Name: Raymond Francis Sarmiento, MD

Job Title & Company: Public Health Informatics Fellow, U.S. Centers for Disease Control and Prevention (CDC)

Location: I am the first and only CDC fellow based outside of Atlanta. I have been based in Cincinnati, Ohio since 2014 because I joined the fellowship program with a lot of health informatics experience primarily because of my prior NLM fellowship. The Public Health Informatics Fellowship (PHIF) program was looking to pilot test how to send out a fellow into the field, if you will, so they asked if I was willing and I said yes. They wanted to try and see if that could be a successfully proven approach in providing informatics technical expertise and support to CDC institutes located outside of Atlanta.  I would say that the whole experience has been a success so far, not only in terms of my work here within my institute (National Institute for Occupational Safety and Health or NIOSH) but also for the PHIF program as well.

How long you’ve been in your current job: Nearing the end of my two year fellowship at CDC

Postdoc Advisers, IC: Dr. Paul Fontelo (medical informatics training director at Lister Hill National Center for Biomedical Communications) and Dr. Clement McDonald, Director of the Lister Hill National Center for Biomedical Communications at the National Library of Medicine (NLM), U.S. National Institutes of Health

What was your career progression after NIH like?

After finishing my two-year postdoctoral clinical informatics fellowship at the NLM, I moved to an applied training fellowship on public health informatics over at the CDC. I’m currently at the CDC, doing work on occupational health surveillance, epidemiology, electronic health records, data analytics, and natural language processing.

What is your day to day like in this role?

The work that I do is a mixture of public health project management as well as conducting research on improving public health using informatics techniques and problem-solving frameworks. In a typical day, I connect with key project stakeholders, including the software engineering team, content development and management team, and internal and external users. On a near daily basis, I communicate the progress we have made on each of the projects to the respective project managers and team leaders. As a team, we work together on improving our health information systems, mostly occupational health surveillance programs and consumer tools, that have been developed here in NIOSH.

How did you find this opportunity?

It was something that I had known about prior to my NLM fellowship because I had previously applied to PHIF in 2010. When it was time to move forward with my career, I felt the need to gain more applied informatics training experience, particularly in public health, mainly because I wanted to expand my horizons in terms of being able to find and apply practical informatics solutions to real-world public health problems.

For individuals who are interested in a public health informatics fellowship, do you have any insights on what would make them a competitive candidate?

Being able to show that you possess a strong foundation in terms of understanding health informatics concepts and that you are competent in your statistical analysis skills are things that are strongly desired for PHIF candidates. A candidate’s willingness to learn is also a critically important qualification.  Aside from those, having previous research and/or evaluation experience will help the would-be fellow succeed in PHIF.

What is your favorite aspect of your current job?

My favorite aspect is being given the chance, on a daily basis, to gain valuable experience and exposure to the workings of public health surveillance and epidemiology as it is conducted in the United States. I value my time and experience here because I believe it will help me in the long term especially when I return to the Philippines, which is my home country. Working in one of the top public health institutions in the world and the premier public health agency in the United States has given the chance to collaborate with the top scientists in the field and this has helped me understand the best practices in terms of implementing informatics solutions to public health problems.

Your work sounds like an intersection of two very popular fields – public health and health informatics. So, what are you hoping to do next after your fellowship?

After the fellowship, I intend to return to the Philippines because I am highly interested in establishing the public health informatics field back home. At present, there are no companies or government agencies in the Philippines that focus on using health informatics frameworks and solutions to local public health problems. Another idea is to join the Philippines’ Department of Health as a public health informatics expert or maybe even be our country’s health informatics czar as the Philippines continues to develop and successfully its national long-term plans for e-health and telemedicine. In addition, I am also open to opportunities where I can apply both my clinical and research expertise, maybe in roles such as Chief Medical Information Officer, Senior Health Data Scientist, or Clinical Research Director who deals with clinical informatics projects.

What are the most important skill sets that you utilize?

Definitely, effective communication skills and the ability to constantly improve are critical skills one needs to use every day. By effectively communicating your message to your intended audience, particularly to key stakeholders and champions who will can greatly influence the outcome of your project, your project is likely to succeed and meet your target outcomes. I cannot emphasize this enough.

For somebody who wants to go down a similar path like yours and get more experience in both clinical and public health informatics, what would you recommend to them?

I would say that the most crucial thing for early career scientists is to identify a mentor or scientist who you would like to emulate or model your career after.  If you do your research and are able to realize that “Yes, this is the career arc that I want to experience... This is the career that would help me grow into the best version of myself as a scientist.”, then by all means do everything you can to try to connect with that individual. Take advantage of what you can learn from your mentors. Ask for the necessary support and guidance that you will need for you to be on your way to your desired career path. Another thing, especially for foreign nationals who are experiencing living in the United States for the first time, is to not be afraid to contact the “fathers” or “mothers” of your chosen field. Often, we feel intimidated so we hesitate in doing this, but you truly won’t know if they will be open or not to helping you unless you try. If everything falls into place, then you have taken that first big leap of working toward your goal to becoming the best scientist that you could possibly be. Furthermore, constantly improving yourself and looking for ways to build your capacity in areas where you feel you need to improve -- maybe in machine learning, maybe in regression analysis, whatever it may be – will contribute immensely to your future success.

When you look at your career to date, is there anything you wish you had done differently?

 probably would have applied for the NLM fellowship a few years earlier in my career. Being on the same career trajectory but on an earlier timeline, I would have likely been working on helping to improve the public health agenda in the Philippines a couple years earlier. But overall, I have no regrets, only a profound appreciation of what I have been given and how much I can contribute towards helping my home country.

OITE’s Career Options Series will give you a snapshot overview of different career paths. The goal of this series is to help you explore a variety of different options by connecting you to new resources.  A large part of making a good career decision is done by gathering information about that field.  We encourage you to follow up this online research by conducting informational interviews with individuals in each field. Search the NIH Alumni Database to find alums doing similar work.

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What is Science Education & Public Outreach? The field of Science Education and Public Outreach (E/PO) is an umbrella term that refers to the education and generation of public awareness of science and its relevant topics and methods. According to NASA, this encompasses increasing the general public’s understanding of engineering, technologies, and education, and engagement in improving the quality of scientific pursuits in these areas. Positions in E/PO arise in a wide variety of settings, including public and private primary and secondary education, zoos, museums, and both non-profit and for-profit companies and organizations. Hiring institutions typically hire candidates with bachelors, masters, or doctoral degrees, and a variety of skill sets are typically used, including science curriculum development, program management, teaching, research, and administrative work such as assembling educational material. Sample Job Titles Program Director/Manager OR Analyst/Coordinator/Specialist; Outreach Coordinator; Science Writer/Educator; Online Communications Specialist; Career Development and Outreach; Science Exhibit Developer; Teacher; Learning Coordinator; etc. Sample Employers Many universities and schools do science education and outreach, so those are great places to start. However, also remember to look at many professional associations as they often have a department dedicated to education and outreach. Additionally, consulting firms could be a place to make a contribution to this field. Just make sure the organization works with schools or agencies of interest to you.   University of Massachusetts Medical School University of Maryland SARE Research Macfadden George Mason University Society for Science & the Public Chemical Educational Foundation Galapagos Conservancy Mercy: The Mississippi Health Advocacy Program Campaign For Tobacco-Free Kids U.S. Department of Education The Schott Foundation for Public Education Burness BCS, Inc Montgomery County Department of Environmental Protection Cognitive Professional Services Inc. Savan Group Many, many more! COMMENT below with organization suggestions. Key Skills - Communication skills, including: presenting as well as writing - Teaching/Education - Scientific/Media Writing - Program Development - Website Development - Writing/editing - Multimedia outreach/communication - Publishing - Web design - Data analytics - Program management - Research methods and data analysis - Interpersonal communication skills Professional Organizations/ Resources American Association for the Advancement of Science Presidential Management Fellowship IRACDA Fellowship/Grant National Association for Science Teachers How to Find Jobs Higher Ed Jobs Chronicle of Higher Education OITE Resources How to Series on Career Education and Outreach Careers in Science Education and Outreach Handout

According to Chapman University’s Survey of American Fears, public speaking is the number one fear. For Americans, it beat out heights, bugs, snakes, flying, clowns, and even drowning!  So, given the anxiety surrounding public speaking, if you are reading this in North America, then there is a good chance that public speaking makes you a tiny bit nervous. In the world of work though, especially in science, you have to present all the time.  How then can you get over a public speaking phobia, especially if you are a self-described shy introvert? Here, we have compiled a list of relevant links which will hopefully give you some tips and even inspiration to tackle your next presentation with confidence:

1. Susan Cain, the author of the book Quiet – The Power of Introverts wrote a great article  for Psychology Today on “10 Public Speaking Tips for Introverts.”
2. “What Grey’s Anatomy Creator, Shonda Rhimes, Can Teach Us Introverts about Public Speaking” is a catchy title and a great article from Career Coach, Lindsey Plewa-Schottland on how she overcame her fear of public speaking. Hint: preparation was key!
3. Watch this TED talk on Secrets to Great Public Speaking to help you tailor your next presentation to make it go from good to great.

When trying to improve any skill, public speaking included, preparation and practice are two essential components.  If you are at the NIH, it might help you to get involved with the NIH Toastmasters Club, with open meetings every Friday at noon.  Toastmasters is an international organization with clubs and meetings all across the world aimed at helping you become a confident speaker and a strong leader. What has helped you get over public speaking anxiety? Let us know with a comment below.

Florida State University has a world-renowned career center which pioneered the Cognitive Information Processing theory.  According to Wikipedia, this “theory asserts that the major components involved in determining career decision-making and problem-solving effectiveness are the content and the process of career decisions. The importance of the content and process in career decision making can be described by using a metaphor of a recipe. To make a good dish (decision) one must have all necessary ingredients (content), and know how to follow cooking instructions (process).” Today, we are going to focus on the instructions or the process.  This process is something that everyone will continually navigate through their own career development. CIP theory has put forth a CASVE decision-making cycle to help understand this process. The CASVE Cycle is a good career decision-making model which focuses on action-oriented steps detailing what you need to do. In this cycle, the process is broken down into five stages. Communication – Analysis – Synthesis – Valuing – Execution (CASVE) COMMUNICATION “Identifying the problem or the gap” This could be anything from “I need to find a new job” or “I have to choose a major”. It is important to be as specific as possible when identifying the presenting issue. According to the model, communication often boils down to external cues (events, significant others) and internal cues (emotions, physiological responses, and avoidance behavior). ANALYSIS “Understanding myself and my options” This section focuses on self-knowledge like utilizing reflection, structured exercises, or even assessment instruments to gain more insights into your skills, values, and interests in order to gain more self-awareness. Knowledge about options can be gained by looking into more specifics about the options you have at hand. It might also be necessary to explore occupations, programs of study, and employers based on your skills, values, and interests which will help you understand the wide array of options available to you through your own personal filters/preferences. SYNTHESIS “Expanding and then narrowing my list of options” In this stage, you are trying to elaborate on your options in order to then crystallize them into a manageable set of options.  You are essentially checking for alternatives to see if there are other areas to explore.  You can generate occupational, educational, and employment options by doing interest inventories like the Strong Interest Inventory, or other informal assessments online, as well as by doing informational interviews. In the narrowing phase of this stage, you are tasked with identifying no more than three alternatives, occupational or otherwise. VALUING “Prioritizing alternatives” Your prioritization of your educational, occupational, and employment alternatives conclude with an identification of your tentative primary and secondary choices. This is accomplished by valuing the costs and benefits to: yourself, your significant others, your cultural group, your community and/or society at large. EXECUTION “Implementing my choice” This stage is about making a plan for implementing your tentative primary choice. Three key factors in beginning the execution of your choice include: 1. Reality testing 2. Preparation program and 3. Employment/Education Seeking.

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RESOURCES Florida State University has put many of its resources and handouts about the CASVE cycle online and they are free for the public to utilize. Take advantage of this handout which allows you to describe your own career problem solving and decision-making process using the CASVE Cycle. Another helpful resource is this exercise entitled "Guide to Good Decision-Making".  It goes into more depth about each stage and even gives examples so you have a sense of how to complete this on your own. Remember, that every decision will have its pros and cons. Very rarely is there a perfect decision to me made; however, hopefully this model will make you feel like you have taken the time to make a fully informed and well-contemplated career decision.

Last week, we talked about how you could use the CASVE Cycle to help you make a career decision. For visually inclined and/or visual learners, you might find this Decision Space Worksheet to be more helpful as it is a cognitive mapping exercise.  It prompts you to map out, visualize, and hopefully get clarity on your decision at hand. Here’s how it works.  On the first sheet, you should list all of the thoughts, feelings, circumstances, people, and/or events that are having an impact on the decision you need to make. Then, within the larger circle on the second sheet (depicted below), you should draw smaller circles that represent each listed item on your Decision Space Worksheet. Each circle should represent the magnitude or relative importance of the item. Florida State University has made their Decision Space Worksheet free for all to use. You can access it from their website. Here is a link to the worksheet.  For your reference, an example is depicted below focusing on career values: