Practicum Profiles
Lili Warren
Certificate: Public Health Research Methods
Practicum: Sexual and Reproductive Health Branch Intern
Practicum Position: United Nations Population Fund (UNFPA)
1. WHAT WAS YOUR PRACTICUM POSITION? WHAT TYPE OF WORK WERe YOU DOING THERE?
I was working in the Sexual and Reproductive Health Branch, part of the Technical Division, at UNFPA, the UN agency whose mandate is to improve sexual and reproductive health and promote sexual and reproductive health choices around the world. My principal task was to help develop an official guidance document on out-of-school Comprehensive Sexuality Education (CSE). CSE is a form of sexuality education promoted by the UN that touches on the mental, social, physical, and emotional aspects of sexual and reproductive health – basically everything ranging from sexual orientation, to violence and harm, to relationships, to desire, to sexually-transmitted diseases (STDs), to respect. In January 2018, UNFPA launched a technical guidance on CSE that discusses the evidence base around CSE and offers recommendations on content and methodology for planning and implementing CSE programs on a global scale. UNFPA plans to launch a new technical guidance on out-of-school CSE as a complement: this one will focus on recommendations around content and methodology of CSE programs for particular groups of vulnerable young people who would likely receive CSE outside of a formal school context. These include LGBQ+, transsexual, and Indigenous young people, young people who use drugs, young married girls, and young people who sell sex. I was tasked with developing the sections for two such groups: young people with disabilities, and young people in prison. Through research (via a literature review in a field where the literature is scarce), identifying experts and self-advocates, and reaching out to them by phone and email, I compiled as much information as I could on how to adapt CSE to address the needs of these groups. My goals were not only to draft comprehensive guidelines, but also to build solid partnerships with external organizations and field experts for UNFPA’s future work in this area.
2. WHAT weRE SOME UNEXPECTED THINGS YOU’VE LEARNED?
I learned that being resourceful and proactive are key skills, including in a professional environment that is restricted by bureaucracy, embedded within global politics, and dependent on multicultural conversation. Systematically reaching out to and collaborating with various staff members, fellow interns and consultants, and even staff from other UN agencies, were the most compelling and rewarding experiences. Doing so, I was surprised to find out that while several branches within UNFPA had overlapping projects (e.g. another branch was working on gender-based violence affecting people with disabilities while we were working on CSE for people with disabilities), there were few opportunities for direct knowledge and resource sharing. I learned that these were opportunities to cooperate and create platforms for exchange, even internally. I was also surprised to find out how much interns were respected and encouraged within the agency; this is in line with UNFPA’s publicly stated efforts to value young people, both internally and externally. Throughout my practicum, I felt empowered to speak up and that my work was truly appreciated. A flat hierarchy was not necessarily what I was expecting to discover as an intern at the UN, so I was definitely very pleasantly surprised by the wonderful experience I had as a valued member of the team.
3. HOW DO YOU APPLY WHAT YOU HAVE LEARNED IN SMS TO THE WORK YOU weRE DOING?
Overall, throughout my research and professional interactions, I found that a better understanding of the social and economic determinants of health helped me make sense of the underlying factors at play in young peoples’ lives. Qualitative methods were also an extremely important foundation for me in my practicum work. While I was drafting guidelines and putting together evidence from research and conversations with experts, I felt these tools helped me to capture the nuances and to summarize more effectively the lived experiences of those I was reading about or with whom I was speaking. It was also a challenge to develop a guidance document at the global level when most of the existing research has been conducted in Western countries. Reflexivity, cultural sensitivity, and relativism, all of which I had practiced in Qual, were some of the things I tried to keep in mind throughout my work. Quantitative foundations were also helpful in understanding some of the literature I examined. More generally, the spirit of interdisciplinary collaboration and mutual respect, the focus on improving the health and well-being of the most vulnerable, and the desire to disseminate knowledge worldwide to promote evidence-based practice, were all SMS foundational values that I carried with me throughout my summer.
4. HOW HAS YOUR PRACTICUM INFLUENCED OR CONTRIBUTED TO YOUR CAREER GOALS?
Working in an international organization, and particularly the UN system, is definitely something that I would love to do long-term. While working at the global level did feel at times removed from local challenges on the ground, I was driven by UNFPA’s commitment to collaborate with field partners and involve the community in its work. And I learned a lot about international research, advocacy, policy, and diplomacy. It was inspiring to serve within an organization that has such a powerful mandate, with people from all over the world, working on projects that have such wide-scale impact globally.
Micaela Gladney
Certificate: Epidemiology of Chronic Disease
Practicum: Intramural Research Training Award Fellowship Intern
Practicum Position: National Institute of Environmental Health Sciences – Epidemiology Branch
1. WHAT waS YOUR PRACTICUM POSITION? WHAT TYPE OF WORK weRE YOU DOING THERE?
I was selected for an Intramural Research Training Award fellowship for the 2018 Summer Internship Program in the Epidemiology Branch in the Division of Intramural Research at the National Institute of Environmental Health Sciences. I worked with primary investigators who are apart of the Social & Environmental Determinants of Health Equity Group. Their focus is on environmental disparities research. Specifically, I investigated the relationship between early life and adulthood chemical hair product usage (as a proxy for hair maintenance patterns) and physical activity among African American women. We conducted a cross-sectional analysis based on data from the Study of Environment, Lifestyle, and Fibroids (SELF).
My responsibilities included conducting literature reviews, analyzing data, drafting manuscript sections, and presenting preliminary findings during poster sessions. I am now working with my PI’s as a co-author in drafting a final manuscript for the research we’ve conducted.
2. WHAT weRE SOME UNEXPECTED THINGS YOU’VE LEARNED?
The most salient takeaway I have learned from this experience is the importance of flexibility in conducting epidemiologic research. When performing a secondary analysis of existing data transparency is key. Often times there are several people involved in the data analysis and manuscript writing process. Their feedback is important to ensure soundness in your research design and analysis. Therefore, you are constantly weighing and implementing changes, while still making sure that you are meeting your assigned deadlines.
3. HOW DO YOU APPLY WHAT YOU HAVE LEARNED IN SMS TO THE WORK YOU weRE DOING?
I was given the opportunity to engage in groundbreaking research around a topic that lacks prior quantitative studies. Therefore, I utilized my knowledge about health determinants and disparities to contribute to the research we conducted. My foundation in quantitative research methods also proved to be helpful to me. I was able to apply this knowledge when creating analysis plans, analyzing data, and interpreting results.
4. HOW HAS YOUR PRACTICUM INFLUENCED OR CONTRIBUTED TO YOUR CAREER GOALS?
I am pursuing a career in the medical field, specifically pediatric cardiology. Working at the NIEHS was a great opportunity for me to engage in some of the research that I will be utilizing and building upon throughout my professional career as a physician. My practicum experience has helped me to further understand the importance of research around the determinants of the morbidity and mortality of chronic diseases in low income and minority populations for clinical work. Specifically, when looking at disparities in the prevalence and outcomes of chronic diseases. The practicum experience also gave me the confidence to further explore the epidemiologic research as a part of my professional goals.
Sarah Goddard
Certificate: Dual Degree - SIPA
Practicum: Abt Associates, International Development Division
Practicum Position: International Health Analyst Intern
1. WHAT is YOUR PRACTICUM POSITION? WHAT TYPE OF WORK aRE YOU DOING THERE?
As an International Health Analyst Intern, my primary responsibility is to support the USAID-funded Health Finance and Governance (HFG) project in the Eastern and Southern Caribbean. I have been most involved with working with the governments of Barbados and Trinidad and Tobago and local stakeholders to develop sustainability plans for the HIV response in the region as countries transition from PEPFAR and Global Fund funding. I have been conducting literature reviews on health systems, setting up meetings with stakeholders, and drafting content and recommendations for the sustainability plans. I was also able to travel to Barbados to support this project! My other responsibilities at Abt include supporting internal knowledge management processes and building the business development pipeline for the division focused on health systems strengthening.
2. WHAT weRE SOME UNEXPECTED THINGS YOU’VE LEARNED?
I was really surprised by how much I enjoyed working in the private sector. I had never considered the private sector for a career in global health and international development but this experience has totally changed my perspective. I also learned how important it is to be able to learn on the job; courses and past experiences truly build up skills and knowledge that may not seem related to the job but actually come in really handy when accomplishing tasks like literature reviews, interviewing stakeholders, and writing reports. Finally, I discovered how challenging and demanding traveling for work is, and how difficult it is to actually see much of the country you're working in when you're there for work.
3. HOW DO YOU APPLY WHAT YOU HAVE LEARNED IN SMS TO THE WORK YOU arE DOING?
My focus for the HFG project was on building capacity for civil society organizations that provide important HIV services to vulnerable and key populations. Having a foundational knowledge of the social determinants of health was critical for understanding that key populations (including MSM, trans, and sex workers) face unique challenges in accessing services. Being able to provide policy recommendations and write reports for our client was heavily influenced by the theories and skills taught in SMS. Working on group assignments and with diverse classmates in SMS also helped me to be able to effectively work with my team of Abt colleagues.
4. HOW HAS YOUR PRACTICUM INFLUENCED OR CONTRIBUTED TO YOUR CAREER GOALS?
My practicum has confirmed my desire to work in global health and international development, and has opened up the possibility of looking at careers in the private sector. It was reassuring to see how my MPH and my other degree in International Affairs complement each other and how I will be able to apply the skills from both programs in my future career.
Megan Urry
Certificate: Accelerated Program
Practicum: ICAP at Columbia’s technical HIV support programs in Central Asia
Practicum Position: Next Generation Intern
1. WHAT waS YOUR PRACTICUM POSITION? WHAT TYPE OF WORK weRE YOU DOING THERE?
I worked for ICAP, Columbia’s global health organization, as an intern supporting their HIV mitigation programs in Central Asia. I was based in their Almaty, Kazakhstan office but assisted with projects in Kyrgyzstan and Tajikistan as well. All of the work I contributed to focused on three objectives: strengthening HIV care and treatment for people living with HIV/AIDS, improving medication-assisted therapy (MAT) for people dependent on opioids and who inject drugs, and implementing surveillance technology that better tracks and manages care for patients and their healthcare providers. I helped evaluate these programs, contributed to reports, analyzed data sets and visited the facilities in each country to speak to patients and healthcare staff about their work.
My primary focus was on evaluating and creating project documents for two programs – one that strengthened the technical skills of nurses providing treatment to people living with HIV and/or who inject drugs, and another that brought together MAT (medication assisted treatment, which combines behavioral therapy and medications, like methadone, to treat substance use disorders), tuberculosis and HIV treatment services together in one place. These services were in entirely separate facilities under the Soviet healthcare system (pre-1994), which created a lot of barriers to treatment for patients who needed medical attention for all of these conditions, so ICAP is working with each country’s Ministry of Health to integrate them and make treatment more accessible.
2. WHAT weRE SOME UNEXPECTED THINGS YOU’VE LEARNED?
One major driver of Central Asia’s HIV epidemic is injection drug use and opioid dependence, and the sub-field that addresses these issues – narcology – is not one that I had had much exposure to firsthand before my practicum, despite studying America’s own afflictions with opioid addiction at Mailman. I was initially surprised to see an embrace of MAT there because of the stigma and conservative legislation around drug use and sex work in this region, much like parts of the US. There is still a lot of debate there about whether MAT programs should even exist (again, the same ones we have in the States: “Why are we spending tax money on criminals?”) but these treatment programs will thankfully continue despite sentiments like these. Knowing that these issues are not unique to the US doesn’t give me a ton of comfort, but seeing such progressive strides here, where most Americans wouldn’t expect them to exist, does give me some solace and hope that governments around the world will support and fight for harm reduction initiatives in the future.
I read lots of texts and papers on the successes and failures of MAT and addiction counseling programs and needle exchanges, big pharma’s role in prescription drug abuse in the US, etc. because of the work I was a part of in Almaty. Every time I travel I learn about some facet of the United States from a fresh perspective, and while I certainly didn’t expect to learn so much about the evolution of my own country’s opioid epidemic when I went abroad this summer, that’s exactly what happened.
3. HOW DO YOU APPLY WHAT YOU HAVE LEARNED IN SMS TO THE WORK YOU weRE DOING?
So many theories that we discuss in our social determinants of health classes are applicable to this work. Behavior change principles are key to incentivizing groups of people to seek out and adhere to medical treatments for HIV, TB, etc., and many of the presentations and documents I helped senior staff develop (subtly and sometimes overtly) combatted the moral arguments against supporting harm reduction and drug treatment programs. Who is deserving of social benefits, and who isn’t? I was in Kazakhstan during serious heated political debates about whether to shut down their MAT programs because they directly benefitted people engaging in criminal behavior, and I felt that it really fed back to our discussions about who has the most and least social capital to expend in order to protect their own interests. Systems thinking played a big role in this work too because of how many factors from the top down have impacted health outcomes for key populations there.
4. HOW HAS YOUR PRACTICUM INFLUENCED OR CONTRIBUTED TO YOUR CAREER GOALS?
My quantitative and qualitative research classes really helped me contribute to program evaluations and work with data sets correctly. Culturally and otherwise, my experiences in Kazakhstan made me grow by another dimension professionally. I had the privilege of interviewing and listening to patients talk about how methadone let them wean off their addiction safely and in a supportive environment and ultimately live healthfully. I found such profundity in our conversations that I never would have gotten from a classroom, and it has made me want to work in addiction circles in the future. There needs to be more literature and proof that programs like these work, if even just to convince the powers at be that they should continue to be funded, and I intend to help produce it.
Hector Sanchez Perez
Certificate: Health Policy & Practice
Practicum: Market Performance Fellow
Practicum Position: Massachusetts Health Policy Commission (HPC)
1. WHAT waS YOUR PRACTICUM POSITION? WHAT TYPE OF WORK weRE YOU DOING THERE?
This summer I was a fellow for the Market Performance Team of the Massachusetts Health Policy Commission (HPC) located in Boston. My main project focused on the Massachusetts Registration of Provider Organizations (MA-RPO) Program which is a first-in-the-nation healthcare initiative that the HPC oversees. Specifically, I developed a research report that made recommendations for MA-RPO data release that can be useful for patients, providers, payers, journalists, policymakers, and researchers. This project had three components: (1) examining what Massachusetts and other states have done in data release and visualization for provider data, (2) exploring identified data visualization and release gaps from previous Massachusetts stakeholder interviews, and (3) developing recommendations for a potential MA-RPO data release tool. My recommendations will be useful as the HPC finalizes its plan for releasing data collected by the program in a more user-friendly and interactive way.
Additionally, I developed a logic model that communicates complex MA-RPO data elements in a more straightforward manner to audiences that are unfamiliar with intricate healthcare terms. This will assist HPC staff in communicating the relationships of certain data elements that are collected in the MA-RPO Program.
2. WHAT weRE SOME UNEXPECTED THINGS YOU’VE LEARNED?
Working at the HPC this summer was truly an invaluable learning experience that allowed me to pursue my interests in public health and the healthcare field. Prior to the fellowship, I had no experience working in a state agency that is dedicated to research and policy making processes to improve healthcare systems. My experience at the HPC has allowed me to see first-hand how the different executive, policy, and program teams collaborate and work towards allowing Massachusetts to have better health, better care, all at a lower cost.
I also learned the complexity and magnitude of a large health system at the state level. Massachusetts is one of the few U.S. states that currently has universal healthcare coverage and has implemented several measures towards cost containment. My summer fellow project at the HPC allowed me to see the contracting and corporate relationships of the largest hospital systems in Massachusetts such as Partners Healthcare, Beth Israel Deaconess Care Organization, and Lahey Health System among others. Therefore, I was able to learn how the Massachusetts healthcare market has changed over time as well as getting a snapshot of the number of practicing physicians in the state with their respective specialty.
3. HOW DO YOU APPLY WHAT YOU HAVE LEARNED IN SMS TO THE WORK YOU weRE DOING?
My SMS coursework was important for my project during my summer fellowship at the HPC. Specifically, I utilized the skills I learned from the Qualitative Research Methods course in order to analyze the Massachusetts healthcare stakeholder interviews for my report. Through thematic analysis and memoing, I was able to piece together common themes that were stated by the stakeholders that guided the methodology for my research report.
Additionally, the Evaluation of Health Programs course taught me how to develop a plan for evaluation that guided my thinking for my research report. The skills I obtained from that course allowed me to explore how to improve an already successful initiative such as the MA-RPO Program.
4. HOW HAS YOUR PRACTICUM INFLUENCED OR CONTRIBUTED TO YOUR CAREER GOALS?
My practicum experience allowed me to see the policy making processes in action and how a forward thinking agency is invaluable to reforming healthcare. The HPC is an independent state agency that is only focused on providing healthcare data without sway from politics. Looking back, this is something that was refreshing and unique.
My future aspirations in my career is to attend medical school and eventually combine health policy, public health, and healthcare as a future practitioner. I believe that my experience at the HPC allowed me to envision how a successful agency operates in addressing healthcare costs while also improving quality and access to care. I hope one day I can work in this type of environment or even create a program or agency that is similar to HPC.