Employment of Public Health Students: Looking to the Future.
This Dean’s Note is co-authored by Assistant Dean of Career Services Lisa Metropolis-Toby.
As we look ahead to our Commencement ceremonies next week and prepare to graduate another group of trainees, we thought it was an apposite time to look at employment of our graduates, both today and, perhaps more importantly, in the coming decades.
The School of Public Health currently enrolls 907 MPH students, 34 MS students, and 109 doctoral candidates. Our trainees come to us from 34 states and 52 countries and are the vibrant center of our school community. There is much that we aspire to give our trainees. We hope that during their time with us they will engage in a thriving, committed, and dynamic intellectual community where ideas are developed, discussed, and debated and contribute to the broader national and global public health conversation. We hope that they experience a diverse, inclusive, and welcoming environment where all members of our community can make a contribution commensurate with their energy and enthusiasm. And, we want to make sure that we prepare our trainees for employment, upon graduation, that suits their dreams and aspirations.
A previous Dean’s Note pointed out that the world’s public health needs are changing, and with that so must our educational programs. Part of that change must also be informed by our aspirations for our trainees, by a clear and principled perspective on the type of experience we wish to create for our students, and also by the end-goals that our students seek from our education. Put more simply: What are the jobs we are training our students for today? What will those jobs look like 15 and 30 years from now during our students’ working lives?
We start addressing this question by considering our current graduates and their employment paths. Our graduates currently are employed across a wide range of sectors, including local health departments, federal and state government agencies, healthcare delivery systems, nonprofits and NGOs, academic institutions, and healthcare consulting firms. SPH alumni are also employed at pharmaceutical and medical device companies, improving global access to treatment and making meaningful contributions on the payer side by developing evidence-based strategies and programs. Figure 1 shows where our graduates were employed in 2014.
The large number of MPH graduates from our programs dominates our employment patterns. A narrower look at our Master of Science and doctoral graduates shows that, among that cohort, graduates hold positions in academia, government, pharmaceutical companies, health economics outcomes research firms, NGOs, health delivery systems, public health consulting firms, and nonprofit organizations. I shall comment in a future Dean’s Note about the role of research education in a graduate academic school of public health; today we focus much of this Dean’s Note on employment principally among our MPH graduates.
Figure 1 presents a compelling picture of employment among our graduates, one where our graduates are working predominantly within public health but are engaged in a variety of “functional” areas or “job types,” expanding well beyond traditional roles as epidemiologists, state or local health officers, and community health advocates. Public health graduates are finding roles in program management, business development, consulting, health economics, quality improvement and new population health management roles are cropping up as societies, organizations and individuals increasingly focus on population health and healthcare as a key concern.
As the public health employment picture diversifies, it then behooves us to wonder: What will the public health jobs of the future look like? What employment should we be preparing our graduates for?
Expert thinking in the area, perhaps most succinctly captured by the Association of Schools and Programs of Public Health Framing the Future report suggests that a decreasing percentage of MPH graduates will be employed in traditional public health agencies while an increasing percentage will be employed in a wide range of settings, including other government agencies, health care delivery organizations, insurers, drug and device makers, and others.
There are other harbingers of how our graduates’ employment landscape may shift. Domestically, President Obama signed the Patient Protection and Affordable Care Act (ACA) on March 23, 2010. This has created an influx of positions centered around the ACA’s goals to improve access to care; improve quality and lower healthcare costs; and create new consumer protections. Other shifts include our changing demographics. According to The National Health Care Workforce Commission, established by the ACA to play a central role in formulating a national strategy for bolstering the health care workforce, it is estimated that by 2030, 3.5 million additional healthcare professionals and direct-care workers will be needed in order to meet growing demand for care. The rise in public health-related jobs, as measured by jobs posted on Indeed.com (search term: Affordable Care Act Public Health) has increased as much as 1,000 percent in 2013, and is at a current increase of 400 percent since the Affordable Care Act’s passage in 2010.
This therefore suggests that public health graduates will be employed, going forward, in an ever-greater diversity of sectors drawing on their public health training. The next question then becomes, why will employers hire our graduates, and how should we be preparing our graduates for employment going forward?
On the first point, we routinely conduct interviews with potential employers. Interviews with employers including the Beth Israel Deaconness Medical Center, Blue Cross Blue Shield of MA, Massachusetts Department of Public Health, John Snow Inc., and Evidera suggest that our students and graduates are prepared to succeed in today’s critical public health roles. Our colleagues in these sectors note that our students:
“Have the skills necessary to do the jobs they have, and to move beyond them.”
“[Are] engaged, informed, and high quality.”
“[Are] qualified, capable, and prepared for the workforce—continuously growing into new challenges.”
“[Possess a] caliber … unmatched in terms of their intelligence, skills, experience, and expertise.”
“[Are the] best and the brightest.”
This is heartening, and a terrific testament to our trainees and instructors. It suggests that we do well by our responsibility to transmit the knowledge we generate in the school by ensuring that our students are scrupulously well-trained and prepared to meet the challenge of the work force they are entering.
In an effort, though, to think ahead, we have also been asking employers and alumni the following question: “As you look to the future, what are the changes MPH graduates should be prepared for?” Summarized below some of the common themes that emerge from these interviews, together with excerpts from their responses.
Solid grounding in public health content: “Know the issues/aspects of public health—why is it a problem? Understand the distinction between prevention and intervention. Sound epidemiology skills. Mix of quantitative and qualitative skills. Know how government works.”
Management and leadership: “Given the current trends toward accountable care organizations (ACO) and patient-centered medical home (PCMH) (i.e. patient centered care), it behooves us to teach students about leadership and management.”
Project management: “The ever-changing healthcare landscape has caused clients to want results in shorter periods of time, sometimes two weeks. Must be able to put a project plan in place, prioritize, work quickly and efficiently, and deliver high caliber.”
Communications and interpersonal skills: “Collaborative to work in team, but also self-directed. Ability to communicate professionally, be respectful, and take constructive feedback well. Be prepared for the job to change; expect to be asked to do something completely different than your original role.”
Making the ROI argument: “We are facing changes due to ACA (Chapter 224, Cost Containment Bill). All state health departments are under the gun. We must demonstrate return on investment more than ever, and NOT 5 OR 10 YEARS OUT. We must show short-term gains. We are talking about creating a health economist role here at DPH. For future MPHs, they should have good sense of healthcare finance.”
Deeper “Big Data” analysis: “We’re looking for smart people who can go beyond ‘looking at the data for the sake of the data.’ They need to translate it into recommendations. It could be related to new programs, new pricing, etc.” This was also echoed at the Annual Devex International Development Career Forum attended by more than 65 international development organizations in March 2015. One of the key takeaways: Big data is permeating every aspect of global development work.
High proficiency with technology: “We expect consultants and research analysts to not only analyze the data; they should be able to do queries, and ideally have programming skills. This is no longer just the SAS Programmer’s role.”
Our assessment is that employers are looking for trainees who are well-suited to a rapidly changing health environment, and who have training that combines both the core content of public health—the understanding of the essentials of public health training—with professional development and practical experience that prepares them for a dynamic, complex workforce. Our revised BU MPH, subject of a previous Dean’s Note, outlined changes to our MPH that well reflect these anticipated trends in employment and needs of our students’ employers. As we noted in that Dean’s Note “The BU MPH aims to ensure that graduates are competent in the knowledge and skills required for professional public health practice and are also well-informed, intellectually curious, and prepared for lifelong learning. The BU MPH provides training for both a first job and a foundation for a successful career in public health. It is interdisciplinary, practical, and adaptable to the needs of the students and their future employers and reflects the School’s mission to improve the health of populations locally, nationally, and internationally.” It is our aspiration that our MPH reflects the needs of both our students and our employers, with an aim towards creating the best possible workforce that can address the pressing public health challenges of both today and tomorrow.
I hope everyone has a terrific week. Until next week.
Warm regards,
Sandro
Sandro Galea, MD, DrPH
Dean and Professor, Boston University School of Public Health
@sandrogalea
Acknowledgement. We would like to acknowledge the help of Associate Dean of Education Lisa Sullivan on this Dean’s Note and of the entire Career Office on their work with student employment.
Previous Dean’s Notes are archived at: https://www.bu.edu/sph/category/news/deans-notes/