DIVERGENT PATHS TO CAREER FULFILLMENT IN APPLIED ANTHROPOLOGY

Abstract

Despite their academic training, most anthropologists do not work in tenure-track positions in departments of anthropology. While some systematic data indicate where these anthropologists are employed, we know less about their experiences or what led them to work outside the academy. This paper discusses examples of divergent career paths among the special issue contributors and analyzes key themes in their papers. While their histories vary generationally, our authors share commonalities. Many mastered cross-over skills that prepared them to work collaboratively and to apply anthropological insights and methods in research and community settings. Some perceived stigma and barriers to communicating with traditional academic colleagues. Others merged theory and practice to develop pedagogical reforms. Drawing on lessons as mentors in training programs and advocates in our own careers, we recommend that practitioners’ narratives be used to re-imagine career options, revise training programs, and increase visibility for applied careers across the anthropological community.

Introduction: Stories of Divergent Careers

This guest edited issue features stories that illustrate the “lived experience” of three generations of anthropologists who followed divergent career pathways as practitioners, researchers, and educators. Our authors work in a wide variety of roles and professions, some in medical schools and hospitals, others as teachers and administrators in colleges and universities (see Table 1). Their current responsibilities vary, but all have faced professional and personal challenges and share an identity as anthropologists whose careers have unfolded in unexpected and often innovative directions.

Table 1.

Education, Employment, and Training of Authors

Author	Anthro. Degree	Primary Employer	Dept/Division	Additional Positions		Additional Training
Ann McElroy	Ph.D. 1973	State University	Anthropology
Linda S. Kahn	Ph.D. 1985	State University	School of Medicine; Department of Family Medicine	Sales Support and Financial analyst: 1986–1989		UB/Royal College of Physicians Certified Educator
				Adjunct Professor, Dept. of Teacher Education (private college):1991–1997
				Assistant Professor, Dept. of Psychiatry (Medical School): 1997–2003
David Himmelgreen	Ph.D. 1994	State University	Anthropology	Senior Researcher and Associate Director of Research Hispanic Health Council, Hartford, CT: 1994–1998
				Visiting Assistant Professor, Dept. of Anthropology, State University: 1993–1994
				Affiliate Faculty, College of Public Health, State University
				Adjunct Faculty Member, Monteverde Institute, Monteverde, Costa Rica
Nancy Romero-Daza	Ph.D. 1994	State University	Anthropology	Hispanic Health Council Hartford, CT 1994–1998		MA, Linguistics/Socio-linguistics
				(Had the following positions): Senior Researcher Coordinator of Women and Chemical Dependency Unit Coordinator, HIV/AIDS Unit Internship Coordinator
				Affiliate Faculty, College of Public Health State University
				Adjunct Faculty Member, Monteverde Institute, Monteverde, Costa Rica
Linda Barnes	Ph.D. 1996	Private University	School of Medicine; Department of Family Medicine	Community/Labor Organizer, Ministerio Ecuménico de, Trabajadores Agrícolas Springfield, MA: 1974–1976		Curriculum in Latin American Literature: 1978 Masters of Theological Studies: 1983 MA, Comparative Religious Studies: 1985
				Adjunct Lecturer, Committee on the Study of Religion, Private University: 1996–1999
				Adjunct Lecturer, Religion Department Private University: 1998–1999
				Visiting Lecturer, Dept. of Social Medicine, Private Medical School: 1999–2003
				Assistant/Associate Professor, Dept. of Pediatrics, School of Medicine: 1999–2007
				Visiting Faculty, Tri-State College of Acupuncture: 2008–2012
Lance Laird	Th.D. 1998+	Private University	Medical School, Department of Family Medicine	Assistant Professor, Graduate Program in Religion	Certificate in International Health: 2007 Fellowship in General Pediatrics: 2008 Fieldwork in US Muslim communities
Jennifer Randall	Ph.D. 2006	National University	Centre for Global Public Health	Lecturer, Global Public Health Co-Director of Distance Based MSc in Global Public Health	Fellow of the Higher Education Academy, UK
Renee B. Cadzow	Ph.D. 2008	Private College	School of Health Professions; Dept. of Health Administration and Public Health	Research Assistant Professor, Dept. of Family Medicine, State University: 2008–2012	Archaeology Field School Global Public Health Field School Community Health Worker certificate Health Leadership Fellowship
				Director of Evaluation, NYS AHEC (Area Health Education Center) System: 2008–2012
				Affiliate faculty, Dept. of Pediatrics, State University: 2012-present
				Director, Center for Research on Physical Activity, Sport and Health, College
Gemmae M. Fix	Ph.D. 2008	Federal Gov. Agency	Health Services Research Center	Graduate Assistant (Medical School): 2000–2007	Postdoctoral Fellowship in Health Services Research
				Research Assistant Professor School of Public Health: 2008-present
Jessica Somers	MA 2010	State University	doctoral student	Public health program evaluation	MPH
Bonnie M. Vest	Ph.D. 2012	State University	School of Medicine; Dept. of Family Medicine	Research Associate, VA Healthcare System
				Affiliated Investigator, VA Healthcare System
Bayla Ostrach	MA 2010; Ph.D. 2014*	Non-profit health education center	Research	Appointed Faculty in Medical Anthropology and Family Medicine, Private University Visiting Research Scholar-in-Residence, State University
Kathryn M. Glaser	Ph.D. 2015	Comprehensive Cancer Center	Population Sciences; Department of Cancer Prevention and Control	Assistant Professor of Oncology Co-Director, Cancer Screening and Survivorship	Practice Facilitation Certificate Executive Training on Navigation and Survivorship Lean/Six Sigma
				Research Assistant Professor—Cancer Pathology and Prevention (Graduate Faculty—State University)
Sedona L. Koenders	MS 2019	State University	School of Medicine, Dept. of Psychiatry and Behavioral Sciences

⁺Theology degree utilizing ethnographic methods;

^*specifically in applied medical anthropology

This paper will analyze personal accounts by these authors describing their training and job history, and in several cases, their contributions as educators and program developers, in relationship to shifting employment patterns in anthropology, ideological and pragmatic differences between academic and applied programs, and changing concepts of career fulfillment. We will look for key themes among the papers, including the sufficiency of practice and community service opportunities in the authors’ training, strategies used to adapt to non-traditional work roles, the sense of division that some feel between academic and practitioner communities and how this affects their identity and degree of isolation or collegiality, and the need to revise academic curricula and training components to prepare students more sufficiently for practitioner careers.

Being trained in traditional academic programs and then finding work in non-academic settings can be a challenging transition that often involves not only learning new skills but also adaptation to new environments. We can draw on anthropological concepts to understand emotional and cognitive aspects of these transitions, for example, noting a sense of “culture shock” in an unfamiliar work setting with different levels of expected productivity, tighter deadlines, and increased reliance on teamwork. Differences in worldview between those with anthropological training and their new colleagues with different professional training can be problematic, leading some anthropologists to describe feelings of “liminality,” that is, a sense of ambiguity or of being between two worlds in their narratives.

The experience of professional divisiveness, particularly differences between applied and academic research foci, institutional privileges, and status, is also found in these stories. For several contributors, it has not been easy to reconcile the goal of attaining a faculty position with the reality of severe competition for the few tenure-track jobs that are available. The reality today, in 2020, is that despite their academic degrees and training, a large proportion of anthropologists do not currently work in tenure track positions in departments of anthropology.

There were, and continue to be, plentiful adjunct, temporary, and part-time positions, but they offer little security and low salaries. In a more egalitarian world, academics and practitioners would join forces to develop training programs better suited to prepare students for the job market. In reality, when anthropology departments are ambivalent about promoting applied careers as a viable option, they may block students from access to practice experiences such as internships. In our four papers on teaching and training programs, however, we see workable alternatives for productive collaboration between universities and communities that provide templates for re-imagining career options for students.

A Brief History of the Academic-Practitioner Divide

Anthropologists have long worked outside anthropology departments in applied settings. In the 1930s, 1940s, and 1950s, anthropologists built the discipline not just in colleges and universities but also through work in state and national government agencies, international agencies, hospitals, and clinics. Many of our honored “ancestors” in anthropology made their first significant contributions as practitioners before becoming professors, particularly during World War II. In his Malinowski Award acceptance speech in 2012, Cliff Barnett, a medical anthropologist, recalled that the only work he could find after graduating in the 1950s was with the United States Census Bureau. Similarly, Dorothea Leighton, an MD/Ph.D. medical anthropologist, worked for many years with agencies on Navajo reservations and in Yupik Alaskan communities before accepting university appointments.

Despite their long disciplinary tradition of contributing solutions to societal problems through applied research during times of war, economic depression, ethnic conflict, and environmental crises, anthropologists have a history as educators of not adequately preparing students for the practice of anthropology outside academic settings. Students are often unaware of the diversity of the job market, which heavily skews towards positions outside academia, leaving many anthropologists to individually discover how to bring anthropological insights and skills to settings and people unfamiliar with anthropological practice.

It could also be argued that faculty have not traditionally prepared students for field research very well either. Ann McElroy’s account (see Narrative) shows how little grounding she received in identifying applied issues during fieldwork. Colleagues have often mentioned that they faced a “sink or swim” experience as students in the field. In contrast, we are impressed with the structured guidance and systematic training of students described in the papers by Koenders et al.; Romero-Daza and Himmelgreen; Barnes, Laird, and Ostrach; and Randall in this issue.

Current Trends in Employment and Training

There is a notion within the broad network of anthropologists that graduates will naturally seek university positions and if unsuccessful will then have to go the practitioner route. Graduates who take practitioner positions are thus settling for a lower status career. We need to examine and challenge this perception. Actual employment figures cited below confirm that increasing numbers of graduates are seeking and finding work as practitioners. The data do not tell us much about specific job descriptions or whether or how these practitioners use anthropological skills and insights in their work. We do know that some of these anthropologists can be found in the technology sector (Singer 2014), in health care (Greenhalgh and Swinglehurst 2011), and in the federal government (Fiske 2008; Fix 2013). Some have job descriptions explicitly as applied anthropologists, while many function as practitioners, researchers, administrators, and health educators. Yet, because these anthropologists are not housed in anthropology departments, they have limited opportunities to share their experiences with early career anthropologists or to act as role models for students.

What are the recent trends in employment for anthropology graduates? A decade ago, in 2009, an American Anthropological Association survey of MA graduates showed that 20 percent were working in educational institutions, including universities, community colleges, and grades K-12, while 80 percent “worked in other sectors, from consulting firms to federal government” (Fiske and Freidenberg 2018:2). In 2016, the United States Bureau of Labor Statistics listed 6,470 anthropologists and archaeologists in non-academic jobs and 5,700 teachers of anthropology and archaeology employed at two- and four-year postsecondary institutions (Fiske and Freidenberg 2018). In other words, 53 percent of these individuals worked in non-academic positions. This ratio of 47 percent to 53 percent is more encouraging than that found in the 2009 survey, but it still demonstrates that the majority of people who identify as anthropologists and archaeologists work outside of educational institutions, a reality that should cause us to question the long-held implicit assumption that most graduates will search for tenure-track positions. Presently, almost 80 percent of those receiving doctorates in anthropology do not get tenure track positions in departments of anthropology (Speakman et al. 2018). Moreover, those who do get tenure track positions almost exclusively graduated from a subset of universities such as Harvard and the University of Chicago (Kawa et al. 2018).

In 2019, an online jobs site listed twenty-seven newly posted university jobs in the month of August for anthropologists. Of these, 37 percent were non-tenure track openings for adjuncts, instructors, and lecturers; 26 percent were tenure-track professorial (the majority in departments of sociology), 22 percent for post-doctoral fellowships, clinical faculty, and a librarian; and 15 percent were for senior-level administrators (AcademicKeys 2019). Although the sample is small, these ratios for tenure-track versus non-tenure track positions conform to figures cited in the Speakman et al. (2018) study. This data resoundingly demonstrates the gulf between the jobs anthropologists train for and the jobs they attain.

The career trajectories of this article’s authors, Ann McElroy from 1963 to 2014, and Gemmae Fix from the early 2000s to the present, conform to the history described above. McElroy’s training in ethnography and cultural theory from 1963 to 1971 was narrowly geared toward academic employment. Fix’s training in human biology, in contrast, provided a wide range of quantitative and qualitative skills that led to an unconventional dissertation topic in a Veterans Administration (VA) hospital and to employment from 2008 to the present as a researcher and federal employee with the VA (See Fix’s narrative).

There has always been both university and practice-based work, with the university positions viewed as the norm. However, there used to be more university-based options; that balance has now skewed with more practice-based options. This can be seen in prototypical stories like ours. McElroy’s path was university-based with a focus on practice-based work; Fix’s work has skewed heavily toward practice-based with a lighter university connection. In each path, the other exists, but the balance differs and so does the home.

Analysis of the Narratives

A primary theme linking most of the papers is the concept that research competency develops through practice experiences in community and clinical settings rather than from classroom activities and training manuals. A second theme is that developing skills in networking and collaboration is essential for success in applied careers, and such skills are best fostered through local research opportunities. Thirdly, there continues to be a divide in college and university graduate training between preparing students to become educators or practitioners. We question how realistic that distinction is, given the 21st century job market, and recommend strategies for stronger integration of applied and academic training tracks. The authors in this special issue have “worn many hats” in their careers and filled several roles and statuses in their working lives. They have learned to navigate differences between the academic world and the world of practice, and their narratives give us clues to construct a framework for increased integration and unity.

Practice Experience

Many of the contributors (see papers by Vest, Cadzow, Glaser, Kahn, and Randall) describe their practice experiences in diverse, non-anthropological settings. The diversity of these experiences can be seen in Table 1. Our authors represent anthropologists who received their terminal degrees spanning five decades from the 1970s (McElroy) to a recent graduate (Koenders). Of note, the more recent graduates represent both a broader range of additional training as well as work experiences outside anthropology departments. It was in these settings that they learned, sometimes with difficulty, how to apply their anthropological thinking. As Somers describes, imbuing anthropological thinking in non-anthropological contexts can take explicit effort. She notes the reflective process she undertook to see her work anthropologically.

Notably, many frame their experiences as non-traditional, a liminal status that Bonnie Vest characterizes as being betwixt and between, yet the ubiquity of these non-traditional paths demonstrates that they are indeed part of the anthropological tradition. Vest felt her interest in practice did not reflect the discipline, while both Vest and Somers questioned if and how they were anthropologists. Somers wondered whether she had lost her “anthropological compass.” What makes these paths anthropological may be the ability and potential to apply anthropological thinking across diverse settings. Examples of these settings include the Hispanic Health Council in Hartford, Connecticut, where Romero-Daza and Himmelgreen worked as researchers for four years after completing their Ph.D.s; the Roswell Park Comprehensive Cancer Center in Buffalo, New York, where Kathryn Glaser accepted a position in hospital administration; and the University of Texas Health Science Center in San Antonio, Texas, where Sedona Koenders took a research position explicitly because of her anthropological training after completing her MS at Boston University’s School of Medicine.

Developing Skills

Several of the authors describe skill development in the context of higher education as department administrator (Barnes et al., Romero-Daza and Himmel-green, and Cadzow); as teacher (Randall, Somers); and as student (Somers, Koenders). Romero-Daza and Himmelgreen note that they try to train students for both traditional positions in anthropology departments as well as more applied positions using integrative methods, particularly with attention to ethical issues in various professions.

Interestingly, Barnes and colleagues decided to develop a graduate program because of their own academic experiences as doctoral students. Both wished they had received more training in research design, fieldwork, data analysis, and theoretical development and integration. In many ways, their starting point lay not only in the training they had received but also in what they had not been taught to do.

A hallmark across the narratives is adaptation to a variety of career opportunities. Cadzow states that “training to be an applied anthropologist may have to happen organically.” Vest and Kahn describe how their traditional training left them unprepared for the job market. They subsequently had to navigate a sometimes difficult and meandering path.

Vest raises two important and related points. First, she notes a lack of exposure to other practicing anthropologists during her graduate training. There is a collegial divide between educators and practitioners, with little opportunity for communication. When embedded in anthropology departments, anthropologists are automatically part of a community of practice; they can share experiences about the patterns of balancing academic demands and fieldwork within a community of peers. But in non-academic settings such as hospitals or public health clinics, there may be only one or two anthropologists if any at all.

Second, Vest points out that traditional anthropological training has a “lone wolf mentality” where students compete with one another for financial aid, go alone into the field for master’s and doctoral research, and ultimately compete with their peers for teaching positions. The cross-disciplinary nature of the Costa Rican field school that Romero-Daza and Himmelgreen directed and Himmelgreen’s food insecurity projects in Tampa Bay are notable exceptions. Randall’s innovative teaching in the United Kingdom also employs a team approach in learning. By abandoning large lecture formats or individual tutorial meetings and convening instead with small groups in café style settings, Randall worked to empower the students to reflect “on their own vulnerabilities and privileges in society” and to engage more strongly with their peers, the educator, and the assigned readings.

Yet, despite their “lone wolf” experiences in graduate school, most applied authors in this special issue describe their employment settings as highly collaborative, with researchers, clinicians, and other personnel accustomed to working in teams. Nevertheless, they may be the sole anthropologist working among a community of public health, health services, or medical school researchers (for example, in papers by Cadzow, Glaser, Kahn, Somers, and Vest). Working as the only anthropologist means a person has to explain what skills they bring to work as well as to learn the disciplinary norms of the other field(s). This leaves them without an “anthropological home.” For example, although Barnes, Laird, and Ostrach function as a team, they are anthropologists isolated within a medical school, a hierarchical system that has its own challenges. For these lone anthropologists, activities like attending anthropology conferences may provide a rare opportunity to connect with peers, particularly conferences held by the Society for Applied Anthropology. Despite these issues, we find it quite remarkable that our contributors have been able to move into other disciplines where they had little to no formal training. This may be a testament to the perseverance of these authors or broader statement about the character of people who become practitioners.

Preparing Anthropologists to Practice

Koenders’s and Kahn’s papers vary drastically in terms of preparation for an applied career. Kahn encountered many barriers and received little help. The skills, perseverance, and professional identity that she developed to survive and thrive are part of what some of our contemporary colleagues acquire in their graduate training. However, it is important to note that Koenders was trained in a terminal master’s program that was embedded in a medical school and explicitly designed to prepare students for an applied career. We are fortunate to have a detailed description of this program, as described by Barnes, Laird, and Ostrach. In part, it was the medical school administration and faculty who saw the value of their training program and helped them navigate the considerable barriers to program development.

Few of our Ph.D.-level contributors felt completely prepared for their careers, and sometimes there is a steep learning curve to master the demands of a job. But whether anthropology students are trained to work alone or in groups, they usually develop skills in understanding how systems work. As Glaser mentions regarding a shift in jobs within a hospital, “I had to adapt quickly from a clinical research position focused largely on primary care to the business world of hospital operations.”

Cadzow and Vest each end their papers with calls to prepare anthropologists to practice. We note that several of these recommendations are actualized in the training programs described by Romero-Daza and Himmelgreen and Barnes, Laird, and Ostrach. One of Cadzow’s recommendations, to “facilitate understanding of the non-profit world, including the role of the board of directors, board governance, and budgeting” is particularly challenging, as many faculty are not experienced in teaching such topics. An efficient training process would be to organize workshops run by experts from various disciplines or to have students rotate as interns or externs in settings where they could learn specific skills.

Practice also takes the form of teaching. Randall describes how an anthropological foundation contributes to a pedagogical approach that prioritizes diversity, equity, and inclusion. As a teacher in an institution that enrolls many first generation and non-traditional college students, she sees beyond the transactional nature of 21st century education. Through immersion in current health-related topics using a biocultural anthropology lens and fostering a culture of accountability, trust, and critical inquiry, she helps to train students for future public health and health services positions.

Conclusion

This special issue features the professional histories and personal accounts of researchers, practitioners, and educators with unconventional career trajectories filled with unexpected challenges and opportunities. These histories illustrate divergence: the point where things separate from each other or deviate from conventional or normative patterns. In a narrow sense, divergence can mean a schism between two groups or paradigms. Historically, this process has been considered dysfunctional, but the professional paths of our authors suggest that divergence can lead to new models of learning and practice. Changes in academic-based programs may seem disruptive to conservative elements in academia, but educators committed to training students for meaningful professional roles view divergent training methods as an adaptive response to a changing world.

Their narratives suggest that the skills needed for competency in applied anthropology often develop through opportunities to practice in community and clinical settings rather than from classroom activities and training manuals. Whether practice occurs during graduate school through field schools and internships or during post-degree employment, it is clear that networking and collaboration with community agencies are essential for successful careers as practitioners.

A theme underscoring these narratives is the long-simmering tension between academic and practitioner-based careers. This gulf was not so apparent in the early stages of anthropology, but a fundamental fissure began in the 1980s and 1990s, as Linda Kahn’s article suggests. Not coincidentally, during this time, anthropology became the subject of harsh critiques, both internal and external, about the use of anthropological data by government agencies, particularly by the CIA and the military (Price 2016). Rising awareness of the historic partnership of ethnologists and colonialism unleashed new trends toward auto-critique, standpoint theory, and reflexivity near the end of the 20th century. To legitimize itself and avoid accusations of partisanship, academic anthropology had to demonstrate that it was a conservative, theoretical discipline conducting basic research that was unaffected by political agendas. Thus, we entered a period in which decision makers in the academy perceived proposals to establish applied research programs as “beyond their mission.” As a senior colleague responded to Ann McElroy, “We are anthropologists, not social workers.”

The current divisiveness in anthropology manifests in fundamental differences among those who work in traditional academic settings, those who practice, and those who combine both teaching and practice. The differences are most prominent in contemporary work schedules (semesters or quarters versus twelve-month schedules), job security (tenure-track versus clinical faculty or research appointments), level of funding and time-release to attend conferences, pressures to publish, and other elements of contemporary work life.

Even among the editors of this collection, as we organized our timeline and divided the labor, the work pressures and tight deadlines that practitioners navigate were obvious. The articles in this special issue provide insight into the career paths of the contributing authors. We editors (McElroy, Kahn, Cadzow, and Fix) gained further insights into the daily patterns of each other’s lives over the year we worked on this volume. Despite not being embedded in departments of anthropology, Kahn, Cadzow, and Fix were each “Making Anthropology Matter” in the broader world. For example, Cadzow worked tirelessly as the chair of a department of health administration and public health, balancing administrative needs, imbuing anthropological perspectives into the next generation of health care workers, and continued her work in the community. Fix was awarded a five-year VA grant to change practice in eight VA medical centers across New England. The grant’s goal is to broaden traditional, biomedically focused clinical conversations to include patients’ lives and personal goals—key tenets of anthropological thinking. These activities, interspersed throughout the editorial process, prompted McElroy to note the demands of today’s practicing anthropologists. Practicing anthropology should be lauded instead of perceived as settling for less anthropological or less rigorous careers.

The occupational cultures of practice and academic settings differ; their paradigms differ, and now there is a crisis in placing graduates in secure employment, a concern for all anthropologists. MA and Ph.D. graduates often do not find work for several years after graduating, or the employment they do find as lecturers, instructors, and adjuncts is exploitative with little job security and few union protections. These occupational inequities have been problematic for several decades and reflect a tension between the stagnant job market in departments of anthropology and the growing utilization of anthropological approaches in contemporary, high-demand settings. It is clear that new paradigms of anthropological training and models of anthropological success are needed.

Can Thomas Kuhn’s (1996) classic writing on paradigm shifts in science help us interpret this crisis? There is an “essential tension” between paradigms central to academic culture and those central to practitioner cultures. The conventional wisdom is that essential tension is a breakdown of shared models of reality. But are theory and application really incompatible? The discourse tends to focus on dysfunction and incompatibility, but narratives in this volume offer a different interpretation: divergence in anthropology today provides evidence that essential tension can be productive and transformative. Perhaps divergence is a normal process in the evolution of a discipline. Certainly, the field of medicine has undergone immense specialization in the last few decades. Is the divergence we are observing a sign of maturity in anthropology as well?

Final Summary

Practitioners’ narratives about post-graduate challenges and opportunities are a valuable and often overlooked resource for evaluating and revising graduate training programs. By increasing the visibility of applied careers across the broad anthropological community, we can reduce current divisions and work toward a truly integrated discipline. Given the perceived hierarchy, it might be assumed that those who have chosen careers as practitioners, or as teachers and mentors of those who will become practitioners, may worry that they have not lived up to the expectations of what it means to be an anthropologist. Yet, the narratives in this special issue tell a more nuanced story about new paradigms, expanded identities, and models of collaboration that will bring anthropology to a new level of productivity and impact.

Ann McElroy’s Narrative.

Ann McElroy: As a freshman at the University of Kansas in 1960, I chose psychology as a major, but after taking two exciting courses in anthropology, I switched my major. My advisor was an ethnohistorian specializing in Native American history whose research documented indigenous land claims. I was fortunate to receive an NSF undergraduate training grant to participate in a project in a Prairie Band Potawatomi Indian community. However, my honors project on traditional and current Potawatomi child-rearing did not focus on applied issues.

Nothing really prepared me for the field. I had never seen so much poverty in my life. The homes I visited were small and crowded, and the refrigerators and cabinets were often empty. Allopathic health services were minimal. The roads were terrible, and my car kept getting stuck in the mud. But I eventually found that being stuck in the mud was a great way to connect with people willing to give me a hand. I learned to bring bags of fruit to interviews, tried to help a family find a functioning wheelchair for their grandmother, and found that driving people to clinics and pharmacies in town about twenty miles round-trip from the reservation was a good way to reciprocate for interviews. I did survive the summer and managed to write my senior thesis, but it was a humbling experience with little direct learning of applied methods.

My graduate research at the University of North Carolina, Chapel Hill (1966 to 1971) focused on impacts of change and biculturalism on children’s identities, this time among Inuit communities in the Canadian Arctic. Many Inuit were affected by alcoholism, illness, and traumatic relocation from hunting camps. I could have developed an applied project using the participatory action methods developed by Sol Tax’s students at the University of Chicago, but the concept of involving community members in planning research was not a major part of UNC’S graduate training.

I accepted a faculty position at SUNY Buffalo in 1971 to teach arctic ethnology and psychological anthropology. Medical anthropology was an emerging field in the 1970s, and I developed some applied health projects for graduate student teams in an urban clinic serving Hispanics, African-Americans, and immigrant and refugee families, a rural clinic for migrant farm workers, a study of family impacts of brain injury, and a project on traumatic grief and loss.

Subsequently, I co-directed an MA track in Applied Medical Anthropology that emphasized early, in-depth training in research methods and participation in community-based projects. But my department never considered applied anthropology to be a major focus, and we were discouraged from establishing a formal medical anthropology degree program.

Most of my MA advisees did applied research, and many were successful in finding practitioner jobs. A few chose to pursue an MS in Epidemiology while also meeting doctoral requirements in cultural anthropology, and a few added practitioner degree programs (including medical school) after completing their anthropology degrees, but these were the exception rather than the rule. The curriculum and requirements for the majority of graduate students in the department were geared toward educating scholars who would compete for increasingly scarce academic positions.

Since retiring in 2014, I have reflected at times on how fulfilling my career has been. There were frustrations and disappointments in dealing with academic bureaucracy but also many high points in working with excellent medical anthropology and human biology students. The success of these students in negotiating pioneering roles as practitioners as well as educator-activists has been the most fulfilling aspect of my career.

Ann McElroy with Migrant Farmworker Family in California, 1979

Gemmae Fix’s Narrative.

Gemmae Fix: I pursued an anthropology degree because I’m curious about human behavior. My graduate training focused on examining human behavior across place and time by reading canonical work. My interest in practitioner career paths stemmed from my own career trajectory. My graduate training (2000–2008) was fairly typical with courses in physical anthropology, archaeology, and cultural anthropology. We spent minimal time talking about life beyond graduate school. There was an unspoken, underlying assumption we would work in Anthropology Departments although I never saw this path for myself. Only one course explicitly talked about applications of medical anthropology in a variety of non-academic settings, an applied medical anthropology class taught by Ann McElroy.

It was my unconventional doctoral fieldwork that most prepared me for a practitioner-based career. Since 2008, I have been a federal employee using anthropological theories and methods to understand and improve healthcare in the United States’s largest integrated health care system. My doctoral fieldwork led directly to this current position, yet it was a fortuitous confluence of circumstances and not a prescribed path. My dissertation advisor found a graduate assistantship at the medical school with a former student who worked in administration. One day, I was chatting with a Chief of Anesthesiology at this medical school about my doctoral program. The anesthesiologist was intrigued and offered me the opportunity to conduct fieldwork at the Veteran Affairs (VA) Medical Center where he worked. I subsequently developed an anthropological dissertation that could be conducted in the VA.

A key component of the doctoral process was identifying funding. This was one of the first markers that I was embarking on a non-traditional path. I found that my plan to use an anthropological approach to understand patients’ experiences of open-heart surgery was a poor fit for traditional, anthropologically focused granting agencies like Wenner-Gren or the National Science Foundation. I was told I had little chance of being funded by them. I therefore broadened my search to the National Institute of Health (NIH) where I found a grant that looked like a good fit for using an ethnographic approach in a health care setting. I was awarded what I later learned was a prestigious grant through the Agency for Health Research and Quality, the NIH’s health services research agency.

For the past decade, I have been a practitioner-anthropologist and academically-oriented health services researcher. The anthropology-health services duality has illuminated the ongoing tension between academic and practitioner-based careers. Health services researchers value the insights provided by ethnographic approaches. Anthropologically informed VA research is continually highlighted by leadership, such as when our national Director of health services research wrote about anthropological contributions to VA research (Atkins 2014). There are now over 100 anthropologists working in VA, with many holding high-level positions or being funded through prestigious grants such my own VA-funded Career Development Award (1IK2HX001783).

In contrast, I recently submitted a grant application to a revered anthropological funding agency; the un-identified peer reviewers made it clear that this work was not anthropology, noting the grant was “problematical” in part because it sounded like “sociology.” These experiences of not fitting the traditional anthropology pathway are further underscored by the slew of early career anthropologists looking for practitioner-based employment opportunities. Many have reached out to me seeking advice they did not get in graduate school. Beyond the data, there are few systematically gathered stories of practitioners working in the field.

Gemmae Fix, third from right on the back row (right side) with Fellow VA Anthropologists, Having Dinner at the 2017 SfAA Meeting in Santa Fe, New Mexico

Biographies

Gemmae M. Fix (gmfix@bu.edu) is a Research Health Scientist with the United States Department of Veteran Affairs, Center for Healthcare Organization and Implementation Research (CHOIR) and a Research Assistant Professor with Boston University’s School of Public Health. In these roles, she actively promotes the practice of anthropology. Her research focuses on bringing patients’ life experiences into health care.

Ann McElroy (mcelroy@buffalo.edu) is Associate Professor Emerita at the University at Buffalo, SUNY. Her research interests include medical ecology, the history of cultural and environmental change among Canadian Inuit, and disability studies. As an applied medical anthropologist, she has focused on graduate student projects with underserved populations, including migrant farm workers, immigrants, and families traumatized by violent death.