I would say we ID physicians should be in demand, right?
• 21:28
  SPEAKER_03: We have, and especially healthcare epidemiologists, we're at the back end of a global pandemic.
• 21:33
  SPEAKER_03: We have a skill set that really all hospitals and healthcare settings need.
• 21:39
  SPEAKER_03: And so I think we should recognize the value that we bring.
• 21:43
  SPEAKER_03: And I know that negotiations and contracts can be difficult.
• 21:48
  SPEAKER_03: I certainly find it difficult.
• 21:50
  SPEAKER_03: And some of it also is you don't know what you don't know.
• 21:53
  SPEAKER_03: You don't even know what it is that is up for negotiations sometimes, or what are the things that you can ask for.
• 22:00
  SPEAKER_03: And so I would say, similar to what Dr.
• 22:02
  SPEAKER_03: Hanrahan was mentioning, talking with people that are in the positions, and that can be junior people as well, that have just started in the last couple of years.
• 22:11
  SPEAKER_03: And I think I've always found that people are very, in general, very giving with information because they it's not so long since they've been in that position themselves.
• 22:21
  SPEAKER_03: And so people can be very forthright with giving you information about what they did negotiate for, et cetera.
• 22:26
  SPEAKER_03: And certainly those things and more are open for you.
• 22:29
  SPEAKER_03: So I think thinking widely and asking others for information, including people who've recently started and people that have been in positions for a longer period of time can help you as you kind of negotiate your value.
• 22:42
  SPEAKER_01: Thanks.
• 22:43
  SPEAKER_01: And Dr.
• 22:43
  SPEAKER_01: Rock and Dr.
• 22:44
  SPEAKER_01: Henran, did either of you renegotiate anything in your contract after being on the job for a few years?
• 22:50
  SPEAKER_01: Dr.
• 22:50
  SPEAKER_01: Henran, maybe sounds like you did initially.
• 22:54
  SPEAKER_02: I renegotiated a lot.
• 22:56
  SPEAKER_02: But so, you know, I would have to say that my first contract was one page, you know, it which is kind of funny now when I go back and look at it.
• 23:05
  SPEAKER_02: It said nothing except we're offering you this position, you are employed at will.
• 23:10
  SPEAKER_02: And so I think that there was a lot of renegotiation.
• 23:14
  SPEAKER_02: But I would say what Dr.
• 23:16
  SPEAKER_02: Rock said is really important.
• 23:17
  SPEAKER_02: Talk to people, find out what they make that they negotiated for, realize that absolutely everything is up for negotiation.
• 23:25
  SPEAKER_02: Everything is.
• 23:26
  SPEAKER_02: So you you just need to be clear about what you actually want.
• 23:29
  SPEAKER_02: Now, don't be unrealistic.
• 23:31
  SPEAKER_02: You know, if you go in and say, I just finished training and I want half a million dollars a year and I only want to work 20 hours a week, that's not going to happen, right?
• 23:38
  SPEAKER_02: So you have to know what are the things that you really that are realistic and what are the things that are really the most important to you.
• 23:45
  SPEAKER_02: And just one last thing it's much easier to negotiate up front than to try to renegotiate.
• 23:51
  SPEAKER_02: Renegotiating is difficult.
• 23:53
  SPEAKER_02: Important point for sure.
• 23:54
  SPEAKER_01: Dr.
• 23:55
  SPEAKER_01: Reddy, what advice do you have about contracts and negotiation?
• 23:59
  SPEAKER_00: Sure.
• 23:59
  SPEAKER_00: I think this was touched on earlier, but just understanding your activities and what proportion of your time is going to be spent on them is really important.
• 24:07
  SPEAKER_00: And I think for public health jobs, actually the amount of clinical time is actually important and something that you should really be thinking about.
• 24:14
  SPEAKER_00: Obviously, if you're employed by the hospital, that's a different discussion.
• 24:18
  SPEAKER_00: But when you're employed by the public health entity, they might see value in you doing clinical time, but that's not necessarily their baseline.
• 24:26
  SPEAKER_00: And so you have to kind of come to them and say, I want to do clinical time or not, and be part of that interview and the negotiations.
• 24:33
  SPEAKER_00: So there's a wide range of things that you could do.
• 24:35
  SPEAKER_00: You could continue doing inpatient ID consults or seeing outpatients at clinics, you could do moonlighting, you could do nothing, right?
• 24:42
  SPEAKER_00: I mean, I think it's up to you to decide what you want to do, but make sure that you're advocating for what your ideal is.
• 24:49
  SPEAKER_00: I'd also say that our work in healthcare epi is by nature is very clinically minded.
• 24:55
  SPEAKER_00: So you'll always be thinking about ID diagnostics and antibiotic use, antibiotic stewardship, resistance elements and whatnot.
• 25:03
  SPEAKER_00: But what might be missing obviously is the patient contact.
• 25:06
  SPEAKER_00: And so you need to really think through what is the right balance for you.
• 25:09
  SPEAKER_00: And then especially in the long run, in terms of maintaining your clinical skills, you know, there could be time periods where you don't have a lot of clinical care, but in the long run, you'll have to try to figure out what's the right balance to ensure that I can maintain my clinical skills so I can go back to a clinical job if I want to, or just continue it in any form.
• 25:29
  SPEAKER_01: Thank you.
• 25:29
  SPEAKER_01: I think what all of you have highlighted is that it's an individualized path and understanding your goals and what's a priority for you is important.
• 25:39
  SPEAKER_01: Now I wanted to ask if any of you have advice on training opportunities, courses, or even skill sets that you think would be helpful for ID fellows or trainees interested in healthcare epidemiology.
• 25:51
  SPEAKER_01: So, Dr.
• 25:52
  SPEAKER_01: Reddy, I'll ask you to go first this time.
• 25:55
  SPEAKER_00: Sure.
• 25:55
  SPEAKER_00: Obviously, Shea has numerous training opportunities and courses from the Shea CDC training course in healthcare epidemiology, which is in the spring meeting, or online courses like the Shea CDC Outbreak Response and Training Program.
• 26:09
  SPEAKER_00: There's lots of resources on both CDC and Shay websites.
• 26:13
  SPEAKER_00: In terms of if you're interested in a career in public health, you should consider the Epidemic Intelligence Service or EIS.
• 26:20
  SPEAKER_00: It's a two-year fellowship specifically designed to provide training in applied EPI and public health.
• 26:26
  SPEAKER_00: EIS officers are in the front lines of public health, and the program is pretty well known for its investigative and emergency response efforts.
• 26:34
  SPEAKER_00: As for those listeners who haven't done ID fellowship yet, CDC is recently partnered with IDSA to create a joint ID EIS program to develop future public health leaders.
• 26:45
  SPEAKER_00: The joint fellowship begins with a two-year ID fellowship and then it continues with a two-year EIS program.
• 26:52
  SPEAKER_00: If you're looking for opportunities at the state and local health departments, several years ago CDC funded IDSA, Shea, and PIDS to create the LEAP Fellowship, L E A P.
• 27:03
  SPEAKER_00: This one-year fellowship is to support the training and development of ID physicians who's interested in a career and collaborating with academic healthcare settings and in public health.
• 27:15
  SPEAKER_00: The fellows get experiential learning and training in public health, healthcare epi, and native box stewardship with a goal that they'll continue a career kind of in the intersection between the healthcare facility and the public health entity.
• 27:28
  SPEAKER_00: I'd also mention that some states have their own EIS-like program.
• 27:32
  SPEAKER_00: So try to connect with your health department and see what opportunities might be available.
• 27:37
  SPEAKER_00: I know this podcast is focused on kind of ID fellows, but for the non-physicians of the audience, there's lots of other training programs that are also available in Healthcare Epi and Public Health.
• 27:48
  SPEAKER_00: So I encourage you to check out our website, check your health department's website, and just like we said before, start talking to people to hear about their jobs and what opportunities may be available.
• 27:57
  SPEAKER_01: Thanks, Dr.
• 27:58
  SPEAKER_01: Reddy.
• 27:58
  SPEAKER_01: That's a lot of great opportunities.
• 28:00
  SPEAKER_01: Dr.
• 28:01
  SPEAKER_01: Rock, do you have anything to add?
• 28:03
  SPEAKER_03: Yeah, I think those are all terrific opportunities and will give a lot of learning in healthcare epidemiology.
• 28:09
  SPEAKER_03: I think specifically for learning academic skills, like you know, study design, stats, more detailed EPI, et cetera, you know, most of the universities affiliated with the ID fellowship programs will offer some sort of master's program.
• 28:24
  SPEAKER_03: And those can be funded through the fellowship.
• 28:26
  SPEAKER_03: So that's a very important thing to understand when you go to interview for fellowship programs.
• 28:31
  SPEAKER_03: What are the opportunities for gaining some of these skills, et cetera?
• 28:35
  SPEAKER_03: And it will it be in a formal degree process?
• 28:37
  SPEAKER_03: And it doesn't necessarily have to be, right?
• 28:40
  SPEAKER_03: There's many of these classes that you can audit and you can gain the skilled without necessarily having to go through onerous exams, et cetera, et cetera.
• 28:47
  SPEAKER_03: So I think really exploring and understanding that can complement all the great training that Dr.
• 28:52
  SPEAKER_03: Reddy just alluded to.
• 28:54
  SPEAKER_01: Thank you.
• 28:55
  SPEAKER_01: And I know I think you mentioned and Dr.
• 28:56
  SPEAKER_01: Reddy mentioned that you both got master's degrees through your fellowship.
• 29:01
  SPEAKER_01: So, Dr.
• 29:01
  SPEAKER_01: Henren, anything else to add?
• 29:03
  SPEAKER_02: Yeah, I would just also mention that a lot of your training is actually going to be on the job through questions that you're going to get for which there are no guidelines.
• 29:11
  SPEAKER_02: So, one of the most important things, and Dr.
• 29:14
  SPEAKER_02: Rock mentioned this earlier, it is really important to have mentors.
• 29:17
  SPEAKER_02: So there's it's important to have mentors for research, but it's also important to have mentors who can help guide you in terms of how to deal with difficult situations.
• 29:25
  SPEAKER_02: You're going to have to give advice when you don't have all the information that you need.
• 29:30
  SPEAKER_02: So, probably the single most important skill is to know how to ask for help and just don't be afraid to ask for it.
• 29:37
  SPEAKER_03: I would just add one thing, actually, to what Dr.
• 29:39
  SPEAKER_03: Hanuman said that is really important that I forgot to mention the importance of the infection preventionist.
• 29:45
  SPEAKER_03: They are like, you know, have such a wealth of knowledge that you, as an early person understanding the field, you have so much to learn just by tagging along with them as they go through rounds because they really look at the world through a different lens.
• 30:00
  SPEAKER_03: And you need to be able to adapt that lens for yourself so that when you go onto a unit or into an operating room or any other area, you're seeing things through that lens.
• 30:10
  SPEAKER_03: And the only way, I think, just to your point, Dr.
• 30:13
  SPEAKER_03: Han, when it's really on the ground learning, is to actually be with an experienced IP and have them explain to you what it is they're looking at, what it is they're looking for, what their observations are, and asking questions and not being too afraid to be like nobody expects that you know all of this, right?
• 30:28
  SPEAKER_03: You're just starting off, it's a whole specialty area of its own.
• 30:32
  SPEAKER_03: And I think just being vulnerable and asking the questions, they're more than happy to share and very happy to have physicians and other people interested in the area.
• 30:41
  SPEAKER_03: So there's a huge amount to be learned from infection preventionists.
• 30:45
  SPEAKER_01: Thanks, Dr.
• 30:45
  SPEAKER_01: Rock.
• 30:46
  SPEAKER_01: Yes, as an early healthcare epidemiologist, I completely agree with your points there.
• 30:52
  SPEAKER_01: So just to conclude our podcast, I wanted to ask each of you if you had any final thoughts you'd like to share with our listeners.
• 30:59
  SPEAKER_01: So, Dr.
• 31:00
  SPEAKER_01: Rock, I'll actually start with you.
• 31:02
  SPEAKER_03: Final thoughts.
• 31:03
  SPEAKER_03: I would say from my perspective, the career I've had so far has been really rewarding and very satisfying.
• 31:10
  SPEAKER_03: Feels like I'm helping address important problems and working with a ton of people all interested in the same area to address the important problems.
• 31:19
  SPEAKER_03: And I think to some of the earlier points, that really helps give purpose to what I'm doing.
• 31:24
  SPEAKER_03: And that makes it easier to go to work and just more enjoyable.
• 31:28
  SPEAKER_03: And so I think trying to find that, and I think that can change as careers evolve, but keeping that to the fore, I think it helps keep you motivated and helps keep you thinking about the problems that are there to be solved.
• 31:41
  SPEAKER_03: And then I think finally, obviously, Shea is a huge resource for anybody that's looking to get into this area.
• 31:47
  SPEAKER_03: Such a mountain of experience within the Shea membership and then all the online education center, et cetera, there's just a huge amount of resource of information available to people that are looking to get into this area.
• 31:59
  SPEAKER_01: Thanks.
• 32:00
  SPEAKER_03: Dr.
• 32:00
  SPEAKER_01: Raddy, any final thoughts?
• 32:02
  SPEAKER_00: Yeah, I think even if you don't get a job with a public health entity, like you don't get a job at CDC or a state health department, I would encourage folks to maintain contact with your health department.
• 32:13
  SPEAKER_00: You can still provide valuable insights to those entities and who knows what might happen in the future.
• 32:18
  SPEAKER_00: Even if you're based at a hospital or another healthcare facility, there might be other opportunities that open up in the future that will appeal to you, or you might be able to do contract work with those health departments.
• 32:29
  SPEAKER_00: So maintaining contact, I think, is helpful in the future.
• 32:33
  SPEAKER_02: Thank you.
• 32:33
  SPEAKER_02: And Dr.
• 32:34
  SPEAKER_02: Hanorhan?
• 32:35
  SPEAKER_02: I just want to echo that healthcare epidemiology is really a great career choice.
• 32:39
  SPEAKER_02: It's a good way to get into leadership positions if people are interested in doing that.
• 32:43
  SPEAKER_02: And it's really rewarding.
• 32:45
  SPEAKER_02: Don't be afraid to take this type of job because you don't think that you have the training.
• 32:50
  SPEAKER_02: Just be eager to learn and know where to get help.
• 32:53
  SPEAKER_02: Be open to listening to people.
• 32:55
  SPEAKER_02: I would say that credentials are not really what's important when it comes to healthcare epidemiology.
• 33:00
  SPEAKER_02: Some of the most important information I've learned has been from listening to people in environmental services who knew a great deal more about some of the problems that were going on than I was aware of.
• 33:11
  SPEAKER_02: So just be sure that you're open to listening to others.
• 33:15
  SPEAKER_02: And especially, like Dr.
• 33:16
  SPEAKER_02: Rock said, the infection preventionists are a huge wealth of information.
• 33:21
  SPEAKER_02: So just know where to get help.
• 33:23
  SPEAKER_02: And I would encourage everyone in infectious disease to consider this.
• 33:27
  SPEAKER_02: It's one of the things that we have that really allows us to make a bigger impact than just on individual patients.
• 33:33
  SPEAKER_01: Wonderful.
• 33:34
  SPEAKER_01: Thank you, Drs.
• 33:35
  SPEAKER_01: Rock, Reddy, and Hanrahan, for such a fantastic conversation.
• 33:39
  SPEAKER_01: We appreciate you joining us today.
• 33:41
  SPEAKER_01: You can find more educational content like the podcast on Shay's online education center, learning CE at www.learningce.shay hyphenonline.org.
• 33:52
  SPEAKER_01: This concludes today's episode of the Leadership Management Series.
• 33:56
  SPEAKER_01: Thank you for tuning in.