The Realities of a Global Health Career
1. It's not hierarchical. You won't move slowly up some ladder with steady promotions. You'll have jobs so different that you can't tell if you went up, down, or lateral. You often won't even have hierarchical relations within your employer. Organizations will tend to be made up of lateral or circular relationships, even if their org chart is hierarchical. One vice-president will have more authority than another. The DC-based regional director may oversee the country directors on paper while in practice they answer to no one. The Monitoring and Evaluation coordinator may have make or break control over every project you run.
2. You'll get laid off, repeatedly, through no fault of your own. The funding for your project will end, and your employer won't have any open positions to put you in, no matter how great they think you are. You'll often have to choose between what's best for the work - staying through the end of your project - and what's best for you - finding a new job and avoiding employment gaps.
3. No one will understand your job. Your friends from high school, and most everyone else, will never understand your job. No matter how many times you tell them you are, say, advising the government of India on what the best evidence-based choices are for vaccine policy, people will picture you in a hungry village with a needle giving MMR shots. Combine this with the fact that you never get an obvious promotion, and people will tend to assume you're a peace corps volunteer, a perpetual student, or a health care provider. Also, everyone will always think you work for MSF.
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