Statement of Purpose

Maryam Hosseini, M.D. — Master of Public Health

The refrigerator in the village health house held exactly eleven vials of insulin for thirty-four registered diabetic patients. I counted them on my first morning as the physician for a cluster of villages in South Khorasan, during the rural service year that follows medical school in Iran. By the end of that year I had learned to stretch supplies, negotiate with the district warehouse, and teach patients to recognize the signs of rationing gone wrong. I had also learned something more uncomfortable: I could practice excellent clinical medicine every day and still watch outcomes be decided upstream, by supply chains, budget cycles, and data nobody was collecting. I am applying for the MPH because I want to work at that upstream level, with the quantitative training to do it credibly.

My clinical foundation comes from Tehran University of Medical Sciences, where I graduated in the top decile of my class. My research interests turned toward health systems early: as a fourth-year student I joined a registry project on non-communicable diseases, cleaning and analyzing follow-up data for 2,400 hypertensive patients across five clinics. The resulting paper, on which I am second author, documented a 31 percent loss-to-follow-up rate and traced most of it to referral friction rather than patient behavior — my first evidence that system design, not individual compliance, was the tractable variable.

During the COVID-19 waves of 2021, I volunteered with a Red Crescent data team and ended up building, with two colleagues, a line-list dashboard that district health officers in twelve districts used to allocate oxygen concentrators. It was improvised epidemiology — spreadsheets, late-night phone calls, imperfect denominators — and it convinced me of two things: that timely, honest data changes decisions within days, and that I lacked the formal training to do this work to the standard it deserves. I can describe a cohort; I want to be able to design one. I can read a cost-effectiveness study; I want to be able to challenge its assumptions.

Your MPH program fits that intention precisely. The health systems and policy stream offers the sequence I most need — health economics, implementation science, and advanced epidemiological methods — taught by a faculty whose work on primary-care financing in middle-income countries speaks directly to the problems I saw in South Khorasan. The Center for Global Health Equity's practicum placements with regional health authorities and multilateral partners would let me test classroom methods against institutional reality, which my dashboard experience taught me is where public health work is actually won or lost. I am also drawn to the program's cohort structure: a year spent arguing about evidence with clinicians, economists, and policymakers from thirty countries is itself part of the training.

My goals are specific. In the five years after graduation, I want to work on non-communicable disease programs in the Eastern Mediterranean region — with a ministry of health, a WHO country office, or a research group that advises them — focusing on how primary-care systems keep chronic patients in care between visits. The problem that met me in that village refrigerator is regional, not local: NCDs now drive the majority of mortality across the region while surveillance and financing still assume infectious disease. In the longer term, I intend to return to Iran's health system with the skills to help redesign chronic-care delivery at scale.

I finished my rural service having treated roughly three thousand patients. The honest accounting is that the clinic mattered enormously to each of them and very little to the statistics of the district. I have made my peace with that arithmetic by deciding to work on the district level and above. The MPH is the deliberate next step, and your program is where I want to take it.