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The Challenges Of Being An International Researcher: Implications For Advanced Degree Labor Markets, Part 2

5/11/2020

Perspective Piece, Opinion (Part 2 of 2)

Last week, I discussed the effects of temporary visa holders in the academic workplace. This week, I turn to discuss the H-1B visa system in more detail and how for-profit employers utilize this mechanism for better and worse.

H-1B Visa Overview
The majority of advanced degree holders working in the United States (US) are sponsored under an H-1B visa for "specialty occupations". The program is administered through the United States Citizenship & Immigration Services (USCIS) and a job must meet one of the following criteria to qualify as a specialty occupation:

Bachelor’s or higher degree or its equivalent is normally the minimum entry requirement for the position
The degree requirement for the job is common to the industry or the job is so complex or unique that it can be performed only by an individual with a degree
The employer normally requires a degree or its equivalent for the position
The nature of the specific duties is so specialized and complex that the knowledge required to perform the duties is usually associated with the attainment of a bachelor’s or higher degree.

Currently there is a "cap" on H-1Bs granted each year to for-profit companies and a lottery is used to allot the 85,000 visas available to advanced degree holders. The H-1B pool open to all applicants is 65,000 with an additional 20,000 visas available only to those with at least a Master's degree.

The success rate of "winning" the lottery hovers around 25% to 35%.
An employer who seeks to hire a foreign worker on an H-1B visa, then, must literally take a chance on them by entering a lottery to be assigned a visa for said employee. Even then, a company's paperwork might be filed improperly and the H-1B denied (a more common process in recent years as these visas have been scrutinized in more detail). All these steps require time and money to navigate, which dis-incentivizes companies from pursuing this path for a potential employee.

However, university and nonprofits are exempt from the H-1B cap (see last week's post for more on this), encouraging many nonimmigrant advanced degree holders to occupy positions in these institutions after completing their schooling.

Changes to H-1B Selection Process for Fiscal Year 2021
USCIS has taken some action to make the H-1B application process more efficient. This includes allowing employers to pre-register for a potential visa without the full paperwork being required until they have been notified whether they have been selected in the lottery. This change took effect for fiscal year 2021.
Another significant change for this fiscal year includes one that seeks to increase the odds for advanced degree (Master's or Ph.D.) holders being selected.

The 65,000 general visa pool will be drawn first
Followed by the 20,000 advanced degree pool draw

This order is the reverse of the previous process and USCIS estimates that it will result in an increase of up to 16% (or 5,340 workers) in the number of selected petitions for H-1B beneficiaries with a Master’s degree or higher from a US institution of higher education.

Immigrants & the Economy
The main goal of the US's H-1B program is to fill gaps in the US workforce.

There is certainly debate around whether encouraging more advanced degree holders to enter the US has a positive impact on the economy. Some reports make a strong case for the value of advanced degree immigrants: showing they contribute more in taxes than they consume in benefits and their presence correlates with a higher number of American jobs. Others refute the interpretation of these data.

Indeed, there are many reports of how the H-1B visa program is being used to supplant American workers with visa holders, often with a cost savings to the employer.

H-1B Prevailing Wage and Fair Compensation
H-1B sponsored employees must be paid the "prevailing wage" for their work area, level of expertise, and geographic location of work. This presumably prevents a company from using the H-1B visa as a source of cheaper labor than hiring a US citizen. However, this determination of prevailing wage is open to much interpretation and abuse. In fact, some have argued and data have shown that H-1B employees at for-profit companies make lower salaries than their peers and that this mechanism is used to, potentially, suppress wages for all employees.

Furthermore, outsourcing Informational Technology (IT) consulting companies including Infosys, Tata Consultancy Services, Deloitte Consulting, and Cognizant are often used to circumvent some of the prevailing wage rules that apply to H-1B visas. And these consulting firms employ large numbers of H-1B visa holders (though mostly those holding a Bachelor's Degree). In the most recent 2019 H-1B data, the four aforementioned consulting firms employed 32,357 H-1Bs...the top four other for-profit employers (Amazon, Google, Microsoft, & Facebook) employed 22,202.

So, how much are H-1B holders being paid?
Data from NSF's Science & Engineering Indicators 2018 reports median income of H-1B visa holders for initial employment obtained from USCIS. Below are data taken from USCIS for fiscal years 2016 & 2017.

Source: Department of Homeland Security, U.S. Citizenship and Immigration Services, Characteristics of H-1B Specialty Occupation Workers, Fiscal Year 2016 & 2017 Annual Reports to Congress

The relatively low earnings of life scientists probably reflects their presence in postdoctoral positions at universities...~60% postdocs are in the life sciences (see Fig 2-2 in this report). While universities and other nonprofit or governmental research institutes are exempt from the H-1B cap, they still must report H-1B information for those they employ to USCIS. Thus, this and the following data also contain salary information for H-1Bs employed at universities, non-profits, and government research institutes.

Diving into 2019 H-1B Data from USCIS
USCIS has extensive data on those receiving H-1Bs over the past several years on its website.
Below, I present some details from the "Approved H-1B Petitions by Employer" data from 2019. First, the cap-exempt nature of nonprofit institutions, which includes universities, academic medical centers, hospitals, and government institutes and labs, results in these employers representing a majority (75%) of Ph.D. H-1B employers in 2019 data.

Of all those H-1B sponsored employees at institutions or companies with 100+ visas awarded in 2019, 75% of Ph.D. awarded H-1B visas were to those working at nonprofit organizations, including universities.

EXPLORE 2019 AWARDED H-1B DATA

The USCIS H-1B data also requires employers to report median salary of the H-1B-sponsored employees. Note, this averages earnings over the full population, including those with Bachelor's degrees, Master's degrees, and Ph.D.s. Looking at these data, you can see median salaries are much higher in those working at for-profit companies.

Average of reported median H-1B salaries for sponsoring institutions in 2019. Data are averaged over those employers awarded 100+ H-1Bs in 2019 and also sponsoring Ph.D.s on H-1B visas. Salary is reported by employer as a median across all H-1B holders, regardless of degree.

The lower salaries for H-1B employees at university and nonprofit/governmental agencies could be the result of a a variety of factors. The most likely is that this population is heavily enriched with postdoctoral researchers, whose salaries hover around $45,000-$50,000 at most universities.

And as most H-1B holders in for-profit companies ("industry") are working in the computer science and engineering space (~60% of all H-1B holders, see report) where salaries are rather high, it is unsurprising that their industry salaries are well over $100,000 (where the Bureau of Labor Statistics reports mean annual earnings of ~$94,000 and ~$101,000 across all employees in the computer/mathematical and engineering sectors, respectively).

Interestingly, and supportive of the notion that job outsourcing companies may be used to suppress wages, the average median salary of H-1B holders employed by Cognizant, Tata Consultancy Services, Deloitte Consulting, and Infosys was $90,798 (+/- $14,340) versus $139,358 (+/- $8,407) employed at the four largest other for-profit employers (Amazon, Google, Microsoft, & Facebook). Note, this is not a perfect comparison as the 4 outsourcing/consulting companies rarely employ Ph.D.-holders.

Which for-profit companies employ the most H-1Bs with Ph.D.s?
Relevant to my work supporting postdoctoral researchers, who all possess Ph.D.s, I wanted to better understand which for-profit companies employ Ph.D.s on H-1B visas.

The list is dominated by big-tech (see chart, below). In fact, Google, Intel, Apple, Amazon, and Microsoft employ ~56% of ALL H-1B holding Ph.D.s in for-profit companies (of those sponsoring at least 100 visas) in 2019.

Indeed, an earlier report looking at occupational groups by H-1B cap status in 2010-2011 found that computer science related occupations represented ~51% of all capped (for-profit) H-1B employees, followed by those occupying engineering roles (~9%) or working in financial services (~6%). This distribution differs when looking at H-1Bs awarded in the cap-exempt category utilized by universities and nonprofits: life scientists (~28%), postsecondary teacher (23%), health practitioners (14%), and physical scientists (7%) were the most common categories.

Clearly, roles that focus on computer science, technology, and engineering are disproportionately represented in for-profit H-1B sponsorships. So, if you are an international student or postdoc seeking employment with a company in the United States, you should work on developing your data science, coding, and other analytical skills that are in demand.

See these pieces and personal accounts of those who successfully transitioned to a career in data science.

However, as a fraction of all H-1Bs employed, the Ph.D. labor pool is rather small at some of these companies. For example, only ~9% of all H-1Bs employed by Google in 2019 hold Ph.D.s and that percentage at Intel and Apple is 14% and 10%, respectively. Looking at which company H-1B employee pools are most represented by Ph.D. holders, we get a slightly different group of employers.

Kelly Services, which contracts with the federal government to staff a variety of roles in government agencies, has the largest percentage of its H-1B workers occupied by those with Ph.D. degrees. Several pharmaceutical and biotechnology companies (Bristol-Myers Squibb, Abbvie, Genentech) appear on this list as do some companies that might be less well known to the casual Ph.D. student or postdoc: KLA Tencor and Global Foundries.

H-1Bs, For-Profit Companies, and Labor Market Effects
What effect does utilizing H-1Bs have on their sponsoring employers and co-workers' earnings?
Much commentary has called into question whether the H-1B program is a net benefit or detriment to labor markets with some researchers describing a reduction in estimated wages and domestic employment in high tech sectors without the program.

Data looking at the effects of H-1B workers in for-profit companies suggest that payroll per employee may be slightly reduced for those companies who "win" the H-1B lottery. In addition, corporate profits are higher in those companies employing H-1Bs. Indeed, one report estimates usage of skilled H-1B holders placed in discounted prevailing wage levels, which the employer is allowed to select with little oversight or vetting, can save employers around $40,000 per employee per year (see details here). And stories of H-1B holders replacing US domestic workers in tech are plentiful.

Whether companies actively use the H-1B program to curtail labor costs, among other complaints, is a complex question to answer, especially when comparable salary data for positions at for-profit companies is unknown. Some work has tried to address the issue, though.

A study comparing computer scientists and electrical engineers previously on F-1 visas versus domestic workers found a reduction in salary of 6% in visa holders working in computer science but no difference in salary in the electrical engineer group. Others have found H-1B holders earn higher salaries and occupy jobs that are difficult to fill.

A separate piece of research investigating the computer scientist labor market, estimated that in the absence of H-1B holders, wages for U.S. computer scientists would have been 2.6-5.1% higher in 2001 AND that employment in the field by U.S. workers would have been 6.1-10.8% higher.

That study went on to show that Information Technology goods prices and output benefited from immigrant labor by between 1.9 and 2.5%, benefiting companies and consumers. This finding highlights the possibility that immigrant labor and work visas may be a net benefit for the US economy while being detrimental to the visa workers themselves.

Paths to Citizenship & Needed Reforms
Many temporary workers on H-1B visas wish to transition to permanent residency status in the US (i.e., obtain a green card). Many for-profit employers will sponsor green card applications for their H-1B employees. Those with advanced degrees can purse the EB-2 "exceptional ability" employment-based immigration path to permanent residency. However, country-specific caps make queuing for one of these immigrant visas a long process.

The current H-1B and immigration system in US is under intense scrutiny by the White House. Surely changes to these processes are needed and modification to the awarding of green cards have been proposed in Congress. But in its current form, this legislation may preferentially benefit Indian workers where the green card backlog is over a decade long. In addition a "points-based" system (RAISE Act) to prioritize immigration was introduced in Congress in 2017 but failed to receive necessary levels of support. Canada currently runs such a system and has seen growth in its educated immigrant population as a result.

While H-1B reform often has bipartisan support, the politics and special interests behind visa and immigration reform are complex. However, most would agree the current system doesn't work as intended and is subject to some abuse.

Big tech and business interests are often involved in shaping the visa and immigration reform conversation via groups such as FWD.us. The large IT outsourcing firms that employ H-1Bs have also engaged in lobbying to prevent changes to the H-1B system. Certainly some of these business leaders, at least partially, mean well in their efforts. But to pretend there are not vested financial interests in ensuring a steady supply of often under-paid immigrant labor, who then depend on being "in good standing" with their employer for green card sponsorship, would be naive to any impartial observer. And the long backlog for green card processing for some groups, especially Indian workers, has also been suggested by some as another way companies may "lock in" their employment for many years. These workers have little career mobility and negotiating power as they wait on their employer-sponsored green cards to process...which can take over 10 years to occur, even for those in the exceptional ability EB-2 category.

With all this said, perhaps it is unsurprising that some have likened the current work visa system to modern-day slavery or indentured servitude (see also) as the workers' ability to remain in the US depends on their current employment with a set employer. This employer-employee power imbalance is highly problematic and may prevent visa workers from raising any employment concerns with authorities for fear of their sponsorship being revoked. Reforms clearly are needed.

Looking Toward the Future
Clearly, balancing the positive impact of temporary and immigrant workers on firm productivity and innovation with their potential negative effects on US labor markets and the well-being of the visa workers themselves is a difficult task. Diversity has been linked to greater creativity and innovation. However, the accounts referenced in this post suggest some for-profit entities utilize the H-1B and future citizen sponsorship to lock immigrant workers into roles that are underpaid with little room for advancement.

While the current political climate in the US has resulted in serious changes in how the H-1B visa system operates (for better or worse; see also), most would agree that the spirit of this system is a good one: encourage high-skilled workers to bring their talents (and associated spending and tax base) to the US.

Certainly some recent changes to how H-1B visas are reviewed and approved have been good. For example, there has been a decrease in the number of H-1Bs awarded to IT outsourcing consulting firms (traditionally, the bad actors in the system) and subsequent rise in those awarded to large tech companies in recent years.

More needs to be done to improve our H-1B visa and immigration system.
The economic and demographic consequences of not doing so are many. This includes the important effects of immigration on US population growth and workforce participation, while saying nothing about their effects on technological innovations and discoveries in STEM.

Is America Still the Land of Opportunity?
America bills itself as the land of opportunity and many highly skilled and educated individuals from across the world come here to better their lives - to pursue the proverbial American Dream.

In addition, most (78%) Americans support high-skilled immigration to the country. However, we as a nation must do better to provide true opportunity to those who come to the US to study and work and ultimately wish to contribute their talents and abilities to the US workforce. We must also resist the influence of corporate interests and political operatives who seek to shape the work visa and immigration process to serve their own needs.

Our current processes negatively affects highly skilled and motivated individuals who have frequently trained for advanced degrees at US institutions. We as a nation have invested in these individuals and stand to gain financially for allowing them to live and work here. International trainees and workers have also made the often difficult choice of coming to this country to better their lives and, in the process, the lives of others including their current or future children and American citizens. The least we can do is create a system that helps them do so.

Only then can we fulfill our full potential as truly the land of opportunity to all.

For Further Reading
The H-1B Visa Program: A Primer on the Program and Its Impact on Jobs, Wages, and the Economy

The H-1B Visa Issue Explained

The H-1B Visa Debate, Explained

U.S. Degree? Check. U.S. Work Visa? Still A Challenge

The Pandemic’s Effects on Recruiting International STEM Trainees

Are foreign students the ‘best and brightest’? Data and implications for immigration policy

Guestworkers in the high-skill U.S. labor market. An analysis of supply, employment, and wage trends

Is There Really a Shortage of Skilled Workers?

STEM crisis or STEM surplus? Yes and yes

The Skills Gap: Is it a Myth?

Paying Skilled Workers More Would Create More Skilled Workers

Upcoming H-1B lottery gives US-based advanced degree candidates an edge over foreign degree ones

RESOURCES
USCIS H-1B Employer Hub (search for companies who have sponsored H-1B visas)
Additional H-1B Data

US Department of Labor H-1B Willful Violator List
What is a willful violator?

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The Challenges of Being An International Researcher: Implications for Advanced Degree Labor Markets, PART 1

5/1/2020

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Perspective Piece, Opinion (Part 1 of 2)

While I debated devoting this post to covering online resources and tips as most of the world continues to try to work remotely in response to COVID-19, I have come to realize this crisis has laid bare the unique challenges of one highly-trained and often exploited population in particular. Those individuals are international researchers working under temporary visas in the United States (US). The group encompasses international graduate students and postdocs as well as those working at for-profit companies under H-1B visas.

As this is a complex topic, I have divided it into two posts, to occur over the next two weeks.
First, we'll focus on international researchers in academia.

International Trainees in Uncertain Times

While Canada has taken action to better support some of their international trainee population during this challenging time, the current US administration has been taking steps to curb immigration and many international graduate students and postdocs are nervous about the uncertainty of their future working in the US. Indeed, reports indicate companies are moving some of their visa workforce hiring to Canada. The Canadian government's Express Entry immigration program (including the Skilled Worker pathway) and goal of adding 1,000,000 new permanent residents by end of 2021 will undoubtedly accelerate this trend.

And while I don't have the first-person perspective of an international researcher working in the US, I do interact with many of these individuals in my current work in postdoctoral affairs at NC State University where ~50% of our postdocs have countries of origin outside the US. I empathize with the unique challenges international students and postdocs encounter trying to work in the US while admitting I can never fully know what it is like being them.

I am certainly not the first person to write about international graduate students and postdocs and the unique challenges they face. Here, though, I want to present my and other's perspectives on international temporary workers, including:

the value they bring to research and innovation efforts,
the stress they put on labor markets, and
how more transparency and data regarding their experiences and outcomes can help guide policies to support all advanced degree trainees.

International Researchers Have a Profound Effect on US Academic Institution

International trainees have a large economic and productivity effect on the academic research labor force and higher education (including contributing tuition dollars) in the US, especially in science, technology, engineering, and mathematics (the so-called "STEM" fields; see). Many have argued about the need to recruit these highly-trained researchers from other countries to the US. This thesis is based on the notion that the US has a deficit in STEM graduates and thus needs to import labor with that expertise, though whether such a deficit exists is not a straightforward state to measure and has been debated (see also). Indeed, some data indicate Ph.D.-holding US citizens employed in science and engineering has decreased over the period of 1973 to 1991 relative to non-citizens, which is at least partially explained by displacement of citizens with non-citizens within the advanced-degree STEM workforce.

The US is a country of immigrants and it is an important component of American identity. Clearly, we as a country are stronger because of our diversity.

Read more about this motto of the US: https://en.wikipedia.org/wiki/E_pluribus_unum

This is supported by important work showing the impact traditionally under-represented groups, including international trainees, have on scientific innovation and productivity. Other data indicate that non-English/European/domestic graduate students and postdocs authored nearly 59% and 54% of first-author publications, respectively, in the prestigious journal Science from November 2007 to May 2008. And there is data showing immigrants to the US are more entrepreneurial and innovative, contributing disproportionately to STEM research breakthroughs. Amazingly, 39% of US Nobel Prize winners in chemistry, medicine, and physics since 2000 were immigrants.

Top countries of origin of temporary visa-holding PhD recipients in US in 2018: China (36.1%), India (11.9%), South Korea (6.0%), Iran (5.5%)

1/3 of Ph.D.s from US institutions are not citizens...17,500 people in 2018!

Stay rates of Ph.D.s in US hover around 70%

~14% of the ENTIRE US scientific & engineering workforce with Ph.D.s are not US citizens

>50% of US postdocs are temporary visa holders

International Trainees by the Number

In the National Science Foundation's (NSF) Survey of Doctorate Recipients (SDR) conducted in 2017 (the most currently available data), ~14% of the ENTIRE science and engineering US-earned doctorate workforce is occupied by non-US citizens (permanent or temporary residents). This percentage is nearly 28% in computer and information science fields and ~24% in engineering fields. Temporary residents on "student" F-1, "exchange visitor" J-1, or "worker" H-1B visas represent about a 1/3rd of that population, translating to over 36,000 individuals across all science and engineering sectors reporting in 2017.

Approximately 1/3rd of US doctorate (Ph.D.) recipients reported to the NSF in its 2018 Survey of Earned Doctorates (SED) were not US citizens...over 17,500 individuals. While many leave the US for employment, the majority do not intend to.
NSF's 2018 SED data reports ~72% of temporary visa holding Ph.D. recipients intend to stay in the US after they receive their degree. And this number has remained quite stable since 2012, averaging between 70% and 74%. Furthermore, 5 and 10-year stay rates from doctorate recipients in 2005 & 2010 range between 66% and 76% in science and engineering fields.

Many recently graduated international Ph.D. students take positions as postdoctoral researchers (postdocs) in the US. In fact, starting in the mid-1990s the percentage of postdocs who were temporary visa holders surpassed those who were US citizens or permanent residents.

In the mid-1990s the percentage of the U.S. postdoctoral population that were held by temporary visa holders surpassed that of U.S. citizens or permanent residents. Source: NSF GSS survey data, https://www.nsf.gov/statistics/srvygradpostdoc/

Why Postdoc? Career Prospects of International Graduate Students are Limited

Do more international students pursue a postdoc than their domestic peers? Or are the temporary visa holding postdoc numbers driven by the many internationally-trained individuals who come to the US to postdoc? Data from the NSF SED, see below figure, suggest that traditionally more temporary visa holders pursue a postdoc after completing their Ph.D. in the US.

After earning their Ph.D. in the US, temporary visa holders consistently pursue postdoctoral employment at higher rates than US citizens or permanent residents, though the gap has narrowed. Source: NSF Survey of Earned Doctorates 2018, https://www.nsf.gov/statistics/srvydoctorates/

In addition, one study found that the status of "temporary resident" was the strongest predictor of which US Ph.D.s pursued a postdoc within 3 years of completing their terminal degree. A variety of conditions exist to push international students on temporary visas into postdocs. Part of this is due to a systematic arrangement that allows non-profits and universities to employ an essentially infinite number of international trainees as they can access a "cap-exempt" H-1B visa pool unavailable to for-profit companies. Most international postdocs in the US are sponsored on "student" F-1, "exchange visitor" J-1, or worker H-1B visas, all of which are contingent on the visa-holder maintaining a specific status in order to continue to study and work in the US. As a postdoctoral position is both employment and training, this diverse group of visa types are available to this workforce allowing more paths to employing temporary visa holders as postdocs.
A working paper from George Borjas at the National Bureau of Economic Research has found that "a 10% increase in immigration-induced supply of doctorate recipients lowers the wage of competing workers by 3-4%, with about half of this adverse wage effect being attributed to the increased prevalence of low-pay postdoctoral positions." Indeed pursing a postdoc in general has been associated with lower initial and lifetime earnings though it is often an essential training step for those pursuing faculty positions and can be useful for one's career advancement.

By design, a postdoctoral position is both research and training and, as such, postdoc compensation has, historically, been low (see MD residents versus attending MDs as a somewhat comparable example). However, international postdocs often face even lower salaries. A Sigma Xi postdoc survey published in 2005 found temporary visa holding postdocs had a salary that was, on average, $2,000 lower than the median postdoc salary of $38,000. This data suggest international postdoc salaries could be ~5% lower than their peers.

This salary discount is potentially the result of postdocs on temporary visas accepting lower "market" rates for their positions, which may potentially deflate postdoc pay across the system. Indeed, work by Xiaohuan Lan at the University of Virginia reports that a 1% increase in the share of temporary immigrants among new Ph.D.s decreases the relative wage of native postdocs to non-postdocs by 0.9-2%.
As more temporary visa holders with Ph.D.s enter the system, they inflate the postdoc labor pool "supply" and decrease potential postdoc wages.

Many of these visa-holding individuals would not pursue a postdoc if their visa status was more permanent. Lan also showed that holding a permanent visa decreases the probability of postdoctoral participation relative to temporary visa holders by 24%. This is evidence that the temporary visa system, specifically the availability of more temporary visa types and "cap-exempt" H-1B visas in academic institutions, pushes non-citizen Ph.D.s into postdoc positions that are easier to obtain under the current system.

These data suggest visa policy changes could play a role in decreasing the number of postdoctoral positions as well as increasing the wage of all US postdocs.

Certainly required minimum postdoc salaries and initiatives that have prompted the National Institutes of Health (NIH) to consistently increase its NRSA postdoc stipend level (a common benchmark for postdoc salaries) are reducing salary inequities among postdocs. However, since these are suggested (for trainees not funded via NRSAs) or minimum (as determined by each university) salary levels, the degree to which compensation inequities exist between international and domestic postdocs remains largely unknown.

International Trainees at Academic Institutions are Especially Vulnerable

While pursuing a graduate degree and postdoctoral work is an inherently stressful experience with known mental health effects on many, international trainees face specific and unique challenges.
It is important to emphasize there exists a power dynamic in any academic research lab where the supervisor/principal investigator controls the fate of their trainees (by providing letters of recommendation, mentorship experiences, funding, etc...), which includes graduate students and postdocs. This dynamic can be even more imbalanced when the trainees are international and on either student or work visas. In fact, it crosses the line to exploitation more often than anyone in academia would like to admit.

One may wonder why would a supervisor exploit young researchers trying to advance their careers? The fact that academic research is so pressure-filled doesn't help. Supervisors are normally faculty on the tenure-track trying to keep their own carers afloat. Some are still struggling to obtain tenure, others need that next grant to come through to pay a portion (or all of) their salaries or keep their lab open.
It is not uncommon for postdocs, especially those on temporary visas, to report long work hours as they strive to support their lab's work.

It is not surprising that employer-tied visas such as H-1Bs, and F-1 visas tied to being a graduate student in good standing can lead to extreme power imbalances in the visa holder-employer/student relationship. If you ability to stay in the US is contingent on being in good standing with your employer or institution, you probably won't complain about your working conditions. This is especially problematic in academic research settings but undoubtedly happens in other employment areas.

Another important point beyond the scope of this piece is that individuals who are not US citizens or permanent residents are ineligible for applying for research grant funding from most federal agencies (but see this list of agencies supporting non-citizen researchers). This prevents international postdocs wishing to remain in the US from obtaining a research funding track record needed for most faculty positions at R1 universities.

The plight of international researchers reflects a systematic problem: academic research and career advancement is under-supported.

The H-1B Visa: Pathway to Opportunity or Tool to Consolidate Employer Power

At many US institutions, the postdoc position is a temporary one with limits on how long a person can be employed as a postdoc. So, what becomes of the large, international postdoctoral population after their postdoc positions end? The short answer is we don't really know as tracking postdoc outcomes has not been a priority at most institutions.

Given their limited work options within the US, though, international postdocs who wish to stay have few employment options. This most often means taking research-related positions at academic institutions with titles such as research associate, research scholar, or research assistant professor. And whether these positions represent career advancement from a postdoc is questionable. Some see these roles as means to skirt the term limit rules for postdoc positions (typically around 5 to 6 years, see) while others see a path toward professionalization of researcher roles for former postdocs (see also). Further tracking of postdoc outcomes and career progression is needed to support these arguments.

What we do know from data collected in a 2016 national postdoctoral survey is that "residency status in the U.S." is a significant predictor of postdocs' career choices. Clearly, the career paths open to temporary resident postdocs are different from their permanent resident or US citizen peers.

The H-1B work visa is a common path to employment for advanced degree holders seeking to remain in the US. H-1B sponsored employees, including postdocs, must be paid the "prevailing wage" for their work area, level of expertise, and geographic location of work. However, this determination of prevailing wage is open to much interpretation. In fact, some have argued and data have shown that H-1B employees at for-profit companies make lower salaries than their peers and that this mechanism is used to, potentially, suppress wages for all employees.

Currently there is a "cap" on H-1Bs granted each year to for-profit companies and a lottery is often used to allot the 85,000 visas available to advanced degree holders. The success rate of "winning" the lottery hovers around 25 to 35%. However, university and nonprofits are exempt from this cap. The current system, then, incentivizes advanced degree holders to continue working in a university or nonprofit setting on a "cap-exempt" H-1B visa if they want to remain in the United States. And many of these academic researcher positions are often underpaid and unstable given they are commonly supported by research grant funding.

So, the H-1B cap-exempt status of universities may contribute to the under-employment of international trainees, locking them into academic research support positions, especially given the low rates of these (and most Ph.D.-holding) individuals transitioning to more well-paid and stable tenure-track roles. Data from the US Department of Education show 3-3.5% of all tenure-track (Assistant Professors) and tenured professors (Associate or Full Professors) at US post-secondary institutions (universities and colleges) are not citizens or permanent residents. Looking just at the tenured professor population, the percent that are not US citizens/permanent residents is only ~1.4%. Obviously, there are various reasons for temporary researchers to not pursue a faculty position in the US from a desire to return to their home country to making the decision to not pursue a faculty route for employment in the US. However, for the international immigrant and temporary visa holding population to go from representing >50% of US postdocs to approximately 1.4% of tenured faculty and 6.5-7.0% of tenure-track faculty (definitely a better number in this younger population) at US institutions represents serious issues in career advancement that require further study and scrutiny.

Closing Thoughts: Complex Problems Have No Straightforward Solutions

Clearly, the visa landscape and its intersection with international trainees pursuing postdoctoral positions, their job prospects, and the effects on wages (more in Part 2) is quite complex. In no way is this piece suggesting that temporary visa holders are the problem. Rather, the system is set up in such a way as to limit opportunity for many advanced degree holders, especially temporary visa holders. These individuals often pursue postdocs and stay employed in various research roles (research associate, research assistant professor, etc...) because these roles are most accessible to them given the cap-exempt nature of H-1B visas for universities and non-profit organizations, among other factors.

The National Research Council laid out policy recommendations for international graduate students and postdocs in 2005 including further study on the effect these populations have on U.S. research productivity and innovation and the larger economy (i.e., the employment they pursue if they remain working in the US, or elsewhere).

Fifteen years after that report, while some studies, including those referenced in this piece, have been completed, MUCH remains unknown about the the international researcher population and whether it is a net positive or negative for the research enterprise. Some institutions have begun reporting outcomes data of their Ph.D. students & postdocs, which can in some cases be filtered by international status - see the Coalition for Next Generation Life Science initiative. But more outcomes tracking of the international trainee population in the US is needed, especially those who received their graduate degrees outside the country and pursued a postdoc in the US (as NSF's Survey of Doctorate Recipients and Survey of Earned Doctorates focus on US Ph.D. recipients only).

Work that lays out career pathways & outcomes for trainees such as this one for biomedical Ph.D.s from ASCB are necessary moving forward. Source: https://www.ascb.org/careers/where-will-a-biology-phd-take-you/

Another challenge in supporting international researchers is allowing them to effectively transition from trainee (graduate student or postdoc) to stable employment.

In my opinion, we are doing these individuals a disservice by allowing them to come to our institutions within the US to train and then not being able to easily support them in their career transitions when the data suggest a vast majority (70%+) wish to stay and work in the US. Expecting the number of individuals we train each year to be able to secure one of the ~85,000 H-1B visas sponsored by a for-profit company (more on this in next week's post) seems irresponsible. And if a company has to enter a lottery for the ability to even hire someone on an H-1B, we dis-incentivize them from using the mechanism effectively.

Thus, the pathway remains heavily tilted toward temporary visa holders remaining to work in academic settings, often in contingent labor positions, as postdocs, research associates, research scholars, research assistant professors, lecturers, etc... These positions often lack the ability for career advancement and pay wages that are below market value for these highly-trained researchers. The system allows these positions to exist, though. Academia is not immune to the pull of cheap labor.

In these uncertain times, being an international trainee is even more problematic. Traveling back to one's home country is not even feasible at the moment with the restrictions in place due to COVID-19. How we as institutions respond to the challenges of this vulnerable population will, I believe, be telling of how we deal with the coming issue of supporting the vast number of advanced-degree holders we produce each year.

Will we be bold and seek to make the difficult choices needed to sustain and support graduate education and postdoctoral training? Or will we continue to ignore the real challenges those we train face in securing meaningful employment? In the end, our trainees' outcomes will be the ultimate judgement of the "success" of our system. Through greater transparency and accountability, we can correct course, though, and fulfill our mission of advancing the lives of the students and postdocs from around the world who entrust their training to us.

MORE on H-1B Effects in For-Profit Companies and their Economic Impact Next Week

For further reading:
International Student Precarity in the Humanities Academy

International Students and COVID-19

The Economics of University Lab Science and the Role of Foreign Graduate Students and Postdoctoral Scholars

Internationalization of the postdoctorate in the United States: analyzing the demand for international postdoc labor

Permanent Visas and Temporary Jobs: Evidence from Postdoctoral Participation of Foreign PhDs in the United States

Choice of Country by the Foreign Born for PhD and Postdoctoral Study: a Sixteen-Country Perspective

Reports & Briefs on High Skill Immigration from the National Foundation for American Policy

The Future of the Postdoc

National Academies of Sciences. The Next Generation of Biomedical & Behavioral Sciences Researchers: Breaking Through Report

Resources
National Postdoc Association's International Postdoc Survival Guide

Resources to address challenges for international students and postdocs (ASCB)

Coronavirus resources for international trainees from NAFSA

National Science Board Science & Engineering Indicators (2018)

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Post-Ph.D. Career Plans: Consider the Possibilities

3/7/2020

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Ph.D. Career Trends

The post originally appeared on PassioInventa, a site run by graduate students to serve as a platform for science communication.

Many people assume Ph.D.-trained individuals work in two predominant areas: academia or industry. Most professors have Ph.D.s, and academic careers are considered to be the “default” or even preferred path during one’s graduate training.
The other major career bucket Ph.D.s fall into after their training is industry. What do we mean by “industry”, though? Many assume an industry Ph.D. works in pharmaceutical development or some other research and development (R&D) role, and some, indeed, do. However, there are so many additional roles Ph.D.s can fill in industry as well as in government, nonprofits, and academia that don’t fall into the neat buckets of academic or industry scientist.

What do Ph.D.s do for work? Let’s look at the data.
A wealth of career data for Ph.D. recipients is collected by the National Science Foundation (NSF) in its Survey of Earned Doctorates (SED) and Survey of Doctorate Recipients (SDR). The SED focuses on recent Ph.D. graduates each year (Table 1) while the SDR captures employment information of individuals with Ph.D.s in science, engineering, or health fields, regardless of when they received their degree (Table 2).

Table 1: Survey of Earned Doctorates (SED) data on primary work role for 2018 Ph.D. graduates in the life sciences, physical/earth sciences, and engineering. R&D, Research & Development

Table 2: Survey of Doctoral Recipients (SDR) showing primary work role of individuals with life sciences, physical/earth sciences, or engineering degrees in 2017. R&D, Research & Development

The data collected by the NSF demonstrate that anywhere from 34.1% to 37.3% of science/engineering doctorates ultimately perform work beyond R&D and teaching (Table 2, Something Else column). That number might surprise current graduate students and postdoctoral trainees who often consider their career options limited.

Ph.D. employment trends are changing: The elephant in the room
A great challenge in graduate education and career/professional development is ensuring Ph.D.-trained researchers understand that the “traditional path” of securing a faculty position is becoming more difficult to follow. This trend was summed up well by Schillebeeckx et al 2013 (reproduced below), who show that the cumulative number of Ph.D.s awarded in Science & Engineering fields has grown rapidly compared to available faculty positions over the past few decades.

This chart includes data collected through 2011; the startling trend has unfortunately continued. More recent data can be accessed from the SDR & SED on employment trends for Ph.D.-trained scientists and these data continue to show the decline in the percentage of Ph.D.s working in tenure-track faculty positions. The trend is most apparent in the SDR data where employment in academic positions is broken down by tenured faculty, those on the tenure track, and those in positions not eligible for tenure. In addition, the data is categorized by those who received their Ph.D.s <10 years from the survey (representing early career researchers and postdocs) and those 10 or more years post-Ph.D.. The change in the academic employment landscape for these recent Ph.D. graduates (Table 3) illustrates the radical shift occurring in Ph.D. employment at 4-year educational institutions.

Table 3: Percentage change in recent (<10 years from degree) Ph.D.s employment at 4-year educational institutions in the United States from 2010 to 2017, calculated from NSF SDR data.

Growth in non-tenure track employment among science Ph.D.s
Where are these Ph.D.-trained scientists going? While some are moving into career fields outside of academia -- in fact the 2017 SED data showed private sector employment of science/engineering Ph.D.s (42%) was nearly on par with educational institution employment (43%) -- many are working in non-tenure track positions that could include lecturers, adjunct faculty, research faculty, or postdoctoral positions. Table 3, above, shows the 2-3x growth in these non-tenure track positions in a period of just 7 years.
Further examination of the 2017 data showed an astounding 17.1% (~1 in 5) of those with life science Ph.D.s employed at 4-year academic institutions were postdocs.

What is a postdoc and should I pursue one?

"A postdoctoral scholar (postdoc) is an individual holding a doctoral degree who is engaged in a temporary period of mentored research and/or scholarly training for the purpose of acquiring the professional skills needed to pursue a career path of his or her choosing."
-National Postdoctoral Association

While completing a postdoc has been a natural step toward securing a faculty career, it has also, unfortunately, become a holding place for Ph.D.s who have not been able to secure faculty employment. In addition, remaining a postdoc for too long may have serious effects on one’s lifetime earnings potential. In fact, many Ph.D.-trained individuals should probably not pursue a postdoc but a lack of information on career opportunities for Ph.D.-holders leaves many to default to the postdoc path.

My own story navigating the academic career path
I was one of those individuals on this default postdoc path. I had a great graduate school experience at UNC Chapel Hill and felt encouraged to stay in academia and pursue a postdoc with the goal of learning a new scientific technique (PET imaging of the dopamine system). My ultimate goal was to land a tenure-track faculty job.

Completing my graduate training in the lab of a recently-hired faculty member certainly showed me that landing the faculty job is only step one on the path to the idealized tenured professor position. An equally difficult step is being productive to obtain tenure. A faculty member who obtains tenure needs to publish papers, secure grant funding, mentor effectively, perform service for one’s home department, and often teach.

While the public sees a faculty job as pretty cushy -- and maybe after securing tenure it gets a bit more cushy (or at least secure in terms of your salary) -- the path to obtaining that tenured position is an arduous and tenuous one. There are so many places where one can fall off this pathway of postdoc -> assistant professor (on tenure-track) -> tenured faculty.

Collaborative work from the Future_PI Slack group which I have been involved with shows that every year, very qualified individuals who apply for assistant professorships don’t succeed.

The average person (and most family members of graduate students) really has no idea the challenges Ph.D.s face in launching their careers. I know I was certainly not the first person whose parents inquired when I would be “done” with training and get a “real job”. They meant well but, like many people, assumed once someone has a Ph.D., aren’t they “done” and on the quick path to fortune?

Acknowledging my faculty career doubts and discovering alternative career paths during my postdoc
I spent 4.5 years as a postdoc at Vanderbilt University and it was a really wonderful time. I felt I grew as a person, contributed important work to my field of neuroscience, and gained leadership experience in the Vanderbilt Postdoctoral Association. And while I went deep down the path toward obtaining a faculty position (even getting an onsite interview back in Spring 2018), in the back of my mind I had doubts about being a faculty member; that path just didn’t feel right. Having access to career/professional development programming at Vanderbilt helped me learn about other career paths for Ph.D.s.

I now work in career and professional development helping current graduate students and postdocs at North Carolina State University. You can read more about my personal career exploration journey and transition to postdoc affairs in my series of NIH BEST blog posts.

Career exploration is where it all begins
Part of the search for a post-Ph.D. or post-postdoc career is a search for yourself. This sounds kind of intimidating - and it is. But trust me when I tell you people like me do make it through a challenging career search, and along the way they often discover what is most important to their wellbeing and happiness. Seems like a pretty nice outcome after navigating the hard, twisty road to a career.

For a deeper dive: Explore the NSF data referenced in this article

See my previous Blog pieces on career exploration:
Start here
career exploration 101

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Why you should get involved in things outside the lab/work

2/5/2020

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Life Advice

Getting involved in my local postdoctoral association changed the course of my professional career. I didn’t know it at the time, though.

I served in the Vanderbilt Postdoctoral Association (VPA) as Treasurer in 2016-17 and Junior Co-Chair (Vice President) in 2017-18. When I decided to volunteer in my first leadership role, I didn’t really consider myself leadership material. I am pretty quiet and reserved but realized this group was doing important work including building a community of support for postdocs and linking them to resources on campus.

Working with the VPA, I met a lot of awesome people doing amazing things, including some postdocs whom I would never had interacted with if I stayed in the lab or only attended departmental events. The VPA senior co-president when I started attending association meetings is now a data scientist and the senior co-president I served with in 2016-17 received a prestigious AAAS Science & Technology Policy Fellowship. The 2018-19 VPA senior co-president, who I interacted with frequently in Fall 2018 as I assisted with our Association website design, now works at Regeneron Pharmaceuticals. Other leaders who worked with me in the VPA over the years have taken positions in medical writing at AbbVie (a pharmaceutical company), an assistant professor position at the University of Florida, and directing NIH BEST consortium activities.

Teamwork & leadership are highly valued
I bring up the careers these individuals have obtained post-postdoc to demonstrate that the leadership and teamwork experience one gains from working with a community organization or group looks great to potential employers. You don’t have to get involved with your local Postdoctoral Association (though the NC State PDA is always looking for volunteers) to find volunteer opportunities that can be useful for you both personally and professionally.

Involvement and/or leadership in organizations can lead to a variety of career options in the future.

There are so many organizations to get involved with
Like communicating science? Why not volunteer at the NC Museum of National Sciences in downtown Raleigh? Interested in a career in medical writing? The American Association of Medical Writers has a local chapter based here in the Research Triangle. Other local organizations to get involved with (that I am aware of) include the International Society for Pharmaceutical Engineering with both an NC State and Carolina-South Atlantic Chapter, North Carolina Regulatory Affairs Forum, entrepreneurship programs, and a host of exchange groups in a variety of life science areas.

Volunteer in your community to hone your skills, meet others, and give back

It is critical to your mental health to seek out activities beyond your lab/research work (or any work, really). Volunteering in local organizations can provide you a broader community of social support and sense of accomplishment in the work you do in them that is independent of how things are going in your graduate or postdoctoral work. You can use volunteer opportunities to work on skills outside your comfort zone and try bold things without your performance being tied to your current salary or stipend.

Prototyping potential alternative careers can be very helpful as you explore what to do after your graduate school or postdoctoral training. Getting involved in specific activities that allow you to pursue a line of work you might be interested in will help you test them out as a potential career path for you. You can self-reflect during these activities asking: do I enjoy doing this?, do I need to hone some skill before seeking formal employment in this area?, etc...

You may discover you can build a fulfilling career out of the skills and experiences you exercise outside the lab, combining them with your other strengths to do something you are both good at and enjoy.
By venturing outside your school/work, you will also meet a more diverse group of professionals and start to learn about the many career opportunities out there in the world.

Take on work that is outside your job duties to build new skills & establish more connections
Just a few months into my role in Postdoc Affairs at NC State University, I sought out opportunities to serve on various committees in professional organizations relevant to my career: the National Postdoctoral Association (NPA) and Graduate Career Consortium. Working on committees tasked with resource development, education research/outcomes assessment, and bench-marking of career development professionals has allowed me to greatly expand my network and learn more about exciting developments in these areas. I am also part of the early conversations around how we will communicate new resources, work, and findings to our membership. This helps me stay informed on new initiatives and advances in the field...something I find immensely valuable.

Certainly don't over-extend yourself but I believe taking on additional opportunities when you think they will help you learn and grow in a new area (I had been focused on neuroscience research for the past ~10 years before this career move) is worth it.

I also volunteered to work with a group of individuals through Future PI Slack analyzing and writing up results from a faculty career applicant survey. While this work took up quite a bit of time on the weekends from June to October, we have submitted this work for peer review and, if accepted, it will be my first publication in the education research/outcomes area. I also plan to continue working with some of my co-authors on this work developing more detailed, future surveys to understand factors that lead to a successful faculty job search.

As I seek to grow in my new area of career/professional development, I expect all this additional "side" work to pay dividends...and perhaps they already are.

I successfully ran for the Board of Directors for the NPA this fall and I think being involved and meeting others in the field probably helped with name recognition on the ballot.

Closing thoughts
Obviously, where you seek to invest your "free time" to grow and develop will be different from my own experience but I urge you to make the time to develop knowledge, skills, and a network outside your current one. This could be in the form of going to local meet-ups focused on some area of interest to you (data science, ag tech, science communication), attending networking events to learn about other opportunities in the area, or volunteering for a cause you are passionate about.

You never know where these extracurricular experiences might lead.

If you don't take part in any, though, you'll never find out.

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New Year's Resolutions: Read More, Learn More

1/7/2020

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Career & Professional Development

As we start a new decade, now is a good time to stop and reflect on how to make 2020 a productive and fulfilling year. I find listening to inspiring podcasts and reading interesting books helps me think about how to live my life more impactfully.

So, I am sharing some podcasts I currently subscribe to and books I am excited to read this year:

Podcasts
The Science of Success
How to be Awesome at Your Job
Good Life Project
WorkLife with Adam Grant
The Happiness Lab

Books
"A reader lives a thousand lives before he dies." - George R.R. Martin
Switch: How to Change Things When Change is Hard
The Happiness Equation
Range: While Generalists Triumph in a Specialized World
Ditch the Act: Reveal the Surprising Power of the Real You For Greater Success
Nine Lies About Work: A Freethinking Leader's Guide to the Real World
All You Have to Do is Ask
Perfectly Confident: How to Calibrate Your Decisions Wisely
Life is in the Transitions: Mastering Change in the Nonlinear Age

Preorder
Social Chemistry: Decoding the Patterns of Human Connection
Joy at Work: Organizing Your Professional Life

“Research is showing pretty convincingly now that happiness is really within us, it’s not outside of us. It’s in what we do. It’s sort of how we act, how we think every day of our lives.”
- Dr. Sonja Lyubomirsky, Distinguished Professor, University of California, Riverside & author of The How of Happiness
Read some of her interesting research on positive affect (happiness) and success here.

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The end of work as we know it: How an increasingly automated world will change everything

12/16/2019

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Career & Professional Development, Opinion

In a few short weeks we will be entering a new decade.

What will the 2020s hold? Technological advances continue to take shape at a blistering pace and will have effects on nearly all aspects of our lives. While most of these tech advances will be a clear benefit (improved healthcare, faster connectivity with 5G wireless, and greater access to online learning), others offer a potentially existential challenge to something most of us do for more than a third of our lives: work.

Work in the Age of AI
The nature of work is changing rapidly. Automation and artificial intelligence (AI) are allowing machines and computer programs to take on an extraordinary variety of tasks.

We think of this as a blue-collar issue with robots now doing most of the assembly at automobile plants across the world and autonomous vehicles coming to take truckers jobs soon. The truth is, though, very few jobs are safe from automation as many jobs are quite routine and skills-based.

Any job requiring technical skill alone may eventually be subsumed by advances in AI. This leads to the important question of how does one prepare for this sea change? How can you make yourself un-replaceable by a machine?

A 2017 McKinsey Global institute study concluded up to 800 million workers worldwide could lose their jobs to automation by 2030.

Workforce Transitions in a Time of Automation (McKinsey, Dec 2017)
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What Skills Will Be Valued in Future Work?
While it seems logical to assume that increases in AI would necessitate increased training in technical skills like computer programming, coding, engineering, or other scientific fields, the fact of the matter is that those technical skills themselves may be unsafe from the evolving capability of our machines.

Specifically, a report by the Brookings Institute where job descriptions were compared against AI-related-patents (see paper by Michael Webb at Stanford University for empirical details) found that white collar, data-intensive jobs in business, technology, engineering, and science are at greatest risk of being impacted by AI. The report quantified impact as having job duties that could be subsumed by coming AI advances. This doesn't mean AI would replace the job completely...in fact, AI may just supplement work in fields such as finance and scientific research. What is clear, though, is that only being good at a skill or technique that eventually can be automated is NOT a winning strategy.

"AI exposure will likely lower wages and lead to job replacement if human workers can no longer bring "extra value" that AI can't."
- Mark Muro, Senior Fellow & Lead Author of the Brookings report

Transferable, Human-Centered Skills are Irreplaceable (for now)
What will be in demand for the foreseeable future are transferable skills. These types of skills aren't technical but rather refer to intra- and inter-personal skills that we use to get our work done efficiently, by ourselves or with others.

LinkedIn found these 5 transferable skills to be most in demand in 2019 (based on job postings on the platform):
5. Time Management
4. Adaptability
3. Collaboration
2. Persuasion
1. Creativity

In addition, as more and more employees become tech-savvy, backgrounds that give employees perspective — historical, global, or otherwise — will become increasingly valuable. We will need to increasingly think about how our machines and interfaces are designed to interact with humans.

Currently, machines cannot think like human beings. The AI we have today is so-called "narrow AI,” performing objective functions using data-trained models. The AI from science fiction movies where machines have human-like intelligence, so-called "artificial general intelligence," is far from a reality and may never be achieved. So, we will need people to serve as the interpretational bridge between AI and society and back again...to insert humanity into our machines and their decisions.

Technical Training is NOT Enough:
The Role of Critical Thinking, Problem Solving, Data Synthesis, & Presentation Skills
There has been an increased emphasis and interest in STEM (Science, Technology, Engineering, & Mathematics) education to prepare the next generation for a new age of work. Colleges, particularly technical schools and community colleges, have invested heavily in career and technical education that seeks to broaden technical skills currently in demand (coding, software engineering, etc...). Ironically, though, being trained in the liberal arts and humanities may be more useful in the age of AI. In addition, there is data suggesting a surplus of STEM majors in some fields (see also this piece from The Atlantic).

It won't be so much our technical skills that differentiate us in the 21st Century economy. Rather, being able to think critically, synthesize information, present arguments persuasively, and work effectively with others will be increasingly valued.

Anyone working in the sciences knows that our knowledge and tools change fast. So, it may not be surprising to consider the skills we value now in coding, data manipulation, and analysis may not be what is needed 20 or even 10 years from now.

"It is not only what you know but how you learn that will set you apart."
- Thomas Friedman, author of The World is Flat: A Brief History of the Twenty-first Century

Graduate Students & Postdocs Have the Skills Needed for the 21st Century Economy
Having the skills to quickly dissect a problem, synthesize and interpret data, and clearly present insights and recommendations from your work are incredibly valuable. Luckily, if you have been pursuing a graduate degree or postdoctoral work, you have experience in all these areas. Each day you are working to troubleshoot problems, synthesize your data with what is already known, and form coherent narratives around your findings. You are uniquely poised to make sense of the flood of data that is and will be produced and stored from the countless scientific publications, device interactions, and web searches that occur each day.

Even the hot career field of data science is focused heavily on communicating insights from analyses. This skill may become even more critical as computers takeover the work of data preparation and analysis, leaving the humans to extract insights from the work.

Ph.D.-trained scientists are uniquely poised to be the data interpreters we will need in the 21st Century.

How to Hone & Leverage Your Transferable Skills Into Meaningful Work
A changing world demands individuals who can change with it. Flexibility and the ability the learn and adapt to new technology will be crucial. Scientists possess these and other transferable skills but need to more effectively hone and communicate them to potential employers.
In addition, current graduate students and postdocs must avoid becoming so focused in one domain or technique that they don't develop the transferable skills needed to succeed in the 21st Century economy.

How can current trainees practice and perfect their transferable skills?
Develop Teamwork & Leadership Skills
Taking leadership roles or volunteering in organizations that you are passionate about (including graduate student and postdoc associations) allows you to give back to your community while also honing your teamwork and leadership skills (for example, see). You can look to get involved with local or national organizations or local chapters of national organizations, potentially in research or career areas that interest you.

Volunteering within an organization while continuing in your current role will also force you to improve your time and project management skills as you seek to fulfill your many obligations. In addition, working with others in these organizations, especially those from different backgrounds than yours, will teach you the importance of effective communication skills (listening, synthesizing, presenting), leadership, and consensus building to achieving success.

Check out Volunteer Match for community volunteering opportunities.

Communication Skills
You should also seek out opportunities to practice and demonstrate your communication skills. Join Toastmaters to practice your public presentation skills or volunteer to deliver a talk to a general audience (local science cafes/clubs are a great venue). You can also start posting articles on the web to demonstrate your written communication skills (LinkedIn has a great self-publication feature). Showing you can speak to a general audience and not just academics is crucial. Your future coworkers and customers will have a variety of backgrounds and speaking to them in an accessible way will increase the rapport you can build with them.

Final Thoughts
While the future of work in the age of automation may seem scary, there is the real possibility that increased efficiencies will free us to do tasks that are mentally stimulating and personally rewarding. Instead of slaving over data we will be able to spend our time thinking about how it can be used to better the human condition. We will be able to spend more time interacting with one another instead of at our screens doing the menial tasks that often accompany knowledge-based work.

A more automated and efficient world will provide us more time to do what we enjoy and give back to others: to do meaningful work. By freeing us of routine, tedious tasks, AI also has the ability to unlock the vast untapped potential in so many of us...to allow us to pursue work and activities that are not motivated so much by their utility and profitability (as the machines will do much of that) as by their ability to bring happiness to our and others lives.
That is certainly a future worth aspiring towards.

Further Reading
AI & Work
Where Machines Could Replace Humans - and where they can't (yet)

What jobs are affected by AI? Better-paid, better-educated workers face the most exposure

Is Technology About to Decimate White-Collar Work?

When Will AI Exceed Human Performance? Evidence from AI Experts

In the Age of AI (PBS Frontline documentary)

Human Flourishing in the AI Age - We Need a New Story

Education & the 21st Century Labor Market
The Myth of the Science and Engineering Shortage

STEM Crisis of STEM Surplus? Yes & Yes

A Humanities Degree is Worth Much More Than You Realize

The Growing Importance of Social Skills in the Labor Market

You Can Do Anything: The Surprising Power of a "Useless" Liberal Arts Education (book)

The Future of Work
Meaningful Work: Viktor Frankl's Legacy for the 21st Century (book)

Life's Great Question: Discover How You Contribute to the World (book)

The Globotics Upheaval: Globalization, Robotics, & the Future of Work (book)

MIT Initiative on the Digital Economy

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Giving Thanks: Finding personal fulfillment

11/4/2019

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Life Advice, Career Exploration/Development

We are entering the month of November and that means Thanksgiving is only a few weeks away.

All too often, however, we aren't thankful enough for what we have. Instead, we can easily become consumed by what we don't have as we compare our life situations to others.

In the end, we need to work to define what life circumstances will truly make us happy, pursue those things, and ignore what others say should make us happy.

Envy & the perils of human competition & comparison
The truth is, it is very difficult for human beings to not envy one another...it is as old as the Biblical story of Cain & Abel, among others.

This brings up the philosophical debate: are humans by nature competitive or cooperative? Obviously, we are capable of both types of behavior. Certain societal and institutional settings, though, can amplify one or the other.

For instance, capitalism and neoliberalism are focused heavily on competition and individualism. In addition, American culture is often centered around individuals striving to be "the best".

There is nothing wrong with working to improve and better yourself but gauging one's progress against others in a race to the top is fraught with peril.

Furthermore, social media platforms have enabled us to know even more about the lives of others and can fuel our envy for what others have that we don't. It's important to remember, though, that on social media individuals often display only the best version of themselves and their lives.

This fact has led many young people to be focused on living the "perfect life" and when they inevitably don't reach that lofty goal, their mental health can suffer.

Finding happiness
We all want to have happy, fulfilling lives but struggle to know what that looks like for us.
Everyone has different values and needs when it comes to what they classify as a "good" life.

So, allowing others to define what you should find meaningful in life is very problematic. It is incredibly common, though. We all have parents we want to please or life plans we think we should follow but that is a recipe to live a life that lacks personal fulfillment. The idea that smart, dedicated people need to aspire toward some high-paying, prestigious job is common among parents who want their children to "succeed". But that job as a doctor, lawyer, or consultant might not be what the child really wants.

You shouldn't allow societal expectations to define your life, either. American society values money a lot. So, if you aren't earning a large salary, you might be socialized to assume your life might not be very "good". Certainly, you need to earn some threshold of salary to live a healthy life without deprivation (one study says the magic threshold number is $75,000, but your mileage may vary).

In terms of how societal expectations apply to Ph.D.-trained researchers, the assumption is that "success" for this type of training is to eventually land a faculty job. Even though there are plenty of roles where a Ph.D. would provide value and the role might better fit the trainee's skills and interests.

There is so much more to life and happiness than money or a prestigious position. But what are those other things? The answer to that is incredibly personal.

The importance of self reflection & awareness
One huge obstacle in allowing individuals to find meaning in their lives is that we often fail to take the time to think deeply about what we want out of our life. While this seems like a basic place to start, our fast-paced, modern world doesn't leave much time for self reflection unless one makes a concerted effort to do it. In fact, psychologist Tasha Eurich's research suggests ~10-15% of people are self-aware.

Self-reflect & begin designing the life you want
Exercises to increase your self-awareness.
Designing Your Career online course from Stanford University (free).
More life design resources from Stanford.

A matter of perspective
The perspective we take to our "success" is the most critical component to our happiness. We can count our blessings or ruminate on our deficiencies. The former, positive thinking is infinitely better for your mental and physical health.

Take me, for example, at age 33 with a Ph.D. I could focus on the fact that I don't make a six figure salary, that I have yet to find a significant other, and that I don't have kids, though I want to someday.
Or, I could focus on the fact that I am in very good health, have loving parents and two sisters who I get to see on a regular basis, have the flexibility in my work to take time for family, friends, and my own well being, and make enough to live pretty comfortably. On top of all that, I am doing work that I think is having a positive impact on the world, helping support others in their career & professional development.

All in all, I am doing alright.

In closing, try to take stock of what you value in your life. Is it money? Prestige? A flexible work/life balance? Autonomy in your work? Plenty of free time to spend with family and friends?

Once you know your values, pursue them and don't let the opinions of others derail you on your path to your own personal fulfillment.

When you set your own metric of success and work hard to obtain it, you can find your own happiness. And that is something to truly be thankful for.

"Everything can be taken from a man but one thing: the last of the human freedoms—to choose one’s attitude in any given set of circumstances." - Viktor Frankl

For further reading/listening
Articles:
The Comparison Trap
How to stop comparing yourself to others
The age of envy: how to be happy when everyone else's life looks perfect
How you think about money can impact how happy you are in life
How the West become a self-obsessed culture
Perfectionism is increasing over time: A meta-analysis of birth cohort differences (1989-2016)
Change your perspective, change your life

Books:
The Road to Character
The resume virtues are the ones you list on your resume, the skills that you bring to the job market and contribute to external success. The eulogy virtues are deeper. They are the virtues that get talked about at your funeral, the ones that exist at the core of your being-whether you are kind, brave, honest, or faithful: what kind of relationships you formed.

Insight: The surprising truth about how others see us, how we see ourselves, and why the answers matter more than we think
Research shows that self-awareness—knowing who we are and how others see us—is the foundation for high performance, smart choices, and lasting relationships. There’s just one problem: most people don’t see themselves quite as clearly as they could. This book offers tips on improving one's self-awareness.

Podcasts:
The Happiness Lab
WorkLife with Adam Grant
The Science of Success

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Using Data Science and Artificial Intelligence to Improve Healthcare

9/30/2019

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Data Analytics & Healthcare

This article originally appeared on the Health:Further blog on October 14, 2018.
It has been updated with current news and findings.

Data science is a buzzy term not only in the technology sector but in the wider culture as well. It has seeped into the common vernacular and promises increased insights and knowledge extracted from the vast quantity of data being generated every day.

The use of data science in healthcare is growing and artificial intelligence (AI) represents a huge business opportunity in the space. However, the potentially identifiable nature of health records and ethical concerns about how the data should be utilized and by whom makes working in this space a challenge.

The recent publication of work suggesting AI may be as good as clinician s in diagnosing disease further highlights the increased importance this technology will have in 21st Century healthcare.

I spoke with data scientists from 3 different healthcare companies on how their groups are using data to improve the quality and efficiency of healthcare.

axialHealthcare, Nashville, TN

Lindsey Clark, Ph.D., is Director of Data Science and Analytics at axialHealthcare in Nashville, TN. Since joining the company in 2015, Clark has watched axialHealthcare grow rapidly from 8 to more than 100 employees. Focusing on pain management and opioid care, axialHealthcare leverages medical, behavioral, and pharmacy claims data to drive improved patient care and financial savings for health insurers through technology-enabled capabilities.

In essence, axialHealthcare's goal is to understand which treatments are both effective and safe in the treatment of pain. Axial is also focused on determining if treatment approaches beyond potentially addictive opioids are viable for particular patients.

A big question at axialHealthcare is, “what does safe and effective pain management look like?” The answer seeks to ensure that 1) opioids are prescribed judiciously given their propensity for causing dependence and addiction and 2) that other pain reduction therapies are considered when warranted.

Clark emphasized the unique challenges of working with health information, including the critical need for data security and privacy as well as navigating the complex United States health system. The focus for most of U.S. healthcare is on what is reimbursable by either health insurers or Medicare/Medicaid (federal & state payers). Thus, every company trying to improve cost efficiency in healthcare must think about how their recommendations fit into the payers’ current reimbursement framework.

axialHealthcare has organized its Research and Development (R&D) group into data science and statistics/communication branches that communicate closely but have different functions. These teams work with the product team whose job is to think about the value they can extract from data insights and models to benefit customers. The R&D groups also provide support to the company’s clinical outreach team comprised of licensed clinical pharmacists and engagement specialists who work to change provider behavior and improve patient outcomes, which ultimately reduces costs on the healthcare system and protects insurers from spending on ineffective treatments.

axialHealthcare synthesizes a variety of data to improve patient care and drive savings for payers.

Most of the company’s data comes from insurance claims, but some is also gleaned from patient behavioral and electronic health record data. Although the team is always focused on new data-derived models of improved care and cost savings, it is critical for the data science team to align their projects with what the market needs.

“Insurers, our main clients, are very focused on short-term costs and so it’s often critical that our company frame the work in a way that indicates both short-term and long-term costs can be improved through data insights. Selling clients on the long-term cost savings can be difficult, especially if the short-term effects are increased costs to insurers,” according to Clark.

This point illustrates the challenge of providing solutions that are good for the business of healthcare and also for the health of patients.

Framing information in a way where payers can see the long-term savings generated from costly approaches in the short-term is critical to enacting meaningful, effective interventions.

Ultimately, the company hopes to collect its own data for two reasons: 1) access to data can be a challenge and 2) variables that may be of interest to the data science team aren’t always available in the data collected by a third party. Nevertheless, axialHealthcare’s current approach has proven effective for patients and payers.

Artificial Intelligence (AI) in Healthcare

At the 2018 Health:Further Festival held in Nashville, TN, I talked with two companies working to use artificial intelligence (AI) to improve healthcare.

Change Healthcare AI group, San Francisco, CA

Change Healthcare is the largest independent healthcare information technology company in the U.S., handling approximately 60% of medical claims. Alex Ermolaev is part of a growing AI team there. The goal of Change Healthcare’s AI group is to improve efficiency and add value on top of existing data management and analytics solutions.

See Alex's video on AI in Healthcare below.

Change Healthcare uses large, aggregated and de-identified claims, medical history, and treatment plan data from their databases to provide insights on how to increase the effectiveness of healthcare, particularly how to provide treatment that is more efficacious and economical. While Change has mostly claims data, Ermolaev said most of it is very extensive, often up to 400 pages per claim, so that meaning and insights can be extracted from the various doctor notes and other details from healthcare providers. Text from claims can be read and analyzed using natural language processing approaches to identify relevant information in the record.

Ermolaev, formerly at Nvidia, mentioned that most AI models can achieve very high accuracy (>95%) as long as the following 3 factors are available: 1) large amounts of data, 2) bigger/more complex models, 3) more computing power.

“The main limit to using AI in healthcare is the lack of large enough data sets,” according to Ermolaev. This shortage of data is not unexpected given the sensitivity of personal health information and the vast privacy protections in place. Thus, companies with access to the data have a great advantage when competing in the AI healthcare space.

As AI and predictive analytics grow in healthcare, Ermolaev believes we are moving from evidence-based healthcare, where treatment decisions are based on what’s been proven effective for the population in general, to intelligence-based care where a particular patient’s medical history informs more personalized treatment.

I was surprised to hear Ermolaev mention that genetic information (frequently promoted in academic circles as the key to precision medicine) is often not required to develop personalized insights. This highlights the fact that currently available medical history, behavioral, and symptom data is often adequate in creating dramatically more effective personalized treatment plans.

UPDATE:
Change Healthcare announced its Claims Life Cycle AI in February 2019, which seeks to reduce the number of denials for medical insurance claims processed by healthcare providers (see infographic).

Droice Labs, Brooklyn, NY

While at Health:Further, I also met with representatives from Droice Labs on Entrepreneur Alley at the 2018 Health:Further Festival, a showcase area where over 70 startup companies could meet with conference attendees.

Droice Labs brings the power of artificial intelligence to hospitals. The company’s technology provides personalized predictions of how a given treatment (e.g., a drug or a medical device) will perform for a given patient. This software solution is based on a combination of the latest medical research and learning algorithms, which together analyze how a treatment has performed on similar patients in the past by aggregating data from millions of patient records and treatment plans. This allows doctors to consider all of their options in real-time and choose the right treatment.

Droice labs uses a variety of patient datapoints to better understand individual differences in response to medical treatment.

Droice Labs has approximately 30 employees and works with providers, payers, pharma, and government clients to build applications that augment processes and improve workflows. The goal of this work is to improve the quality of care for patients while also decreasing the burden on physicians with the ultimate outcome of increasing the efficiency of the healthcare system.

The company has been around for just over 2.5 years. The founders of Droice have extensive backgrounds in technology and AI and take a “deep dive” approach to their projects, trying to understand the causation behind their insights and results. They then communicate these findings transparently to their clients.

The relatively small company has a very collaborative culture with employees from a variety of backgrounds—tech, healthcare (including clinicians), scientific research—that bring different but complementary perspectives to their work. “The company is structured to be very horizontal, an organizational setup that fosters the sharing of ideas among all individuals in the team,” according to Droice Labs Co-founder & CEO Mayur Saxena, Ph.D.

Speaking to M. Saxena and Co-founder & Chief Product Officer Harshit Saxena (no relation), it is clear Droice Labs has a growth-focused, startup-like culture with a hunger from employees to continue to innovate and do more. The company has a mission that appeals to young workers that want to work for a values-driven company. “One measure of success at Droice Labs is how many people we were able to impact by our work today,” says M. Saxena. “Do the insights we develop increase the well-being of an extra 1,000 people? How can we improve things to increase that impact?”

Both of the founders agree with a point mentioned on the main kickoff stage at the Health:Further Festival: healthcare touches everyone. When asked what got them into using their analytic skills in the healthcare space instead of a traditional technology company, M. Saxena emphasized the common human experience of healthcare: “my thought was, if I am going to consume it, I might as well work to improve it.” He went on to say that healthcare is full of great people that work tirelessly to improve human life and that the industry needs technology to enable healthcare workers to do their jobs more easily and effectively.

At companies like Droice Labs, Change Healthcare, and axialHealthcare, the approaches may differ but the goal is the same: to improve healthcare in the 21st Century through data and insights.

Read More
Artificial intelligence in healthcare: Past, present, and future
Artificial intelligence in healthcare
Applied data science in patient-centric healthcare

Additional Resources

Want to get into data science?
The Insight Data Science Fellowship program offers a fabulous training opportunity with demonstrated success in job placement afterwards.

NC State's Institute for Advanced Analytics offers a well-respected Master of Science in Analytics degree with excellent career outcomes for graduates.

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Career Exploration 101

9/3/2019

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Career Exploration/Development

What do you want to be when you grow up?

This is a question we rarely escape in our youth and, if we are being honest with ourselves, something most adults grapple with from time to time.

The 21st Century world of work is evolving quickly and the concept of a "linear" career is quickly coming to an end.

What this means is that deciding what one wants to do with one's life has become an increasingly complex choice. There is rarely a single, straightforward path to most careers and the options for employment continue to grow. Freelance work abounds and employment sectors such as data science and software engineering didn't even exist as recently as a few decades ago.

Where is someone supposed to start on this journey?

As I serve graduate students and postdocs in my role at NC State University, I will highlight resources and tools of particular interest to this group.

Career Exploration Resources for Ph.D.s

One great resource is ImaginePhD, developed by the Graduate Career Consortium.

ImaginePhD and other online resources are used to create what we in the career development field call "individual development plans" - IDPs. Specifically, these resources focus around the concept of aligning your skills, interests, and values with potential careers.

Taking online skills and interests assessments through ImaginePhD, myIDP, or myPath, among others, is the first step in the career exploration process.

Your interests and skills then map on to potential job families which you need to further explore to determine which careers in those families may fit your values and other parameters important to you - work/life balance, salary, autonomy, work travel requirements, etc...

For example, from ImaginePhD my top interests include helping others, connecting ideas from different fields, and meeting and connecting people. My top skills include working with limited supervision, working as part of a team, and contributing to an institution.

These map on to the job families of Higher Education Administration (which I am in now), Communications, Public Relations, & Marketing, and Training.

ImaginePhD also has a nice career exploration worksheet you can print out and hang somewhere prominent to remind you of potential careers that align with your skills, interests, and values. It also, importantly, emphasizes the next steps required in your career exploration process.

ImaginePhD_Career_Exploration_Worksheet.pdf
File Size:	1732 kb
File Type:	pdf

Download File

Digging Deeper Into Potential Careers

After you have identified some job families you are interested in learning more about, ImaginePhD allows you to explore potential career fields further through a variety of resources including lists of common job titles in the field, sample job descriptions, job simulation information from InterSECT Job Simulations, profiles/interviews from people working in the field, and more.

ImaginePhD also offers for each job family a list of resources to allow you to connect with professionals in that field. These include links to online groups (from LinkedIn) as well as national organizations that may have local chapters in your area. The connection step is critical as it allows you to begin the important process of meeting people who work in the field, learning about the typical tasks they focus on in their work, company culture, etc...this is informational interviewing (& see).

As you get to know these individuals working in a career field of interest to you they can be powerful advocates for you when/if you begin to look into employment at their organization. This is how you build a network - meet like-minded people and get to know them and through your interaction with them show your value.

There are also a ton of tips sheets available through ImaginePhD. Some examples:
Informational Interviewing Tips
Networking Tips
LinkedIn Tips
See them all on the General Resources section of the ImaginePhD site

There are also sections for each job family from ImaginePhD focused on skill building - how to get the experiences and expertise needed to be competitive for jobs in that family. These resources include links to webinars and online courses, publications, and more.

When it comes time to apply for jobs, ImaginePhD has example application documents for each job family, links to job boards, and articles with valuable tips on making a great impression with your application materials.

Ikigai - Reason for Being

To summarize, the concept of career exploration is thinking about how your skills and interests intersect with something the world needs and will pay you to do. This process helps you find your reason for being or ikigai in Japanese.

The Importance of Self-Reflection

Tools such as ImaginePhD can help you begin to map out your reason for being but the process of finding a career fit that is right for you also takes some deep self-reflection.

You often need to listen to your gut and not overly rationalize a career choice. If you have some internal feeling of doubt/concern about a potential career path, it could be nerves, but it could also be your body telling you it might not be the best fit. Really, you need to integrate the rationale side of you with your emotions and "instincts" to make smart career decisions.

For Ph.D.s, it is hard to dismiss the "typical" path of pursuing a faculty career. However, you really need to decide if you want the lifestyle that comes with a faculty career. There are obviously many forms of faculty careers from primarily doing research and writing grants to primarily teaching. Irregardless, if you find it difficult to envision yourself as being happy in the role, you shouldn't pursue this path just because you have been "trained" to do it.

Personally, this happened with me. I was applying for faculty jobs at large, research-intensive universities but had this lingering doubt that I didn't really want to spend my time conceptualizing projects, working on grant proposals, and writing papers all day.

Only late in my postdoc did I start shifting my focus to other career options. You can read a bit about that career journey here, here, and here. I am happy in my current choice and feel like it nicely fits my personality while giving me a good work-life balance.

Final Thoughts

There are plenty of career options for Ph.D.-trained researchers. Tools like ImaginePhD and other IDP-planning resources can help you begin to discover what those other career options are.

I believe everyone has a unique set of skills that contribute value to the world. The key is discovering how they map onto your interests and values and can lead to meaningful and fulfilling work.

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NIH All of Us Research Program: A new standard in participant engagement and partnership

8/15/2019

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Personalized Medicine

This article originally ran on the Health:Further Blog on July 2, 2018.
It has been updated with new content and findings.

Precision medicine is a phrase often used in healthcare but not well understood, especially by the general public. What type of precision are we talking about? Precision medicine is an emerging approach to disease treatment and prevention that considers differences in people’s lifestyles, environments and biological makeup, including genes. When the Precision Medicine Initiative launched in 2015 it was promoted as a great leap forward in understanding the various factors that contribute to human health and disease in the United States (U.S.). Read the Precision Medicine Working Group Report here.

The project has since been branded the All of Us Research Program and that title could not be more fitting. The goal of the program is to recruit 1 million individuals who will volunteer to provide their biological and health information in the form of medical records, genetic samples, and lifestyle data that is both self-reported and obtained from wearables (FitBit-like devices).

All of Us Seeks to Represent & Engage a Diverse Population
The All of Us program participants are to reflect the diversity of individuals living in the U.S. and are being treated as partners in the study. This concept of partnership speaks to the idea of participant engagement, an area Consuelo H. Wilkins, MD, MSCI, Executive Director of the Meharry-Vanderbilt Alliance and leader of the All of Us Research Program Engagement Core, knows quite a bit about. Engagement differs from recruitment in that its goal is to involve participants in the design, implementation, and oversight of the research, not just to enroll them in a study. Engagement is also a 2-way line of communication where research plans are transformed based on the perspectives of all those involved in it: researchers and participants.

Leveraging Community Input
Another aspect of how the community provides useful feedback on the All of Us program is in the form of community engagement studios, modeled on a similar program at Vanderbilt University. These engagement groups were held across the country and allowed individuals from the community to voice concerns or share their thoughts on various practices the program was planning to implement to recruit and interact with potential study participants. More than 70 studios were held in preparation for the nationwide rollout of All of Us on May 6, 2018.

Community Engagement Continues
The Engagement Core works closely with community partners across the U.S. to help host the community engagement studios in a manner that makes community members feel welcome. For example, the community organizations are asked for guidance on everything from the time of day the studio should be held to the location and what type of food should be ordered. There was one particularly memorable instance in Chicago where the Engagement Core staff had to bring a large amount of cash to purchase food at a cash-only restaurant recommended by an Asian community group. While a seemingly small thing, acts such as this engender trust between All of Us and its community partners because the partners can see that their opinions are being used to guide not just food but research and policy choices made by the national program. Changes coming out of these community engagement studio sessions have included making the language in participant materials easier to understand (use of less jargon and complex terms) as well as providing a small amount of monetary compensation to All of Us participants. Many potential participants saw the compensation, even if it was small, as evidence they and their time was being valued. Such changes emerging out of these studios can have a major impact on study participation (see, for example) and the Engagement Core expects it to be the case for the All of Us program as well.

Participant Engagement is Critical to the Success of All of Us
So far, All of Us research participants have been “all in” to contribute to the program. Alecia Fair, DrPH, Research Assistant Professor with the Meharry-Vanderbilt Alliance, has been in the public health and health promotion/education field since 1992 and has never seen the degree of investment participants in the All of Us pilot program have displayed since it began in 2016.

Individuals have strong motivations for volunteering as participants. Many have loved ones who are sick or died prematurely from disease and hope their contribution to the program as a participant, and also as a voice of participants, will make a difference in the health of others. Generating a high level of individual involvement, investment, and trust in participants is critical as they can volunteer as much or as little information as they want to the program. In order for deeper insights and knowledge to be gleaned from the program, participants will need to be willing to share information from their electronic medical record, genetics, wearable devices, and self-reported daily lifestyle choices.

The data collected in All of Us is not just for researchers. One important goal of the program is that all data collected from any participant will be provided back to the participant through useful insights. The Participant Technology Systems Center (PTSC) for All of Us is being administered by Vibrent Health, a digital health technology company headquartered in Fairfax, Virginia.

The PTSC is responsible for innovating, developing and monitoring all participant-facing apps and technology systems used by All of Us (available across a variety of platforms: PC, iOS, Android). These systems enable study enrollment and data collection and, on the back end, data storage, organization, analysis, and curation—the full lifecycle of the participant’s involvement with the study. Vibrent Health provides a large-scale, cost-effective, mission-critical system to the program that needs around-the-clock support, a service they can provide that would be difficult for an academic institution to match.

The All of Us system has been designed by Vibrent to provide an overview of the study to potential participants as well as offer an interactive, informed consent process that allows for the opt-in or out of a variety of data collection processes. Importantly, the information is provided in the form of videos and text to make participant engagement and comprehension of the various data types the program seeks to collect clear. Knowledge of participants’ understanding of how their data will be collected, secured, and used is assessed via comprehension quizzes they must pass before being allowed to sign the consent forms.

Vibrent Health CEO Praduman Jain (PJ), spoke to the importance of returning value back to All of Us participants, a value that is above and beyond their own health data. Using the company’s Research Platform, Vibrent will develop useful insights from the large and diverse sets of data provided by the All of Us participants, ultimately enabling researchers and clinicians to more precisely predict, prevent, and treat a variety of health conditions.

Integrating information on participants' environment, lifestyle, genomics, & behavior will be critical to understanding the complexities of human health.

Currently, as the research initiative gears up, Vibrent is in the data collection phase but hopes to soon amass the breadth and depth of data needed to develop meaningful insights through machine learning and other predictive analytics. The security and privacy of the participant information collected by Vibrent Health’s platform is of the utmost importance and various layers of encryption and de-identification of data are in place. In the end, Vibrent expects to develop novel and powerful predictive tools from this work that can be applied to the broader healthcare system in the U.S.

Only through the critical buy-in of participants will a program as ambitious as All of Us succeed. Now over 15 months since the launch of the program, All of Us has recruited nearly 25% of its targeted 1 million participants: 243,000+ at last count (as of August 13, 2019). And you can help them reach their goal (see link to participate)!

In the end, the All of Us program hopes to set a precedent for how long-term, longitudinal, health and lifestyle research can take place in the 21st Century. No longer will participants in this type of research be passive subjects (often distrusting what is being done with their data) who provide (or don’t, or not truthfully) information and samples from which they never learn the insights obtained. Rather, participants will be partners in the research process, knowing their opinions and ideas matter and that their data is leading to new insights in which they are being informed.
In doing all this, All of Us leadership expects participants will feel more engaged and empowered: willing to provide an unprecedented amount of health data with the knowledge that it will lead to discoveries that truly benefit All of Us.

UPDATES:
As of August 13, 2019: 180,000+ individuals have begun enrollment in the program with an excellent ethnic distribution: ~21% African American, ~18% Hispanic/Latino, & 47% Caucasian
80,000+ electronic health records and 188,000+ biosamples are currently in the system

The All of Us Research Hub has an online Data Browser to view publicly-available data:
https://databrowser.researchallofus.org/

For a Deeper Dive:
About the All of Use Research Program

New England Journal of Medicine special report on the project (published 8/15/19)

Want to take part? Enroll in All of Us here: https://www.joinallofus.org/en
Have questions about the program? See FAQs here.
Want to engage your community in the program? See resources here.

Read more about Engagement and the All of Us Program Here:
https://catalyst.nejm.org/precision-medicine-initiative-everyone/

Vibrent Health’s Role in All of Us:
https://www.vibrenthealth.com/knowledge-center/2018/05/vibrent-health-power-technology-history-making-us-research-program/

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Reflections Blog

The Challenges Of Being An International Researcher: Implications For Advanced Degree Labor Markets, Part 2

The Challenges of Being An International Researcher: Implications for Advanced Degree Labor Markets, PART 1

Post-Ph.D. Career Plans: Consider the Possibilities

For a deeper dive: Explore the NSF data referenced in this article

See my previous Blog pieces on career exploration:
Start here
career exploration 101

Why you should get involved in things outside the lab/work

New Year's Resolutions: Read More, Learn More

The end of work as we know it: How an increasingly automated world will change everything

A 2017 McKinsey Global institute study concluded up to 800 million workers worldwide could lose their jobs to automation by 2030.

Giving Thanks: Finding personal fulfillment

Using Data Science and Artificial Intelligence to Improve Healthcare

Career Exploration 101

NIH All of Us Research Program: A new standard in participant engagement and partnership

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For a deeper dive: Explore the NSF data referenced in this articleSee my previous Blog pieces on career exploration:Start herecareer exploration 101

A 2017 McKinsey Global institute study concluded up to 800 million workers worldwide could lose their jobs to automation by 2030.

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Archives

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For a deeper dive: Explore the NSF data referenced in this article

See my previous Blog pieces on career exploration:
Start here
career exploration 101