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March 14, 2021

Reflections on a Conversation with Dr. Margaret Hamburg: Career Shifts and Work Straddling the Fields of Medicine, Public Health, and Policy

By Lydia Good (C’21)

On Tuesday, March 9, 2021, Dr. Margaret Hamburg joined the Conversations in Global Health class for a discussion spanning the many facets of her career, from her early medical training to her recent work as FDA commissioner, founder of the Nuclear Threat Initiative, and foreign secretary for the National Academies of Medicine. Dr. Hamburg began the conversation by reflecting on her career path, particularly how her experience as a medical student at the beginning of the AIDS epidemic fostered her interest in public health and ultimately led her to leave her residency in New York to learn more about health policy in DC. Her move was a sudden shift from the career in academic medicine she was pursuing, but, as a basic scientist interested in policy, I appreciated that Dr. Hamburg was not looking to abandon her interests in medicine. Instead, she wanted to contextualize how medicine related to other issues like public health, social justice, law, and policy.

Dr. Hamburg remarked that the coronavirus pandemic may have a similar transformational effect on members of our generation as the AIDS epidemic did on hers. Indeed, an 18% increase in medical school applications in the 2020 cycle, dubbed the “Fauci effect,” has already been credited to COVID-19. For me, however, medicine is not the only field that has stood out during the pandemic. Basic and translational research, as well as public and global health and health policy, have all contributed enormously in response to the pandemic. Through my own engagement with the past year’s events, I have sharpened and expanded my understanding of the concept of social determinants of health—how socioeconomic status not only affects one’s access to quality health care, but also an individual’s underlying health and the health risks they face. This new understanding has piqued my interest in public health and health policy.

As I look forward to a career in basic scientific research, I am focused on studying biological systems in ways that could have long-term impacts on health care and public health by contributing to therapeutic development. But when envisioning my career, I struggle to balance my focus on the science of health and disease with the urgency of the problems that individuals face day in and day out. Though I might contribute to the development of new therapeutics, if the infrastructure to provide new treatments to individuals is lacking, then my work will not have the impact I imagine. At best, its benefits would be limited by logistical shortfalls, and at worst it could exacerbate existing inequalities in health and disease. Realizing the limitations of scientific advances has challenged me to consider other elements beyond research, namely elements like health care policy, global health cooperation, and supply chain management, that are needed to truly make an impact on individuals’ health.

Through our conversations with global health leaders like Dr. Hamburg, I am coming to appreciate the interplay between science, medicine, policy, and health, which spans many disciplines and institutions. The issues that health policy addresses are more immediate than those tackled by many research scientists, and they are complex in their own ways. The coronavirus pandemic has raised many policy questions, such as how to distribute limited resources, how to improve access to high-quality information, and how to manage public trust in scientific findings and health officials. As I watch governments work to answer these pressing questions, many of which involve not only policymakers and doctors but also researchers, I wonder whether I could make an impact on the issues that public health policies address. In considering my new interests in public health and policy and the many paths my career could take, I am inspired by Dr. Hamburg’s wide-ranging curiosity and her independence in forging her career path.

Lydia Good (C’21) is a senior studying biochemistry and math and a student in the Conversations in Global Health course. She is also a student researcher in single-molecule biophysics in the Maillard Laboratory.