Good afternoon, everyone. Others will be trickling in as we start this presentation. It is really my great honor and privilege to be able to serve as a moderator for today's very exciting panel with some of my most esteemed colleagues working in the federal sector to really share with us their personal experiences for all of us to really understand various career paths within the federal government, federal entities, and how we can expand on even partnerships, even for people who are in the academic sector, corporate sector. I think there's always more that can be done from a collaborative standpoint as well. So it's truly a great honor. And what I will do is I'll give the introduction for the first panelist who is going to be providing us a set of slides as an introduction, and then afterwards, I will introduce the other two panelists that will participate in a very engaging question and answer session. So just to introduce myself briefly, I'm Dr. Romero Santiago, current chair of the Resident and Recent Graduates section. Very grateful to Dr. Karasik for asking me to be a part of this and really help facilitate this very exciting discussion. And so without further ado, our first panelist is Dr. Andrew Karasik, who is a population health physician who is double-boarded in public health and general preventive medicine, as well as occupational and viral medicine. As a medical officer and epidemiologist at the FDA's Center for Food Safety and Applied Nutrition, he's frequently engaging himself with research and regulatory activities related to environmental hazards throughout the food supply. And also, he works as a part-time staff physician at the NIH Clinical Center's Occupational Medicine Service, where he practices on NIH's main campus during that time. And this care that he does frequently involves exposures to novel or especially hazardous substances or organisms. In addition to these roles, Dr. Karasik is also on assignment as a congressional staffer with the U.S. House of Representatives, where he's frequently engaging with our lobby makers, legislators, and so forth. So please join me in welcoming Dr. Karasik. Good afternoon, everyone, and thank you all for joining us today. It's a pleasure to share some of our experiences with you, not just at FDA, although we all have experience there, but the other parts of government we've worked within or worked with. So we're going to start this with a presentation before we get to our audience question and answer session. And so, and also thanks to Dr. Santiago for serving as our moderator. And with that, I will continue. So as any good government employee, we have to provide the obligatory disclaimer. And these experiences, especially during the panel session, are our own experiences and do not necessarily represent any government agency or entity. And no financial relationships or commercial interests to disclose. And the data that we're going to be sharing with you and the analyses that are based on them are from publicly available sources. So civilian physicians employed by the federal government are generally employed as medical officers, known as Job Series 602. And the federal government's Office of Personnel Management generally requires medical officers to have a medical degree. In addition to the medical degree, post-graduate training ranging from one year up to five years, potentially more, and generally require at least one active medical license from some U.S. jurisdiction. And some agencies can have some flexibility in terms of waiving some of these, but these are the general requirements for a medical officer role. So there's a variety of roles that can be performed by medical officers. And while these may not include all of them, these are some of the more common ones. And direct patient care, that's a very common one. And administration, while it can be done by potentially other types of employees, physicians often can perform these types of activities. Surveillance and epidemiology, especially in this specialty, in population health areas, that can be a large component. Regulatory reviewers, especially for certain agencies in particular, reviewing certain applications or submissions to an agency. And then various types of consultations, both within that agency, across agencies. And more often than not, these types of medical officer roles have some combination of these types of roles, and potentially others as well. Also here are some additional distinctions between various medical officer roles. Some medical officer roles are supervisory, some non-supervisory. Some involve, again, direct patient care versus no direct patient care. Some involve some type of a mix. There can be different geographic requirements in person, remote, which is generally a duty station outside of where the agency headquarters or agency facility is. And then telework or some type of hybrid that combines the two different types in person and a remote type location. Here's just a small smattering of different stakeholder characteristics of folks that medical officers might interact with, patients in a more direct patient care setting, as well as health care team and other physicians, bureaucrats within an agency who may have a science background or some other type of background, scientists of various types, lawyers in government agencies. There are lawyers that help advise on what is doable and what is allowable, academia generally in terms often outside of the agency, though medical officers can sometimes have appointments while within some type of agency, industry, and the public are also stakeholders that will sometimes be engaged with by medical officers. There can sometimes be clearance requirements. Some of the work that medical officers do can be sensitive, have national security risks, other types of concerns, and they may require higher levels. Others may be not as critical and requiring as low as public trust. And then in terms of mobility, generally medical officers will have some type of opportunity to do a temporary assignment in other locations, either within that agency or even across agencies. And even if that's not temporary in terms of a different position at another agency or another department, that can sometimes be easier, you know, from a medical officer role than, say, outside the government, whereas, you know, you may already have a security clearance, you may already have certain backgrounds and understandings that are helpful for whatever that new role is. So we explored some data on medical officers employed in the federal government, and we looked into a resource that is a data resource operated by the Office of Personnel Management, which is essentially the federal government's HR department. And so in order to better understand the workforce, and so this particular database is called FedScope. And so FedScope provides a cross-section of data from across the federal government, and so we queried this database earlier this year to better understand sort of what the landscape looks like. And so we filtered for that job series 602, which is filters for medical officers. So using those data, we broke it out by different agencies, and here we can see that the Veterans Health Administration employs a substantial majority of civilian medical officers. And on the right, we can see that most federal government entities that employ medical officers do so on a very small scale. And it's important to know that this list may not, and in fact, does not include every agency that employs medical officers. For example, no agencies within the Department of Labor were included in this list. And you know, it's, you know, for agencies with fewer than 10 medical officers, you know, it seems that OPM excludes them for either statistical purposes or to avoid potential identification of individuals in those agencies. So here, we're going to focus on geography. Here's a heat map of distribution of civilian medical officers across the lower 48 states, and we can see a higher number of medical officers in states with high populations, as well as those in the D.C. metro area. And you know, you can see California has over 3,500, Maryland over 4,000, and here we can see in the right-hand corner of the screen that about a third of those positions have some type of telework opportunity. So some additional characteristics. We can see distribution by age and experience, with the most common being docs that are in their 40s with anywhere from 5 to 15 years of experience, and there's about a 7 to 5 male to female ratio. And here's a summary slide for medical officers listed in the OPM database, and many of these characteristics were described already in the prior slides. And to get more granularity, given that nearly 80 percent of medical officers are employed by the Department of Veteran Affairs, we wanted to provide a summary slide for medical officers in all other agencies listed in the OPM database. And here we can see that compared with the VA-dominated overall medical officer workforce, that medical officers from other parts of the government tend to be older, with more federal experience. They tend to be slightly more likely to be female, far more likely to be clustered in the D.C. area, and as well as more likely to have telework opportunities and tend to have lower compensation. And the vast majority of civilian medical officer positions can be found on USAJOBS.gov, which is the government's hub for job postings seen on the left, which is true of most government positions, but specifically focusing on that 602 job series, that's where a majority of those positions can be found. Occasionally, there can be other areas where federal positions are listed that may not be listed on USAJOBS. So here is a shameless plug for FDA on the right-hand side of the page. So even though FDA doesn't have any current listings on USAJOBS, they do have many Title XXI job opportunities through the Cures Act. And just to share some important caveats with these data, that they only represent civilian medical officers in the federal government, and not uniformed. And just to reiterate that some of the agency data on medical officers were not included in this analysis, and generally, they're those with extremely low numbers of physicians under 10 working for those agencies. Not surprisingly, OEM physicians represent a small portion of the overall federal physician workforce, but obviously, they do represent, there is a substantial representation here compared to some other medical specialty societies. At least outside the VA system. And then some takeaways from this part of the presentation, that civilian federal physicians work in a variety of areas and capacities, and most medical officers are employed by the VA, and that there are a variety of government resources that can help to better understand characteristics of federal physicians, and the various jobs that they hold. And so I'm happy to answer any questions about this part of the presentation, and we're going to move to the panel portion, where we're going to take questions from the audience, and then hopefully answer any other questions that you may have. So thank you very much, Dr. Karasik, for that great overview. Before we go into the Q&A, I just wanted to, like I mentioned earlier, introduce our other two panelists, esteemed colleagues that we have here with us, just so you know their background and can ask the right questions, too. So Dr. Glenn Chang has both medical and law training, a doctorate in both, has been serving as the Chief of Occupational Health of the VA Pittsburgh Healthcare System since August 2021. And Dr. Chang grew up in the northern New Jersey area, and received his medical degree from Rutgers New Jersey Medical School in 2009, and his JD from Rutgers Law School in 2011. And in terms of the law aspect, he's served as a law clerk to two federal judges, the Honorable Robert B. Kugler and the Honorable Kathleen M. O'Malley, and went on to serve as a regulatory counsel for the FDA Center for Drug Evaluation and Research. And in terms of the occupational medicine side, Dr. Chang completed his training through the Harvard School of Public Health and the OEM residency, and has authored publications focusing on OEM health law and policy. And so that's Dr. Chang. And then our last but not least, our third panelist is Dr. Sasha Gutierrez, who graduated from Princeton University with a degree in chemistry, and went on to complete medical school at the New Jersey Medical School, and served three years on active duty as an Army flight surgeon. And during her time, she served overseas deployments in Afghanistan in support of Operation Enduring Freedom. And in terms of the occupational medicine piece, she completed her residency training at the UT Tyler campus, and also did an environmental science master's degree at Stephen F. Austin State University. And before joining the staff at FDA in January 2016, she did work for the US Army as a disability evaluation physician, and did some clinical work with Concentra. And in her tenure so far, she's done quite a lot through the FDA, worked toward standardization of occupational health services provided across FDA, obtaining clinic procedures, and promoting the employee health. So really, we're privileged to have all three of them here today. And so we will go forward with questions. So if anyone has questions, the mic is right here as well. And I will help field those. I guess I'm the first one, huh? Hi. I'm Kang Pasquale. I'm one of the resident physicians at Hopkins. I'll be graduating next year. And the reason why I'm here is because I'm in the process of applying for jobs. And one of the challenges I had is actually with the USA Jobs website, and trying to figure out the timeline that is ideal for someone who's about to graduate next year, and any advice on reaching out to recruiters who also have a presence on platforms like LinkedIn, recruiting for certain jobs. So I'm a little bit just confused on how to best approach just the application process. Any advice on that would be great. Great question, yes. And it's certainly a challenge to navigate USA Jobs. I'm not sure how many of you have tried. I would recommend connecting with a recruiter and keeping on the list serves for all the job announcements. That's actually how I found out about the VA Pittsburgh opportunity, through a posting. And I connected with the recruiter who then forwarded my resume. USA Jobs, it's very tricky to set up the right search terms for an occupational health physician position in a medical officer role. If you don't set it up correctly, you can easily get no results week after week. So I would certainly recommend just reaching out to those you know as well. One thing that was very helpful was having rotated in the VA Boston during my residency and keeping that network within VA as well. I agree 100%. One thing I would add is to reach out to your component society, to people you may know, people who you know may know somebody. That's actually how I got my job, jobs. I showed up at the Maryland's annual conference and someone from the military actually stood up and said, I'm looking for an oc doc. And I was like, here I am. And I got the job. Being a doc in the federal arena, you can be hand plucked. You can skip a lot of the interview and that sort of thing. You didn't mention much about Title 21, but there are different ways to get into the government. And most of them depend on knowing somebody that's in the government. Yeah, and I would say, for example, Title 21, which was one of those options that isn't available on USAJOBS, where you apply to a separate email address and for more specific types of different roles. But still, as a civilian medical officer, those are opportunities that may not be as transparent. But in terms of timing, I would say at least six to eight months before you're hoping to start the new job, because it, at least, at least, at least. So yeah, that onboarding process can be long. With Title 21, it's a little shorter, but not a lot shorter. So definitely making sure that the better part of a year, not to expect. So probably, if you're about to start your second year, probably fall of your second year in OEM before is probably a reasonable time to send those applications in. I also want to say, along those lines, is get a preliminary job that you'll be OK leaving, for two reasons. I can't speak for all federal jobs. My job is not clinical at all. It was vitally important for me to be able to do my job, to have clinical experience. So that's something I think is really important coming right out of residency, to get a job where you're doing nothing but seeing patients, reading medical records, because that experience is so helpful later on. Thank you. Other questions, please feel free to come to the mic here. If not, I have a couple of prepared questions, too. So I will ask one to start with. So one thing I personally am really wondering about this, too, is that what are some ways that, with you working for these federal entities as a physician, how are you able to provide that platform for influencing, like influence and shape health care policies and programs at that local or national level? I would be very curious to hear examples from each of you of how your work has directly impacted some public health initiatives or policies that have moved the needle. Yeah, I've actually been involved in policy on both the legal and medical fronts, formerly at FDA as regulatory counsel within the Center for Drug Evaluation and Research. My role was directly working on policy, responding to things like the citizen petitions, which is a way of formulating policy case by case. That's a very public response by FDA. On the medical side, I've had a lot of opportunity in the VA to shape policy. The VA works on a federated model where there is a central office of employee occupational health. And there are directives as well as national policies. But each facility is expected to implement them locally. So each medical center also has its own whole set of policies. It's been a really great experience to work closely with leadership, with HR, infection prevention, safety, on all of the policies impacting those areas. And we have a lot of input from employees as well through the town hall, through the union partners, and so on. So it's certainly a very diverse set of stakeholders. And it really keeps us with a large variety. So I say, because it's easier than giving my full title, that I'm the Director of Employee Health at FDA. So I'm not impacting national policies like these guys. I am impacting the policies determining work health for the people that are actually taking care of the American public in terms of food and drugs and what we're putting into our bodies. So that's where I get that, yay, I'm doing something. That's what does it for me. There are opportunities. Every time I come back from AECOM, I learn something, I get a new idea, I take it to my leadership. And if we can make this happen at FDA, it can happen anywhere. But that's the line I pitch. And so again, it's not national level things. But working for the government, I But working for the government, I am working for the people that do the national level things. Yeah, and then on the, at least my area, which is in the Center for Food Safety and Applied Nutrition, it's more on the environmental medicine area where we're working with folks from CDC and our inspectors and regional offices to understand potential outbreaks of foodborne illness or other types of toxic concerns. And so understanding and characterizing those issues that we might end up formulating into a recall or a consumer alert where we can have an impact on a national basis on consumers and patients across a wide geographic area, that's sort of one way where we can influence some of those areas. Hi, I'm just curious. A number of the federal jobs you described, candidates have the option to either remain civilians or to enter as a commissioned officer in the Public Health Service. Not all, but many. Can you just talk about when a candidate would opt for the uniformed services, the Public Health Service, versus a straight civilian job? So as someone who hasn't worn a uniform myself, I can let Sasha speak to that a little more fully. But in terms of working, I work closely with other PHS officers at FDA. And some people come in directly through PHS, transfer from another service. So it really depends. But maybe Decker can hear us. No, it's just like you said. There are a variety of reasons. I was in the Army. When I came on board at FDA, there was a huge push from every PHS officer I ever met to join PHS. And the reason was continue the benefits. I had already paid back, or whatever the terminology was. I had bought back my Army time already. So there was no incentive for me. I already had the years. And I didn't want to wear a uniform. No offense. I loved wearing the uniform. But it wasn't the time or place for me. So it's a very personal decision. And you could give a million reasons for or against, and only one is going to resonate with each person. Can I ask my question a little differently? Does the job look any different whether you're wearing a uniform or not wearing a uniform, in terms of what the commitments are? So as far as commitments, as a civilian employee, I'm trying to think. No, other than you wear the uniform to work. Because I have a PHS officer that's working for me now, who's about to retire. And we're looking at filling the position. It's much easier to fill a PHS position with another PHS officer. And that's the route I'm going to go. But it is entirely possible to replace that person with a civilian. So I think to answer your question is, there's not any job difference. It's just the uniform, and the benefits, and retirement differences. Can I piggyback on that real quick? Yes. Is there stability with the civilian job compared to Title 21? And is there more local work in the area that you're working versus assigned to temporary duty elsewhere because you're Title 21? And so you're subject to those measures? So Title 21, as part of the Cures Act, was designed to make FDA's workforce needs more able to be met. For the medical officer component of Title 21, there isn't an enormous difference between Title 21 and the current Title 38 system that FDA had been using for many years as almost like a modified VA system. And so some of the difference are related to pay, to onboarding, speed. But in terms of the actual job functions, many are fairly, I mean, they're extremely similar. So there's not a huge difference other than it's often more favorable to the employee and can be helpful to the agency in terms of that recruitment, retention, those types of things. If I could add one thing about the PHS officers. So they're much more common at FDA and places like CDC compared to VA. I have seen a PH officer before in the VA, but nationally it's very rare. That being said, when I was at FDA, some of the differences I heard were more related to personal growth and personal career trajectory. My understanding is PHS officers following the uniformed services model and kind of the military culture, there's more of a impetus for promotion in terms of showing leadership roles and really taking on committee participation, taking on more regional and national roles, and really putting that in a portfolio every time you're up for the next officer level promotion. One of my former colleagues at VA who went to FDA said that was that kind of personal drive and also the culture of collaboration among PHS officers was an impetus for him to try to convert to PHS after joining FDA. Great. Questions, please feel free to, from your seats or come to the mic. Yeah, any questions are welcome. I'll just put a shameless plug in. My name is Sam. I work for the FAA. You do not need an airspace board to apply to that. We do like occupant positions because of the way your brains think. Many of my colleagues come from a variety of backgrounds, military, non-military. You do not have to be a pilot, but you do have to have an interest in aviation and an interest to protect the national airspace. So that's all I have. Oh, thank you, Sam. And that there is what I was talking about, in the right place at the right time. One question I had that I think would benefit everyone just is if each of you could share just kind of, I know you don't necessarily have a typical day you do different duties, but if you had to take an average of a day in the life of your work as a physician working in the federal sector, what are the unique aspects of your career, kind of if you can interject into that, that really make you excited to continue this work that you're doing? So I think one of the sort of stressful but sort of exciting things is dealing with things that are potentially hitting the news or things of very high national significance, things like foodborne illness outbreaks, having had the chance also to be detailed to the Center for Tobacco Products, working on vaping product reviews, things like that that sort of have national significance and even potentially long-term significance for many years to come, and being able to have my voice heard as a, you know, they call us SMEs, subject matter experts, in terms of being able to tell people who may not be aware or understanding of certain health issues or certain toxicologic issues, and to sort of have that impact on these prominent issues. So I've had a couple different jobs in the federal arena, and each one for me had a different aspect that made me love going to work. When I was a disability evaluation provider at the Army, I got to read medical records all day long, and it was like reading soap operas. This was at Walter Reed. So all the cutting-edge surgeries and trauma care and neurology services, I knew all about it firsthand. I had the best job ever. Then I went to FDA as the chief medical officer for occupational health services. They thought they had a program there. There was not. So I got to build an occupational medicine program that I thought was going to work. I created surveillance programs. I created clinic policies and procedures. I got to do walkthroughs of the labs and the different types of workplaces or work environments. Best job ever. And now I'm actually acting as the director of safety. I've been exposed to ergonomics and safety because that's what I'm now the boss of, in addition to occupational medicine. Those aren't things that I like as much, but you know what? I have learned so much. It's the best job ever. So I'm sure both of you guys think you have the best job ever, but I've had every best job ever there. There is Love the enthusiasm. Yeah, the federal government is really about diversity of experiences I'm everything from having clerked for federal judges Working at a public health agency taking on a more clinical role currently VA in particular is an excellent place to learn I joined right out of my residency in Boston and because of the federated network there's just an automatic community of regional networks in the VA that there's just a lot of mentorship a lot of best practices sharing and There's there's a lot of opportunities as well for development of new staff One thing that I was able to do After joining VA was helping us get up to a full staffing and I was able to hire two very talented physician assistants in the VA scholars program who were extremely eager and have really brought a lot of diverse talents, so With the federal government because all your benefits kind of carry over from job to job including for example the pension The 401k kind of contributions those all can be carried between federal roles and It's it's something to really consider that there's such a diverse opportunity Great You kind of Glenn kind of touched on that part I was going to also just touch base on is you know in terms of the long-term career opportunities for someone really in federal service You know how what's the logistics of transferring, you know Transitioning to a different federal agency from one to another and like is that process, you know Complicated one or is it someone something that is relatively not as difficult to do I'll just start because I like to talk I haven't personally transferred Because I've always had like a civilian job in between my my federal jobs But it's so common at FDA Everybody has either worked in a different Center. We have seven centers doing different parts of Food and drug research and policymaking and all that stuff Most people you meet You They've been working for another Center or another department and they have a plan to move somewhere else and then there are other people where the opportunity just comes up and they said I just took it because it was something different to do and it's just so common and Easy because the federal government wants you to be happy in your job is what I've noticed All right, and I think the the fact that federal civil servants are tenured after a year or two of Service really gives people that mobility Because there's there's that stability inherently in the position and the protections that come with that role so that people feel more opportunity generally to make Decisions that could have broader impacts. There's less of Less of a fear of being wrong. I think because you know that you're in a very stable role And I would also say not even permanently but You have the opportunity to try things out. So there are opportunities like these temporary details You know both designed to be, you know educational and also humanitarian FDA has sent civilian medical officers to help Hhs office of refugee and resettlement to help the unaccompanied minors down near the border or to help it clinics that were processing some of the Afghan parolees, so there are those types of opportunities There are opportunities opportunities for temporary promotions Maybe you're in a non-supervisory role and you you want to try out a supervisory role And see if that's right for you, you know, maybe a three or four month detail will provide you that insight and experience to learn to grow and to see if maybe that new role is right for you and then There are other roles other opportunities, for example, I'm doing a fellowship right now through Brookings that accepts government Employees from a variety of federal agencies to work in a legislative branch For you know up to a year and so that's a different experience You could do official details. So there's a wide range of opportunities to to learn and grow outside of your current role even when You're sort of you may be going back to that role, you know sometime in the future Ma'am I have a question for you and it might be applicable to other uniformed personnel here. Oh I know that you serve in the army Was there a significant gap between the time you got your DD 214 and you started your new job? Because because of the I Know that USA job at least there is a few months that you need to get the DD 214 before you can apply or something to that effect I Don't have an answer for that because right after the army I went to a civilian job and then You know, I got my my DD 214 when I applied for my first federal job working for the army So I I don't have an answer for that. I apologize So I heard several different questions and comments and I just thought maybe I had something to contribute. My name is Samantha Morales I'm currently a Physician working for the VA prior to that. I was public health service commission core and somewhere the distant past I was army as well what I will say is As far as the uniformed services, which is where army and PHS fits their emphasis is big on deployments as far as Leading you to the next level whereas with a civilian job Not so much, right? So in the announcement, they're gonna talk to you about your ability to Be mobile within 72 hours depending on what it is or just periodically throughout your tenure there as far as PHS and army the way the military differs from the other uniformed services is there two totally different pathways So you have a base? Assigned Where you're assigned once you're recruited or selected you work from that particular base and the job is at that base That's where you are and you follow that all the way through words of PHS It's kind of like a dual path where you have to find a federal job that aligns with what PHS wants and so you're Basically getting hired twice you're doing all the steps to get the PHS Commission core requirements your officer basic and then you're also doing whether you're doing IHS Indian Health Service or CDC or whatever that is. You're going to do that as well at the same time What I would say is if you are a resident Trying to figure out what you're going to do. I would say start from day one. Don't wait until like a year before To start looking of course, they were talking about minimums, which is great But what I found is as a program director for preventive medicine It's that as a resident you may find opportunities from the first year you go to a conference Whether it's something in a medical society definitely be a part of the medical society Or if you're doing one of your rotations, you may find out that there's something that might be coming down the pipeline Also, if you're doing two annual conferences So I would say start right away Of course, you have to know yourself if you want to do a fellowship then don't wait until After if you've passed that time period because then there's a big salary issue that type thing as far as benefits They do differ depending on which one you Which path you take so if you have anybody have any questions about anything I have a wide variety of experience across the board civilian and non-civilian. So I'm here. I'm happy to help I Guess in that spirit of that advice, you know something just to ask our panelists to is, you know Are there other like sort of hard skills? I know you had mentioned Sasha about you know, the importance of you know, getting that clinical foundation But are there those things, you know when you reflect back on your current roles and reflect back on your training are there certain things that you would say like specific skills or certain Areas of expertise that you think you know when you reflect back on it could have maybe Helped you more or something that you realized. Oh, you know knowing more about this would help So you you mentioned hard skills and The first thing that came to my mind was soft skills. Okay Communication with people of You know all different Backgrounds and Expectations is so important, you know when I was in the military, I learned how to say yes, sir Even though that's not how I grew up But it was something that I learned and then I got to the civilian sector and It went back to not meaning anything to the people I was talking to So I needed to learn how to communicate differently So those soft skills learn lean forward when you're talking to somebody Go on LinkedIn. They actually have Videos you can watch to learn all this stuff. Take every opportunity to learn how to communicate better and That gets you far especially I think in Working for a government agency where you do need to be able to talk with all different types of people And yeah, I would completely agree I would also say some of the other hard skills that you know sort of a transferable are You know any experience you have at least, you know for in terms of say like for epidemiology or you know disease surveillance or population surveillance A Experience you have with data systems with you know, working working with those systems can be transferable Even if the system is quite different You know, some of the considerations can can be transferable or or similar and so that can be helpful You know, I think yeah, it's you know, there there are some of these these things that sort of you know Are transferable so so I think that you get in your training programs one example, I would say is In the OEM field oftentimes, you know, sometimes exposures and Associated disease states are you know in fairly small clusters small small studies that are potentially hard to interpret or You know, you know or more difficult to make you know Assertions but You know working with those types of different types of data I found for example when I interviewed at the Center for disease diseases at Cedar For the rare diseases group. I don't I'm I'm not a pediatrician, but I Don't I'm not a rare disease doc, but the ability to work with these types of data sets with Unique exposures a smaller exposure smaller more rare conditions potentially adverse events can sometimes those types of those types of transferability If you if you communicate those in the right way, they can be very valuable to a wide range of potential employers I Would say I'm very fortunate to have gone through the Harvard occupational medicine residency where I learned a lot of those skills Dr. Langer's in the audience and she taught the health law and policy course Which was extremely helpful and just kind of knowing the bounds of ADA Gina and so on Also, I I ended up getting MRO and DOT certified after I joined VA, but those are kind of hard skills I learned in those certification courses that I'm required to do so the job may Require you to get those certifications, but with the federal government they would generally pay for it as well And Great great question So this is not necessarily for a physician that my group hired but One of the people we interviewed was an epidemiologist and so she had experience in addition to a lot of publications she had experience with Specific exposure that we were really concerned to in this case. It was arsenic and certain certain heavy metal exposures and You know, sometimes Applicants will have sort of interesting backgrounds that you know, maybe tangentially related But if you have experience that is right on the nose to what you know Or is an area of concern and generally an area of concern is something Related to large press releases that the agency or office has been putting out if you have experience related to those things There's a good chance. There is some type of role for you in or near that office or division, so So One thing I found out the hard way was when you work for the government funding Imagine that is a difficult thing to come by so you have to find ways to get what you want without costing a lot of money so I Couldn't get another doc Home just to be an FTE I Wanted somebody Who was good with data sets and had a medical background I Actually found somebody oh wait, I forgot to mention The only job title I could afford was safety officer A gs9 safety officer, so I was able to find somebody by writing the Position description because that's another thing in in the federal government. There are templated position descriptions But then if you have, you know the stamina and motivation to go through all the rigmaroles You can actually get a specific position description So I did all that it took two years and I was able to hire an exercise Physiologist who had just done like a rotation at CDC Working with data sets and this was the most amazing hire ever cheap exactly the skill sets I needed and Growth potential because this kid He's you know, you can see when you talk to someone if they're gonna be Gs15 or stay at that gs9 level He he's got gs15. He's not a doc, but he's gonna be a huge asset to our clinics I Think with the funding for federal positions certainly varies by year and the funding authorities with kovat and the public health emergency VA and other agencies got a lot of funding This year. It's a little bit of a tougher year but I would say We really take advantage of those opportunities Another thing that was helpful in getting fully staffed was early on we had a site survey from our national EOH office and that showed that Based on all of the the standard can nationally we were understaffed And there was a high need given our the fact that we were a 1a complexity facility So having that kind of central validation really convinced our center leadership to give us the FTS All right, well we've just passed the time and so I just wanted to thank you all for your wonderful questions and a huge Thanks to our panelists for their very enlightening perspectives on this. Thank you. Please join me

federal sector physicians

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Dr. Karasik

Dr. Chang

Dr. Gutierrez

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