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Epidemic intelligence service officer: What I do and how much I make

Dr. Matthew Goers shares how he is using his medical training and passion for public health to combat diseases around the world. Learn about his joint roles as an Epidemic Intelligence Service Officer for the Centers for Disease Control and Prevention and a Lieutenant Commander in the US Public Health Service. The use of images from the Centers for Disease Control and Prevention (CDC) does not imply endorsement of Khan Academy or the information contained herein by the CDC.

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Video transcript

My name's Matthew Goers. I am 29. I am an Epidemic Intelligence Service Officer at the CDC and a Lieutenant Commander in the United States Public Health Service. So the Centers for Disease Control and Prevention, or CDC works 24/7 to basically protect and promote the health of the country. They do this through not only being embedded in state health departments, but also working at national level to address different types of public health threats to the American populous. So this could be anything from putting out small, little outbreaks, like an outbreak of say salmonella or flu in your local community to more national crises such as you're responding to the hurricanes that have recently hit, but also responding to the opiod crisis that's been affecting our country. So the CDC has been embedded in a lot of different parts of the United States Health care system. So I'm part of the United States Public Health Service, which is the military branch under the Surgeon General and the Assistant Secretary of Health. The Public Health Service is embedded in a lot of the different institutions in the United States. Not only in the CDC, but the NIH, the Indian Health services, the Federal Bureau of Prisons. Public Health Officers have been both active in the responses that FEMA has had to a lot of the hurricanes, but also has been involved in other responses internationally, like the Ebola response. So Public Health Services is one of the non-armed services. So there's the five armed services who everyone thinks of and two non-armed services, that's ourselves and NOAA. Epidemiology is the study and analysis of public health ... health determinants and distributions. Basically people who work on the population level to address public health issues, whether that be something that's more like an epidemic, like the flu or something that's more endemic in a population, like obesity or diabetes. They try and address these through, not only investigating the causes, but designing and making recommendations for interventions at the population level. I'm part of the Epidemic Intelligence Service or EIS here at the CDC. So EIS is sort of like the country's disease detectives. It's been around since the 1950s, has trained about 3,500 epidemiologists to kind of be on the front lines to put out different types of public health threats that America faces. There's an EIS officer for almost every state in the union, but also here at the headquarters in different divisions working on very specific subject matters. So for example, I'm positioned at the division for global health protection, in the emergency response recovery branch, and this is the branch that houses the global rapid response team for the CDC, the team that was set up after Ebola and they've responded to about 400 public health emergencies abroad basically ever since they were established. Since I've joined the CDC I have been only to one country so far, I've been to Nigeria, but I've been working in other projects that are in Iraq and in two weeks I'll be going to Papua New Guinea. So my project in Nigeria was an evaluation of a surveillance system that they have in Borno State. So Nigeria's been in a conflict with Boko Haram since 2009 and this has led to a lot of displaced people, not necessarily fleeing their country, but just fleeing in other parts of Nigeria. So they're not really refugees, they're internally displaced people and the camps that have been set up for them, any refugee situation, any internally displaced situation, people are in close quarters, less than ideal conditions. It's less than hygienic and so outbreaks can happen in these areas. So they've put into place, The World Health Organization put into place a system called the Early Warning Alert and Response System, or EWARS, to basically disseminate phones out to these areas and where they normally couldn't send out maybe a report to a higher level because the healthcare infrastructure is falling apart. A local provider can just send a text message to their state epidemiologist, telling them we have a case of something like cholera that could cause an outbreak. They can then send those epidemiologists to that area, to help get that under control rather than it becoming a larger scale outbreak. So our project was to go there and evaluate how well this was running. Kind of do a full audit see the strengths and weaknesses of that system and write up a report on how it can be done better. So as a result, we trained field epidemiology lab training program fellows to go out in our stay to actually conduct these interviews with hospital providers, people who have used the phones, community health workers, basically volunteers in the community and seeing what they noticed about using these devices went well, what they think are areas for improvement. Are the numbers that they're reporting accurate? So this training that we conducted not only was helpful for our evaluation, but we were also helping to train these epidemiologists who will be, after we leave, basically helping guide their countries' rapid response to future crises. In Papua New Guinea, we haven't gone yet so we're working on our protocol, we're working on our interview forms. We're gonna put those interview forms actually into an electronic database so they can use tablets so that it's more accurate and then getting it obviously translated into local languages so that it can be understood during the interviews. So it's a constant juggle of all these projects and kind of what's more immediate and what needs to be worked on and what preparatory work needs to be done. You have to be comfortable getting very little sleep at times. You know, especially when you're traveling abroad that's a lot of jet lag. Papua New Guinea is about 15 hours ahead so that's gonna be a fun little flip. You have to be used to getting back to flexibility, you know being able to do something last minute. So a lot, and whenever your on call for the CDC, you have to be at the airport within an hour. So you have to be ready for those sort of things. And I'm sure a lot of people can do it, it's just about getting the right mentality and getting yourself set and ready for it. You have to be patient, you have to realize that there are changing situations at all times. You know, there might be something abroad that you're really passionate about, but that changes on you. So you might have to be able to be okay with doing months and months of groundwork and then just moving on to the next project. You have to be flexible with that not only emotionally, but I guess just situationally. Other things that I would say is you have to have a passion for it. People who are passionate, people who are compassionate can put more into their work and I think I work with those sorts of people and I can see what that looks like and I think if there's other people who apply to this position who didn't fit that profile, I'd warn them against that because you really have to love what you do. I would say one of the hardest things about this job is just learning something new. I have spent my entire career learning to be a doctor. Learning to sit down with somebody one on one and listen to their story and then prescribe a treatment just for them. So I think shifting to a larger scale, working with populations is something new. It's exciting and I love it, but it's something new that takes a lot of ... This isn't easy work. It takes a lot of work. It takes a lot of extra hours and it takes a lot of commitment to learn something new. Whenever I was applying to the Epidemic Intelligence Service, you have the option, once you get in, to either remain as a civilian or to join the United States Public Health Service. And so, I had already looked into that and I knew from just online how much I would be making as a physician my age, no dependents coming in. So I did know up front. As an active duty military member, I have a base pay of about $55,000 and then with some housing stipends, some sustenance stipends, and as an internal medicine physician, I also get a bonus that comes up to about a gross of $90, 000. As for in the future, your base pay increases kind of year by year, how long you've been involved. If you're promoted to a higher rank, so if I go from Lieutenant Commander to Commander, my pay would go up. And so I know that as long as I'm progressing in my career, my pay will or should continue to increase. If you spend about 20 years in service, you get, I think it's about 50% of your highest amount of base pay the rest of your life. If you spend 30 years it's 75% and then in addition to that, you can continue to pay into other types of retirement accounts, but I thought that that was something that just resonated with me because my plan was to kind of serve as long as I could, at least 20 years at the CDC but at least in the Public Health Service. You know, in 20 years, I kind of want to be doing what I'm doing now, I love this job. I, like I said, I get to do more in just a couple months than I feel I could have done in years as a doctor just because you reach more people all at once and especially, you get to work with some of the most vulnerable people in the world and you give them a second chance and I think that's incredible.