CDC has been in the news a lot lately. In 2001, the agency emerged from a period where, for the most part, it conducted its work competently but quietly, largely below the radar of the media. As the nation's lead disease prevention agency, CDC has led or assisted greatly in investigating weaponized anthrax attacks; worker safety at the World Trade Center site after 9/11; West Nile Virus in 2002; SARS, Monkeypox, and Bovine Spongiform Encephalopathy in 2003; Tsunami relief efforts and influenza vaccine shortage in 2004; and Marburg virus and Hurricanes Katrina and Rita in 2005, among many others. These responses to public health emergencies are the most visible glimpses of the agency to the public.

However, a much larger amount of work is conducted in the background, out of the public view, by approximately 15,000 CDC employees and contractors. The mission of the agency is clear-to promote health and quality of life by preventing and controlling disease, injury, and disability. It seeks outstanding candidates who want to work with partners throughout the nation and the world to monitor health, detect and investigate health problems, conduct research to enhance prevention, develop and advocate sound public health policies, implement prevention strategies, promote healthy behaviors, foster safe and healthful environments, and provide leadership and training.

The bulk of this work involves assisting state and local health departments by providing them with needed resources (funding and/or personnel), serving as the reference laboratory for state health departments, and conducting research into better means of protecting the public from infectious and non-infectious causes of injury, disability, disease, and death. The CDC scientist is sought out because of his/her unusually deep expertise in a particular disease or hazard and its treatment or prevention. Collectively, the scientists at CDC comprise a unique network of expertise embracing all aspects of public health. CDC is perhaps best-known for its work in infectious diseases. After all, it was established during World War II to control malaria.

Since then, however, CDC has grown to encompass the entire range of public health issues. A partial list includes prevention of infectious diseases, environmental health, injury prevention, cancer prevention, mass casualty management, vaccines and immunization practices, genomics, smoking cessation, occupational health, cardiovascular disease prevention, obesity, nutrition and physical activity, vessel sanitation program (cruise ship inspections), quarantine services (including quarantine stations nationwide), and hospital infections. CDC has a brisk global health commitment and provides program services and personnel on all continents except Antarctica. These include surveillance programs, training programs, advisorships, and direct work with the public. In both the United States and abroad, it provides several world-class training programs for epidemiologists and field assignees, and frequently collaborates with the World Health Organization at their Geneva headquarters and on special WHO crisis-oriented teams in foreign countries.

This breadth provides enormous opportunity for talented individuals considering a career in treating populations, rather than individual patients. Public health issues are investigated and applied using tools and techniques that include the fields of medicine and laboratory science, but also especially the fields of epidemiology, biostatistics, economics, behavioral and social sciences, communications, program evaluation, and public policy, among others. This breadth offers the opportunity to open the mind of physicians long engaged in one avenue of work, as several of these techniques or tools are brought to bear on a single problem.

What characterizes CDC scientific work, and what type of personal characteristics are most favored here? The single most valuable characteristic, in my opinion, is a true desire to improve the public health on the planet. Given that, certain additional characteristics are useful, including a strong sense of professionalism (strong work ethic and self-sacrifice), dedication to lifelong learning, and willingness to learn and abide by government procedures. Scientists at CDC are quickly taught the relative roles of federal vs. state authorities vs. public, and the requirements of clearance of scientific documents before publication. They are typically willing to collaborate with scientists on projects that have an allied interest in their field, and flexible in their placement, working wherever needed most. In general, as physicians progress through their years at CDC, they generally adopt more of these characteristics.

Some scientists come to CDC and remain in the same field throughout their long career, while others migrate among topical fields, gaining experience and enhancing their big-picture perspective of public health. Some remain in a field of work for only 3-5 years, while others venture into other fields by serving in a temporary capacity for 3-12 months. Even complete career changes are possible within the agency. For example, one senior physician-epidemiologist recently retrained to study public health law and obtained his law degree, working at CDC throughout that period. So, once at CDC, career changes are encouraged and supported within the realm of public health.

Like academic medicine, CDC offers several excellent opportunities to teach and mentor. Although many lectures are provided for an internal audience, others take the form of invited addresses and workshops at scientific conferences and universities, as well as occasionally at relevant industry meetings. Scientists new to CDC can receive 1:1 mentoring through several fellowship programs, including: (1) Epidemic Intelligence Service (http://www.cdc.gov/eis), the country's critical epidemiology training service that features on-the-job training for two years for young epidemiologists to develop applied epidemiology skills; (2) Prevention Effectiveness Fellowship Program (http://www.cdc.gov/epo/fellow.htm), a two-year program for post-doctoral candidates with expertise in quantitative policy analysis who wish to gain experience and training in assessing the effectiveness of prevention strategies; and (3) Public Health Informatics Fellowship Program, a two-year informatics training and on-the-job experience for fellows to apply computer & information science and technology skills to public health problems (http://www.cdc.gov/phtrain/informatics.html). Several other training experiences exist for scientists at different points in their careers, some as brief as one month. These may provide a means of career change and/or potential employment to CDC, and may be viewed at http://www.cdc.gov/phtrain/public_health_prevention.html).

The opportunity to learn is enormous. A very large internal "corporate university" provides a wide breadth of courses. Accessing outside education is also encouraged. Each employee, regardless of their role at CDC, is provided annually with a $1000 education stipend to be used for courses and books. Within the past few years, several masters-prepared epidemiologists have used long-term training opportunities to obtain their PhD in such fields as epidemiology and communications, among others.

The resources the agency applies to public health are tremendous, exceeding $8B annually. At present the largest programs are the Vaccines for Children entitlement program, infectious diseases (including HIV/AIDS), and terrorism prevention and preparation. Persons entering CDC who are younger than 44 years old can apply for acceptance into the U.S. Public Health Service as Commissioned Corps Officers (http://www.usphs.gov/html/mission.html). The Corps achieves its mission of protecting, promoting, and advancing the health and safety of the nation through rapid and effective response to public health needs, leadership and excellence in public health practices, and the advancement of public health science. However, both physicians and other scientists are hired into CDC without becoming Commissioned Officers, and they too participate in rapid public health responses to outbreaks.

The mission of the agency is clear-to promote health and quality of life by preventing and controlling disease, injury, and disability. It seeks outstanding candidates who want to work with partners throughout the nation and the world to monitor health, detect and investigate health problems, conduct research to enhance prevention, develop and advocate sound public health policies, implement prevention strategies, promote healthy behaviors, foster safe and healthful environments, and provide leadership and training.

The opportunities are clear-to develop expertise in one or more areas, to learn and use tools appropriate to their study, to conduct research and programs addressing serious problems of our population, and to be part of a public health emergency dispatch system. These are internal rewards, constituting an altogether truly fulfilling professional experience.

For scientists interested in serving others and making a personal commitment to public health, CDC can be a remarkable, exciting, and highly rewarding place to work.