Personal/Professional Growth

Developing a capstone written report from scratch to a complete edition was a huge learning curve. It is challenging to accumulate every learned material in a report throughout the MPH journey if one has yet to leverage those skills. Baylor’s MPH is a hands-on experience that challenges students to go beyond academics for practical experience. It was a great time for me, as I was involved with Dr. Liang Wang in data analysis and manuscript development. The graduate researcher job with Dr. Wang allowed me to brainstorm ideas, find relevant datasets, perform literature reviews, analyze large datasets, generate insights from the data through statistical analysis, develop a manuscript, and publish a journal article with him. The whole experience prepared me to develop this final capstone report. However, the capstone experience was challenging, similar to professional life. Thus, this capstone experience has sharpened me to tackle real-world problems.

Challenges

The faculty encouraged us to identify research interests in the first year. I was still exploring my interests; however, the epidemiology class helped me discover my interest in global health epidemiology, specifically infectious diseases. My interest populations are the Hispanic population and refugees. I encountered professionals dedicated to Tuberculosis research through Dr. Lanning’s class, which motivated me. Thus, my initial plan was to analyze TB risk factors in high-risk countries, such as Brazil, specified by WHO. However, it took much work to find relevant datasets, as most of the high-risk countries ranked amongst lower- and middle-income countries lacking data technology. With considerable effort, I encountered WHO’s data on Tuberculosis in lower- and middle-income countries; however, the data is private. To request the data, my PI would have to provide their credentials. Furthermore, it was not certain how long the process to get the data would take and, if any, if the data would be relevant to my analysis. I also talked with my internship location, Baylor College of Medicine, about their research on TB in Eswatini. However, their research included clinical and genomic data irrelevant to my project idea. After discussing with Dr. Wang, I used a nationally representative large NHANES dataset to determine the progression of Latent TB Infection (LTBI) to active tuberculosis disease. However, the United States is not ranked among the high-risk country, so the prevalence of TB is relatively minimal. As immunity is the primary mediator of LTBI toward active TB infection, I selected Total cholesterol as my exposure factor, with obesity and high blood pressure being the significant causes of death in the United States. Some challenges of using NHANES data were that NHANES is a cross-sectional study, so analyzing the incidence is impossible. Furthermore, NHANES only collected the TB data in two survey cycles- 1999-2000 and 2011-2012. Moreover, there is less than a 5% prevalence of TB in both survey cycles. Thus, TB should be considered a rare outcome, allowing me only to use the Odds ratio as my measure of association. It was also challenging to structure the findings in the capstone report format. The report, although comprehensive, turned out to be double the length of the average journal article in epidemiology.

Critique for Future Interns

There were many takeaways along this journey. I learned that one should start their capstone early on and try to align it with the practicum experience. As my practicum was related to training medical staff in the Gambia, the capstone was a new experience. In addition, one should identify the primary or secondary datasets and prepare them before the end of the second semester for time flexibility. Moreover, communication with the capstone coordinator throughout the capstone journey is absolute. I am honored to have received Dr. Wang’s support and mentorship to achieve this milestone. I learned that seeking learning materials from trustworthy sources is crucial to enhance one’s understanding of their interest area. Overall, the capstone experience and the competencies I acquired during the MPH journey have made me confident in my life goals. I feel closer to achieving it with the support of the wonderful MPH cohort and faculty.