Guest Blog: Pursuing a Career in Public Health and Medicine II (Janet's Story)

This week, MyHCN welcomes Janet Chu, giving her perspective on pursuing both public health AND medicine. 

“Why did you want to pursue a Masters in Public Health?”

Having recently started my Masters in Public Health (MPH) at Berkeley, I have been asked this question many times in the last few weeks. Even as I heard myself reiterating excerpts from my personal statement, I found myself thinking, “Why am I here?” And now that I am actually in the MPH program: “What do I expect to get from this year?” and “How will I be able to incorporate both public health and medicine in the future?”

I’m not really sure when the idea of public health crossed my mind.  My undergraduate classes focused on designing and developing innovative medical technology. But what I was particularly interested in was the social determinants of health and how these factors influenced access to both innovative technology (such as medical devices and surgical robots) and low-tech interventions (such as vaccinations) and the consequent implications on quality and cost of health care.  More and more, I found myself drawn to projects that assessed community needs and implemented community-level interventions to address those needs.

In between college and medical school, I participated in the VietFellows program as an Engagement Fellow.  During our time in Vietnam, we conducted needs-assessments on the lasting health and environmental impact of Agent Orange (a defoliant sprayed during the Vietnam War) and Dioxin (a chemical byproduct of Agent Orange) through on-site interviews with individual families, community organizations, and policymakers at the government level. Our work highlighted the history of Agent Orange/Dioxin, challenges of victims living with disabilities in Vietnam and the U.S., the current laws and humanitarian effects in remediation, and the parallels of dioxin and chemical exposures in communities in the United States. Although we identified significant health, social, and economic needs of those who continue to be impacted by Agent Orange/Dioxin and were impressed by the collaboration of organizations in Vietnam and the United States working towards addressing those needs, there is still so much more to be done. 

In medical school, I found myself searching for ways to incorporate public health into my clinical experiences. I was still drawn to the issues of access, cost, and quality of care, especially surrounding the area of biomedical technology. In between my first and second year of medical school, I worked on a clinical trial that evaluated the effectiveness of a mobile phone pill recognition application to help identify unknown medications brought to the emergency department. The ever-growing complexity of home medication regimens has led to an increased risk of patients taking incorrect pills, especially since it is estimated that there are about 30,000 deaths related to accidental poisonings each year. The goal of the project was to determine if using the mobile phone application with the capability of identifying these medications by taking a picture of the pills, would improve the quality and accuracy of care for patients. We also hoped that we could expand the potential use of the application to assist with low medication compliance, which is another issue that is a barrier to favorable health outcomes.

During my clinical rotations of third year of medical school, I noticed the often-discussed cultural and linguistic disparities in access to health care, especially at community sites. While I enjoyed caring for patients and addressing the medical issues for which they were seeking care, I spent a lot of my time addressing the social issues contributing to their medical situation, whether that was lack of medical insurance, food insecurity, housing instability, or dearth of social support. And over and over again, I was reminded that not enough is being done to address the widening gap of health care disparities. More and more, I began to realize that advances in medical knowledge and techniques are inadequate without parallel progress in health care accessibility and widespread health education. 

So, where do I see my life in 5 years? 10 years?

Well, in 5 years, I finally hope to be done with training. Though if I choose to subspecialize, it might be more like 10 years (sigh). Regardless, focusing more on how I imagine a career that integrates public health and medicine, I am honestly unsure. I want to do work on the ground, working as a clinician in an underserved/underrepresented community, determining their needs, and designing and implementing innovative solutions.  However, I am also interested in working at a policy level, integrating system-level changes to address disparities in health care delivery and outcome. 

Slowly, through my clinical and professional experiences, I have come to realize that a career that includes both public health and medicine is not static. It is dynamic and will continue to evolve as I gain clinical and community experience and am exposed to issues that I become passionate about and that empower me to take action. 

In the end, I want to be a clinician applying my knowledge of epidemiology and disease pathogenesis to create tailored solutions that take into consideration social, behavioral and environmental influences on community health. And how exactly will that look? Check back with me in 10 years.

About the Author:

Janet Chu graduated from Stanford University in 2010 with a B.A. with honors in Human Biology, with an area of concentration in Biomedical Technology and Public Health Policy. She is currently between her third and fourth years of medical school at UCSF and is pursuing a MPH at UC Berkeley. Janet hopes to combine her experience and skills from her medical education and MPH to evaluate the potential applications of biomedical technology, to identify and address the way in which socioeconomic and racial/ethnic factors influence access to such technology, and to examine the consequences for health care outcomes and health policy. As an undergraduate and as a medical student, Janet volunteered at health clinics serving marginalized and underserved populations both locally and internationally. Before starting medical school, she participated in a research fellowship that focused on conducting a needs-based assessment for victims of Agent Orange/Dioxin in Vietnam. Recently, Janet has partnered with an organization in Los Angeles to address increasing rates of obesity among the Asian-American Pacific Islander community by implementing an innovative community-supported agriculture program. In the future, Janet hopes to practice medicine with an awareness of the social determinants of health in order to improve the health of underserved and underrepresented communities.

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