Health care has the highest growth rate of any sector in the American economy and is in a period of rapid and dramatic change. These trends mean opportunity for Yale students who are about to embark on health careers.
Nearly 30 alumni, representing many sectors in health care, returned to campus to share their experiences and lessons learned in their career paths on Saturday as part of a Health Careers Panels for students from across the university. The Association of Yale Alumni and the Yale School of Public Health sponsored the afternoon-long event.
“The world you see when you walk out of the school today won’t be there in five years,” Paul Cleary, PhD, dean of the School of Public Health, told the gathering. “ I’ve seen more changes in health care in the last two years than in the last 30 years.”
Careers are not always linear paths, said keynote speaker, Mathew Spitzer, ’90 BA, MD, family physician and past president of Médicins San Frontières-USA (Doctors Without Borders). Crisscrossing between international and domestic organizations and clinical and leadership roles, Spitzer described two principles that he uses to advance health—the ethics of refusal and the idea of bearing witness.
Citing the fight against HIV in Africa in the early 1990s, when treatment cost as much as $15,000 annually per person, people working and living in affected countries refused to accept the economic and political barriers to medicine. They worked with governments and the pharmaceutical companies to reduce the cost to $1,500. HIV treatment in many disadvantaged countries is now affordable in low income countries.
In order to work in advocacy and policy at both the community and individual levels, it is also important for health workers to have empathy and to pay attention to the people in need, said Spitzer. Whether at a patient’s bedside, in a village facing an epidemic or with a family in a refuge camp or an urban slum, health professionals must connect with people authentically and be willing to speak publicly about what they see in the field. While these sound like feel-good concepts, Spitzer argued that they are active and operational concepts that continue to initiate change in his field.
In a panel on health, law and policy, Kenneth Legins, ’95 MPH, senior advisor of HIV Policy and Evidence for UNICEF, shared insights from years of fieldwork and management of domestic and international campaigns in HIV/AIDS and family planning. “The Age of Socratic learning is over. I need problem solvers; I am looking for the person who can operationalize the things science has already solved,” he said. The most critical part of a job interview, in fact, is at the end when a candidate asks questions that show that they are already thinking about how to do the job.
Legins also recommended that students follow the money when looking for opportunities. For example, now that scientists have demonstrated the effectiveness of pre-exposure prophylaxis (PrEP) against HIV, an incredible scale up of its implementation among family planning programs is poised to begin worldwide.
“To get a PhD, you solved a problem no one else did before. You can do it again,” said Rahul R. Prasad, ’87 PhD who urged students to have confidence in themselves and their abilities.
Anees Chagpar, MD, MBA ’14, associate professor of surgery (oncology) and director of the Breast Center at Smilow Cancer Hospital at Yale-New Haven Hospital said the most pressing issue facing health care in the United States today is figuring out cost and value. “The system has to change incentives and get greater outcomes at less cost.”
Chagpar and her co-panelists Alexandra Junewicz, ’08 BA, MD, and Richard Kayne, ’76 MD emphasized the revolution underway with electronic records and the obstacles and opportunities they present. For example, in an urban environment such as New York City where chronically or mentally ill patients may be admitted to one hospital after another, there is no easy way to share the medical records, as each institution uses a different system. In group practices, however, electronic medical records can provide a platform where doctors in different specialties can collaborate and therefore better coordinate adjustments in medications for the patient.
This event is one of several hosted by the Yale School of Public Health during its centennial year that recognize the innovation and inter-disciplinary collaboration required to advance health worldwide.
Grace Park, a student in the Yale School of Public Health, found the day helpful; it helped her integrate myriad interests in health care, such as population health issues and clinical care. “I wanted to know how other people approached that,” she said.
Christina Ramsey, a 5-year BA/MPH student in Yale College and the School of Public Health, agreed it was a valuable experience.
“I found the discussion incredibly useful in assuaging a lot of my fears about making right choices,” she said.
Holly P. Welles, PhD, ’88 MFS, and Rahul R. Prasad, ’87 PhD (Engineering and Applied Science), co-chaired the event.