I spent the first part of my career as a physician in Benin, first in an emergency department and then as a general surgeon in a district hospital. I now lead epidemiologic surveillance and data programs at health departments in the United States. On paper those are two different careers. Most days they feel like the same job, done from further away.
One patient at a time, then a population at a time
Clinical medicine trains you to read one case very closely: this patient, these symptoms, this decision, now. Public health asks a similar question about a whole population. Instead of “what’s wrong with this patient?” it asks “what’s happening across this city, and what should we do about it?”
The instinct is the same. The unit changes. A surgeon has to catch the small detail that changes a diagnosis. An epidemiologist has to catch the pattern in thousands of case reports that changes a response. In both jobs you learn not to trust a story until the evidence backs it up, and not to wait for certainty when waiting is the bigger risk.
What clinical training adds
I’ve worked with analysts who never set foot in a clinic and whose technical skills are sharper than mine. What clinical work gave me is harder to learn from a spreadsheet: a sense of what a number means for an actual person.
When a dashboard shows low immunization coverage in one neighborhood, I don’t see an abstract gap. I see people who couldn’t get to care for some reason, and I want to understand that reason before I recommend anything. A fix that ignores why the gap exists can be technically correct and still change nothing.
Why I moved from patients to populations
I kept running into the limits of one-on-one care. A physician can save the patient in front of them, but what brought that patient into the emergency room (an outbreak, poor access to vaccines, a warning sign nobody caught) is a population problem. It needs population tools: epidemiology, data systems, program management, policy.
So I went back for public health training, and later for business and project management skills so I could run programs and not only design them. Clinical training told me what was wrong. Public health training showed me where else it was happening. I still had to learn how to fix it with a real budget, real staff, and a real bureaucracy, and that is where the business side came in.
What carried over
The lesson that survived the move from surgery to surveillance is that speed and rigor are not opposites. You need both, in a hospital and in a health department. In the hospital, moving too slowly costs a life you can see. In public health, it costs lives you may only notice months later, in a case count or an outbreak that got ahead of you.
The tools are different now, but I still feel the weight of those decisions. That is a big part of why I’ve stayed in this field.