Lieutenant Commander Gavin O’Brien ‘17 began his career with the U.S. Public Health Service in Chinle, Arizona, on the Navajo Reservation with the Indian Health Service. He also served in Belcourt, North Dakota, on the Turtle Mountain Reservation. During his Indian Health Service career, he completed a post-graduate year 1 (PGY1) residency, helped implement pharmacist services in an emergency room, and supported outpatient, inpatient, and ambulatory care pharmacy activities. In 2022, LCDR O’Brien took a position as health scientist at the U.S. Food and Drug Administration in the Center for Tobacco Products. His duties have focused on reviewing scientific literature about e-cigarette products, reviewing research protocols, and improving processes using technology.
He spoke with us about choosing the USPHS as a career path. The views expressed in this interview do not necessarily represent the views of the FDA, the USPHS or the United States.
Tell us a little about the U.S. Public Health Service.
The U.S. Public Health Service is one of the eight uniformed services. Our role is to provide support in public health emergencies and, when there's no emergency, support public health in other ways. There are 11 officer categories, including scientists, nurse practitioners, public health professionals and laboratory scientists.”
The Public Health Service spans a lot of different agencies like the Centers for Disease Control and Prevention, Bureau of Prisons, Indian Health Service, the Food and Drug Administration, Center for Medicare and Medicaid Services, and many others.
I was in the Indian Health Service for five years. My main responsibility was as a pharmacist, providing patient care. Just last year, in 2022, I transitioned to the FDA, to a more public health, big picture perspective. To work as an officer in this kind of position, you need to meet the requirements of both the Public Health Service and the FDA. The personal physical health requirements are substantial, along with the security clearance.
Being in the Public Health Service is about focusing on things bigger than your job. You're meant to continually learn and grow. A pharmacy degree is no small feat. That being said, to make improvements on our public health challenges, more education is often needed. That's what the expectation is.
What sparked your interest in the USPHS?
At ACPHS, I had an experience at the Koinonia Primary Care clinic. It was a collaborative environment where we worked with medical students and provided free healthcare for the patients there. That was one of the most important experiences I had during school from a public health focus. That really told me, this is something that matters a lot to me.
I also attended a presentation at ACPHS by a Federal Bureau of Prisons pharmacist who was also in the Public Health Service. After I learned about the opportunity, I applied for the SRCOSTEP program, where students are paid for their commitment to the USPHS while completing school. I got in, and my last year of pharmacy school, I was an officer in the Public Health Service.
I joined the Public Health Service to serve underserved patients and to make a difference in health, whether it be on a local or national level. That's a driving force for me. Also, the federal scope of practice as a pharmacist is very high. In addition, I had prior experience at a military high school and I was thinking at one point about pursuing a military career, and then ultimately decided to go the pharmacy route. When I realized I could merge those interests, that was really a great opportunity.
Tell us about your work at the Indian Health Service.
I graduated in May 2017. I was licensed as a pharmacist in July, and by early September, I was already leading our shingles clinic within the Indian Health Service, and that was without any residency or specialized training. I later supported the anticoagulation clinic; my work was focused on dosing and monitoring of patients who have atrial fibrillation or other heart issues and are at a high risk of stroke or a clot. There was a huge focus on counseling and that is something I still love doing. I supported the clinicians – whether it be doctors, nurses, nurse practitioners, PAs – in the clinic.
Then on top of that, there's the hospital side. As pharmacists, we might be one of only a handful of providers there, supporting our patients’ needs. I provided chest compressions more than once.
I was also the hepatitis C co-lead. Patients would routinely have to travel about two hours to get to our facility and get medications that they need to take every single day for three months that are exorbitantly expensive. It could take a ton of time to go through insurance. And we may not even have an address on file or their phone works less than 10% of the time. So it was really about trying to be creative in solving problems.
And now you’re with the FDA. What’s your role there?
I pivoted to a role in e-cigarette regulation. I started last year, and my biggest focus was to review the literature surrounding e-cigarette products. My other sub-focus was process improvement and reviewing projects, like a pre-IRB (Institutional Review Board). And then, just earlier this year, I transitioned to a focus in what's called knowledge management. Our slogan, which I think describes my work pretty well, is“connect people, processes and technology.” I support our various websites to make sure that the most important content is presented. And then I also am a leader for one of our IT programs that works to make it easier for scientists to find information. I collect feedback, and then talk with the contractors and say, hey, how can we make our system better?
What traits are needed to pursue a career in the Public Health Service?
Adaptability, flexibility, willingness to learn new things. If you're unwilling to do something unexpected, then this is probably not for you. And on a practical level, being willing to travel and having the flexibility there. You always need to be ready to go on deployment. During COVID, it was tricky. My bag was packed to go for over a month before I ended going out once or twice. So it was just constantly checking email to see if someone's gonna say, hey, you need to be at the airport tomorrow.
You do everything, you do what’s needed. For instance, with the Maui fires, a pharmacist could provide support for patients. But they also might be supporting logistics efforts. They might be providing awareness about resources. They might be helping hand out supplies. There's a lot of different aspects of a public health response.
What should an ACPHS student do to prepare for a career in the Public Health Service?
As far rotations are concerned, apply to the Indian Health Service or rotations within the government. Expose yourself to new experiences. There are free clinics or opportunities to provide pharmacy support or public health support, whether it be abroad or within the country. Or you could be involved in community service activities and see if they excite you.
I would be happy to share my experiences with anyone who is interested. I can be reached at gavin.obrien@fda.hhs.gov.