Author: Lawrence C. Loh, Associate Medical Officer of Health, Peel Public Health & Adjunct Professor, Dalla Lana School of Public Health, University of Toronto. 

In reflecting on my career to date, the most important word for anyone starting out in public health is to say “Yes.”

While it may seem interminably difficult to find time to do things in between studies or in starting a new job, the truth is you’ll never have as much time again to try (and fail) at many different things and really experiment with what you’re interested in and what could be.

Add to this the fact that public health is such a broad field; there will almost certainly be some applicability to your experiences no matter where you ultimately end up.

You’ll never know if you don’t try

Foremost among reasons to say “yes” early on is that you really don’t know what you’re passing up if you don’t try. Some might already have an idea of a specific content area or type of work that might be one’s calling, but for most people, there are numerous, diverse topic and content areas that you will never really be able to make a fair decision on until you try them. So go ahead, work with that professor in writing that paper on maternal/child health, or present at that infection prevention and control symposium. If you’re even remotely interested, you may find your passion – and if you already have things you’re interested in, you might change your mind, or integrate your newfound interests into your overall gestalt.

In my own experience, I entered the field convinced that I would be working on the built environment and health, specifically in creating healthier cities in the developing world. In trying out a few other directions, I gained experience and expertise in volunteering abroad and global health ethics, vaccine safety, communicable disease control, and emergency preparedness, which I was able to integrate into my portfolio. To this day, this allows me to connect key themes among these areas, and has enriched my career opportunities, skill set, and understanding of public health practice.

You need time to build a track record

Just like investing in a retirement account, saying yes at the beginning of your career is like banking experiences for a strong track record. One opportunity often begets many other opportunities, but it all starts by saying yes to the first one. A good example – during my first job with the federal government, I didn’t think that vaccine safety would necessarily be my cup of tea. I had been trained in vaccinology in some small measure during residency, but was still focused on the goal of working on chronic diseases and the built environment.

By giving vaccine safety a try, though, I ended up participating in a national review of the safety of quadrivalent human papillomavirus vaccine in Canada. This led to presentations at the 2013 American Public Health Association meeting in Boston and in Japan in 2014, and ongoing connections with the vaccine safety community that have been invaluable as I’ve become more established in the leadership of a local public health unit. That one investment in 2012 has turned into a reasonable track record in a field I might otherwise have not entered.

Direction, network, and opportunities

As described in the track record section, saying yes also means saying yes to a community. The important thing to remember here is that public health is a very small world and many people move among communities very easily. Someone who might be at the local public health level one day might soon be at the provincial level overseeing a relevant file the next. Building those networks – provided you do good work and are enthusiastically remembered for your time with folks – will allow you to build your network. That in turn will help you find opportunities – both within the community you said yes to, or sometimes even elsewhere as mentors and colleagues move around over the course of your career!

From my experience, this has been where I have landed – having worked at all three levels of government in two provinces at five different agencies during my career, has meant that if I need to pick up the phone and call a colleague at the province, or out in British Columbia, I am privileged to share a familiarity and connection with folks that make it immeasurably easier to get things done together.

(Almost) everything is reversible

It’s important to remember that things are largely reversible – regardless of the stage of career you might be at, but certainly easier so at the early stages.

Try something out and discover it’s not a field you can really sink your teeth into? Take up a job that isn’t giving you what you wanted? It’s never too late to say yes to something else. At least you had the chance to try it out and decide; and in the long run, you’ll note that it probably wasn’t entirely a negative experience.

For me, the best example would have been moving to the West Coast to take up a position as a local health officer. There was much that my wife and I enjoyed about living out West, including a great job, superior sushi and running, good friends who we otherwise wouldn’t have gotten to hang out with, and stunning natural scenery. But we were challenged with distance from our family back in Toronto, and with a kid on the way we longed to return home.

We had originally planned to move out for 3-5 years, but turned back around in just 17 months. If nothing else, my experience was highly instructive of the idea that you can indeed reverse things if you have to – even a cross-country move! – in short order. And the connections, experience, and knowledge of a different system that I gained in BC has paid dividends after my return to Toronto – even if I do find myself longing for a run along the Seawall some days.

It doesn’t get easier

The last thing to remember about why you should try to say yes as often as possible in your early career is that it doesn’t get easier as life goes on. Things remain reversible, but as you become more entrenched, it’s harder to change direction. Eventually, competing life priorities will passively extract a “yes” from you – children, greater responsibilities at work, parents that are growing older, that big project you said yes to in the past that is really starting to take off. Truthfully, you’ll never have as much time as you have in your early career to really try things out and see how it all fits…

When to start saying no

…and when it all starts to fit, and you find yourself increasingly challenged for time, that may be when you are starting to get to that magical point when you are able to start saying no. I’d say give everything an honest chance once, but enough time to watch the idea germinate. Eventually, you will start to see what you are good at, what fits into the overall profile that you are building, and what isn’t progressing, as you like.

As you move into the latter part of your early career, you will have the opportunity to really bring your long-term vision into stark focus, and review your track record against those goals. This will allow you to figure out what to consolidate around; you probably want to focus on the stuff that is really taking off. You’ll also be able to easily identify what started as a fun idea that may have brought you some great learning or other opportunities, but should begin to transition, of course aiming to keep in touch with that community, even if you aren’t actively working on things any longer.

So get on out there – say yes, and see where it takes you!


About the author

Dr. Lawrence Loh, MD, MPH, CCFP, FRCPC, FACPM is Associate Medical Officer of Health at Peel Public Health and Adjunct Professor at the Dalla Lana School of Public Health, University of Toronto.

In his role at Peel Public Health, he oversees the Health Protection division (consisting of Environmental Health and Immunization Records), the Healthy Built Environment portfolio, as well as the department’s strategic priorities around tobacco, digital records, and physician outreach. His work as faculty at Dalla Lana has included research into global health training experiences and teaching with the public health and preventive medicine residency program.

He completed undergraduate training and medical school at the University of Western Ontario and residency at the University of Toronto, during which he also earned a Master of Public Health at Johns Hopkins. He holds certifications in family medicine in Canada and in public health and preventive medicine in both Canada and the United States.