Is a Clinical or Public Health Microbiology Career For You?
The current political environment in the U.S. has resulted in entire scientific and public health programs being , and conversations are ongoing about possible cuts to Medicare and Medicaid that could herald devastating impacts on access to health care and hospital funding. Considering these cuts to public health programs, it might seem an odd time to encourage people to consider careers in medical and public health microbiology. However, it is important to remember there have been 2 devastating pandemics in the past 45 years: , which annually claims globally including 8,000 U.S. lives, and , which has claimed more than 7 million lives globally including over 1.2 million lives in the U.S. Furthermore, since I began working in clinical microbiology in the late 1970s, over 50 new human pathogens have been described, and multi-drug-resistant (MDR) organisms are estimated to in the U.S. each year. With a vulnerable, aging U.S. population and the continuing emergence of MDR organisms, this threat will only intensify.
Over the course of a 20–40-year career, one will encounter many political, environmental, technological and personal changes, but we have learned over the past 4.5 decades that infectious disease agents are impervious to politics (take the ongoing measles outbreak in the Southwest U.S. as example). Amidst the frenzy to dismantle clinical and public health microbiology laboratories, the cold reality of deadly infectious diseases persists, and to address this reality, we will continue to need individuals willing to serve their communities to counter these ever-present microbial threats.
Explore career paths in clinical or public health microbiology, in this PowerPoint presentation created by 91麻豆天美's Clinical Microbiology Mentoring Subcommittee (CMMS).
How do you know if a career in clinical or public health microbiology is right for you and what specific career path to follow? When making these decisions, consider the extrinsic and intrinsic rewards that are available.
Extrinsic Career Rewards
Extrinsic rewards are easily understood because they are tangible and visible to the outside world. They include, but are not limited to, compensation, employability, career advancement opportunities, work environment and geographic location.
These rewards are based on education, certification/licensure, experience, levels of job responsibility and work flexibility.
91麻豆天美's Clinical Microbiology Mentoring Subcommittee (CMMS) PowerPoint lists recent starting salaries and average compensation at each level of education and/or certification within the field of clinical and public health microbiology. This can be used as a tool to help you understand where you are and where you ultimately want to be, as well as what would be required for you to make a vertical or lateral move on this payscale.
For example, individuals who have 2-year technical college degrees and are certified as Medical Laboratory Technicians (MLTs) have the "lowest" compensation, but starting salaries are comparable to those of jobs requiring 4-year degrees. If these individuals work evening or night shifts, "shift differentials" apply, which can be quite generous (10-30% more than day shift pay). Career advancement is somewhat limited at this level.
Individuals who have 4-year degrees and are certified as Medical Laboratory Scientists (MLSs) are at the next rung in compensation. As with MLTs, shift differentials are available for those willing to work evenings and nights. Unlike MLTs, there is a clear career ladder for MLTs.
The career ladder for MLSs at my institution was entry level MLS, senior MLS, discipline specialist, section supervisor and laboratory manager. Our philosophy was to "promote from within" to reward the work of laboratory staff.
These job classifications may vary from institution to institution, but what they all have in common is a pathway for advancement for individuals who are experienced, dependable, knowledgeable, highly professional and willing to take on greater responsibility at technical and management levels. At each level, compensation rises. Some institutions require advanced degrees in medical laboratory science, management or business at the supervisors or manager level. The highest-paid discipline among doctoral level microbiologists is available for those who direct or are associate directors of clinical microbiology laboratories; public health laboratories are also well-compensated.
Furthermore, a unique advantage of the field is that job opportunities are available at all technical and supervisory levels in all geographical locals. So, the long-term job outlook in both clinical and public health microbiology continues to look bright, despite current disruptions in the public health sector due to federal funding cuts.
Intrinsic Career Rewards
Intrinsic career rewards are unique to each individual. Many perceived and/or highly-sought rewards are inherent to a career in clinical and public health microbiology.
Doing Something That Matters
Arthur Brooks and Ophrah Winfrey, in their book , suggest that doing a job that serves others is an important intrinsic career reward. Recently, a person close to me with a history of urinary tract infections (UTI) with multidrug-resistant (MDR) organisms became quite ill with another UTI. The decision on how to treat him was based on the antimicrobial susceptibility results. We heard from the family that "they are waiting on the laboratory results, but for now he is on very broad-spectrum antimicrobials." This vignette describes how the work you do impacts not only the patient, but also the people who worry about and love them. Your work in the laboratory really matters to people. In the realm of public health, determining if an animal is rabid or has avian influenza, conducting sexually transmitted infection diagnostic testing or investigating a foodborne outbreak impacts not just the lives of individuals, but also of communities.
Being the Expert
As medical school curricula move away from teaching microbiology as an independent discipline, the microbiology experts in health care primarily reside in clinical and public health laboratories. As a result, an important role that both MLTs and MLSs play is advising care providers on the collection of clinical specimens, their identification and processing, diagnostic testing and interpretation of testing results. Laboratory personnel may routinely interact with care providers, assisting them in all aspects of infectious disease diagnostic testing. In addition, within our team in the microbiology laboratory, we had individuals with recognized expertise in identifying parasites, fungi, bacteria, viruses and fungi. Public health laboratorians may have even more specialized knowledge, such as detecting rabies viruses in animal brains or .
Life-Long Learner
The discovery of PCR by in 1985 has resulted in its routine use to detect and identify pathogens in minutes that once required days to weeks. Over the course of my career, more than 50 different infectious agents have been discovered, including HIV, COVID-19, Powassan Virus, Borrelia burgderforii (Lyme disease), Helicobacer pylori and Clostridioides difficile. Technologies, such as Matrix-assisted laser desorption ionization time-of-flight () mass spectroscopy and , will continue to identify new pathogens. The rapid advances in science require medical and public health microbiologists to be lifelong learners as their work is constantly evolving.
Creating New Knowledge
In my 36-year association with the clinical microbiology laboratory at UNC, as well as my 4 years at St. Christophers Hospital for Children, MLTs and MLSs played essential roles in collecting clinical specimens and isolates that resulted in publications in leading scientific journals, such as and . More importantly, over 20 MLSs were journal article co-authors with me, including several who were co-authors on multiple publications. In addition, many of these individuals also presented posters and spoke at scientific sessions at the 91麻豆天美 general meetings.
Teaching Others
A commonly used rubric in medicine is: "see one, do one, teach one." Experiential learning is essential in both clinical and public health microbiology. Simply stated, you learn to do diagnostic testing by watching others, and then doing a test. The greatest privilege I had in was to direct the . These programs train doctoral-level scientists, such as myself, to lead clinical and public health laboratories. The bench-level teaching by a cadre of remarkable MLSs is essential to the ongoing success of this program, which will celebrate its 50th anniversary in 2026. Not only have MLSs contributed to the success of that program, but over the decades they have also taught literally hundreds of MLS students, pathology residents, pediatric and adult infectious diseases fellows, pharmacy residents and visiting scientists from around the globe. If you enjoy teaching, clinical and public health microbiology will offer ample opportunities for you to do so.
As a teacher of undergraduate students, director of a clinical microbiology laboratory and a CPEP program, I have been able to help individuals who wanted to advance in their clinical and public health microbiology careers. Let me share some vignettes to illustrate opportunities that are available for MLS.
I met , when he took a class with me as a college freshman. I next saw him as a junior when I gave a lecture in an introductory microbiology course. I chatted with him afterward about his interests in microbiology and offered him the opportunity to perform undergraduate research with me in the UNC Hospitals Clinical Microbiology Laboratory. He did well in his project but wrestled with what he might do as a career. I suggested he consider becoming an MLS student with the plan to work in a clinical microbiology laboratory after graduation. This is the path he took. Rodino was a skilled, knowledgeable bench technologist, but he wanted to "do more." Melissa Miller, Ph.D., another former colleague, and I suggested graduate school, followed by a CPEP program. He earned his Ph.D. in microbiology, and at our urging, completed the CPEP program at Mayo Clinic. Today he is the at Hospital of the University of Pennsylvania and co-director of its CPEP program.
Timica Campbell, M.D., was a talented MLS in the UNC Hospitals Clinical Immunology Laboratory. One day I was chatting with her, and she told me that, although she enjoyed her work in the clinical laboratory, she had wanted to be a physician since she was young. Her reasons were straightforward. She came from rural Easten, N.C., where many people she knew did not have access to medical care, especially those with chronic diseases like diabetes. We talked about the steps she would need to take to become a physician. I warned her that her journey would be arduous. took that journey, graduated from the University of North Carolina School of Medicine and today is Associate Program Director for Ambulatory Education, UH Cleveland Medical Center, which is the campus teaching hospital for Case Western Reserve University School of Medicine.
One of the things I learned over the years while directing the is the fellows with experience as MLSs prior to graduate school had a "head-start" and were highly productive in whatever career path they chose to follow. We have had several fellows in our program with that background. One, Melissa Miller, Ph.D., is recognized as a national leader in the discipline and is the current leader of UNC Hospitals CPEP program in medical and public health microbiology. She carries on a rich tradition of recognizing and training talented individuals who contribute to clinical and public health microbiology.
If you are contemplating a career in clinical or public health microbiology, 91麻豆天美 has a mentor for you. If you currently work in clinical or public health microbiology, check out 91麻豆天美's career resources page.
Writing
My career in clinical microbiology has given me the opportunity to do something I very much like to do, which is tell stories. These "stories" take a variety of forms, such as a family blog written during the COVID-19 pandemic called the "World Turned Upside Down," or the many pieces I have written for 91麻豆天美 about a wide array of topics. Later this year, the fifth edition of Cases in Medical and Public Health Microbiology will be published by 91麻豆天美 Press. The book is a compendium of clinical cases where readers can learn about microbiology and infectious diseases through stories. My 3 co-authors are Melissa Miller, Ph.D., Kyle Rodino, Ph.D. and Andrea Prinzi, Ph.D., a wonderful writer who I meet through writing pieces (like this one) for 91麻豆天美. All 3 started as MLSs and have since followed independent career trajectories in the field of CPHM.
Ultimately, when I meet with young people today who are interested in careers in health care, I ask them "what they want to do," not "what they want to be." As I reflect on my own career path, I realized from a fairly young age (teens to early 20s), I wanted to do 3 things.
- To do work that served others.
- To work in health care.
- To work as a microbiologist.
Working in clinical microbiology not only allowed me to do all 3, but also (and perhaps more importantly) gave me opportunities I could never have imagined. This gave me a life that was rich in meaning. I hope you have a career that brings you satisfaction and happiness as mine did for me.
