Lauren interviews CPH alumna Daniela Moga about her professional journey from medical training in her home country of Romania to pursuing degrees in public health and epidemiology at the University of Iowa to her current career in pharmacoepidemiology at the University of Kentucky.

Lauren Lavin:

Hello and welcome to Plugged in to Public Health. I’m your host Lauren, and I’m thrilled to have you join us for today’s episode. Here we dive into the latest developments in public health, and highlight the brilliant mind and groundbreaking work shaping the field today. Today we have a special guest with us, Dr. Daniela Moga, an expert in pharmacoepidemiology, who’s here to share her journey, her impactful research, and her experience in shaping international guidelines for pharmacoepidemiology. Whether you’re a student, professional, or just curious about public health, we hope that this podcast helps you get plugged into public health.

Hello, everybody. Today we have Dr. Moga on the podcast. And we’re so excited to have you. We’re actually in-person today, which I love even more than on Zoom.

Daniela Moga:

Thank you so much for having me. I’m really excited to chat with you, and I’m happy to be here. It’s been a while since I visited the college, and I’m really excited to be back.

Lauren Lavin:

I’m glad that you are here. So Dr. Moga, can you tell us a little bit about your early career in Cluj, Romania? And maybe a little bit about your background, what led you to pursue public health epidemiology? Just give us your background story.

Daniela Moga:

I didn’t learn about epidemiology, really, until after graduating from medical school. Even though we had a brief module on epidemiology, I didn’t really have a good grasp. So it was back in the early ’90s when I went to medical school. I always wanted to be a doctor, I actually dreamt about being a pediatrician, that was my dream going into medical school. And then when I graduated, at the time, I was thinking of it as a failure, now I think back and say it was a checkpoint for me to reassess, evaluate my options, and decide which path would be a good path for me to take. And when I say checkpoint, setback, whichever you want to call it, it was getting into residency training. By the time I graduated, I moved away from pediatrics to surgery. I like doing things, and I like seeing the end point of doing things, so surgery felt like really the place to go. But I’ll spare you the detailed stories, I did not match for surgery. And so it was a first failure for me, which I can imagine it resonates with a lot of-

Lauren Lavin:

I was just going to say, that, one, I feel like a lot of students that end up in public health start in medicine, but two, I think it’s a good reminder that sometimes when things don’t work out the way we originally thought, it’s actually pushing us towards something maybe better.

Daniela Moga:

That’s exactly what happened to me. And as hard it was to swallow that at the time it happened, after the initial reaction, it really gave me an opportunity to reflect, and think which direction I want to take. And so I decided, in the next year, to look more into other specialties than, really, surgery, and it was… Public health, it was just starting as a residency path for medical students.

Lauren Lavin:

In Romania?

Daniela Moga:

In Romania. So it was a residency training, and so I was like, “What’s that? It sounds great.” I was a little intrigued, and I’m like, “I want to try that. I want to see and learn a little more.” So I gave myself time to explore this. And so it kind of evolved from being exposed to public health as a field, and being in a department of public health. So at the time, we had the Department of Public Health, and then there was a Department of Epidemiology. And it just worked in a way that opportunities came in the Department of Epidemiology after I’ve been for a while in residency training in public health.

My career had a lot of things happening, and opportunities that came my way, that made me stop, and reflect, and think whether the path I’m on is the right one, or whether I need to steer on the side a little, and maybe take a slightly different path, that might still be related, but might be a little different than I even envision ever taking. So that was another one with going to epidemiology, opportunities opened in the Department of Epidemiology, a faculty position, and I was… “Why not? Let’s give it a try.” And so with that, came training, and doing a residency training in epidemiology. At the time, epidemiology was mostly focused on infection prevention, like hospital epidemiology.

Lauren Lavin:

Oh, interesting.

Daniela Moga:

And some opportunities in public health departments, and mostly overseeing the immunization programs, less chronic disease management and things like that, at least [inaudible 00:05:19]. But it still was a different world than I ever thought about, but that opportunity brought the first opportunity I had to come to University of Iowa.

Lauren Lavin:

Exactly.

Daniela Moga:

I always struggled to say, “I see myself in five years doing this, or this, or that.” I always struggled with that. And it took me a while to accept that that was an expectation set by others, and it just didn’t work for me. And I embraced it, and mine was like, “I kind of have an idea of where I’m going, and kind of what I would like to see myself doing, but I’m not sure where I end up. I’m just going to keep my mind open to opportunities, and evaluate, and make decisions as I encounter them on my way and go.”

Lauren Lavin:

And it’s worked out pretty well.

Daniela Moga:

I would think so. Reflecting back, I think it made a huge impact on both my professional and my personal life.

Lauren Lavin:

Yeah. I think sometimes as students, we can get really sucked into doing one path. We think that our end goal is this really specific thing that we set out to do from the very beginning, and in doing so, oftentimes, we can miss opportunities that cross our path, that may not fit the trajectory that we thought we were on, but could provide a really unique opportunity to change that, if not entirely, just to add nuance to what we’re already doing. So I think that’s a good reminder, if students are listening, that you just have to be open to the opportunities, and oftentimes, they will come, and you just have to be willing to say yes.

Daniela Moga:

You have to be able to see them. And I think if you are so focused and one path and one path only… It’s not that opportunity don’t come your way, it’s that you don’t see them as opportunities, you have-

Lauren Lavin:

Yeah, you have blinders on.

Daniela Moga:

Exactly.

Lauren Lavin:

Yeah.

Daniela Moga:

And so it really is allowing yourself a little… And it’s easier in life to see things in black and white, but we know very well, things are not in black and white, there’s more in between. And I think you live a richer life if you allow yourself to see the shades of gray.

Lauren Lavin:

Absolutely. As counterintuitive as that sounds.

Daniela Moga:

I know, I know. And again, it’s easier to say, “Is it yes or is it no?” Well, sometime it depends.

Lauren Lavin:

Yeah. A lot of times it depends.

Daniela Moga:

Yes.

Lauren Lavin:

Yeah.

Daniela Moga:

And what is a strong yes today, might be a strong no tomorrow, or it might be a maybe.

Lauren Lavin:

Right.

Daniela Moga:

So that’s what I’m trying to embrace more and more. And I think my career path had lots of these checkpoints, where I had the opportunity to stop, reflect, and make a new decision.

Lauren Lavin:

Yeah. And one of them, it’s kind of my next question, was the Fogarty International exchange program. So what was your experience like when you… Well, how did you get that? And then once you decided to do it, what was your experience like moving to the United States? And how did that experience kind of shape your career today?

Daniela Moga:

That’s a great question. And Fogarty International was an amazing opportunity that came because I was in the Department of Epidemiology in the medical school, in my hometown, in Cluj. The chair of the department had been closely as part of Fogarty International, University of Iowa having ties in Eastern Europe. Romania was one of the sites, and it just happened that the chair, my chair at the time, was the point of contact for Romania. And so I had the opportunity, and I was presented, “Do you want to go?” Growing up in communist Romania, we weren’t allowed to even hold a passport, so I was so eager to be able to travel internationally, and frightened at the same time. I remember coming to Iowa on the Fogarty in the fall of 2005, was the first time I flew transit. Actually, it was the first time I got on a plane.

Lauren Lavin:

Oh my gosh.

Daniela Moga:

And it was frightening.

Lauren Lavin:

How old were you at that time?

Daniela Moga:

I was, at that time, 32.

Lauren Lavin:

Wow.

Daniela Moga:

And I’ve been out of the country one time, but neighboring country, so I could travel by train, I didn’t have to fly. This was the first time getting on a plane, and having to connect, and having to deal with-

Lauren Lavin:

It’s a whole system.

Daniela Moga:

It was, and it was also at the time where we didn’t have smartphones that can guide you, and you can Google things.

Lauren Lavin:

Right. No.

Daniela Moga:

I didn’t even have a laptop back at that time. And so it was like you had to figure it out, and I survived. Because-

Lauren Lavin:

You made it.

Daniela Moga:

I made it. I made it. It was one of the best things that happened to me. I loved my time in Iowa City. I didn’t really know what to expect, I knew we will have the opportunity to take classes, and I was like, “Okay, let’s see, what am I going to…” And we were all assigned a mentor from the program. Mine was Dr. Gray, he was an ID epidemiologist. He was suggesting classes that I should be taking, and one of them was biostatistics. And I’ve never had a biostatistics class before, and I… As a medical student, you want to think that you’re the smartest, and the brightest, and, “I don’t want to enroll in a class that will tell me I’m dumb.”

We had a joke going on in Romania where it’s like, growing up you were either going into medicine… You go to medicine if you are really passionate about that field, your parents pressure you a lot because it’s very prestigious, or you are bad at math. I don’t think I was that bad at math, but I didn’t feel as confident, and I’m like, “I do not want a class that will tell me I’m dumb.”

Lauren Lavin:

No. I feel that.

Daniela Moga:

I was quite resistant to take that class. Luckily, Dr. Gray was like, “You know what? I really think you should give it a try, and at least audit the class.” I’m glad I did. I started with auditing the class, and it was Dr. Cavanaugh that taught the class, so he was-

Lauren Lavin:

He’s still here.

Daniela Moga:

I know. I know. I briefly saw him this morning, didn’t get a chance to talk to him, but he was another person that really made an impact, even though he might not even realize that, because he gave me confidence in taking his class. He’s an amazing educator. He was the first person that actually also introduced me to American football. I had no idea about football and-

Lauren Lavin:

It’s an important part of living in Iowa City.

Daniela Moga:

I know. But all of his examples were from football world, and I’m like, “I don’t get any of these references and all of that.” So it gave me opportunities to talk to other classmates, and that kind of educated me about football aside from biostatistics. But it gave me confidence that I can do it, and I actually enjoyed that biostatistics class, and turn it for credit, because I’m like, “I can get an A.”

Lauren Lavin:

Absolutely.

Daniela Moga:

So I took a few classes, I think we were allowed to take four classes during that semester, and just loved it, just loved it. But kind of seeing everything that was happening, and meeting with faculty, and the type of research they were doing, it allowed me to think in the future, like, “What do I want to do next?” And I knew I wanted to get my PhD, and so that’s when I kind of made the decision of pursuing one here, but I wasn’t sure how that’s going to work.

Lauren Lavin:

Right. So when you came here on the Fogarty International, was it a scholarship?

Daniela Moga:

I don’t know all the nuts and bolts. The department that was overseeing that in the College of Public Health was occupational environmental health. Tom Cook, I think he retired a while ago, he was overseeing the program at University of Iowa, and they had funding through the Fogarty International Center to provide these fellowships, I guess, that allowed people from Eastern Europe to come and get exposure, and get some training, and establish relationships with faculty and researchers at University of Iowa, and then build networks, and build relationships between Iowa and their home country.

Lauren Lavin:

Then when you came over here first, you weren’t initially planning to get a PhD?

Daniela Moga:

No, I wasn’t. I wasn’t.

Lauren Lavin:

Okay. But you decided-

Daniela Moga:

It’s one of those things where even though I didn’t know exactly how it’s going to happen, being… The way the system was in Romania, you typically… If you got the faculty position, you didn’t necessarily have to have a PhD in the medical school. You had your MD, you might get… And have a faculty position in the school of medicine, and then you would work on your PhD that was related to the department and the work you are doing in the medical school, and it kind of was a requirement to even progress and go up the rankings in that academic setting.

I knew that as I started at the most junior faculty position there, it was a requirement, that I will eventually start working towards PhD. And I just didn’t know that I am going to pursue it, I was trying to figure out… Find my niche, and find a good advisor that would have the ability to take me and have a position open. So it’s slightly different than it is, at least it was at the time. And so I was evaluating the options in the medical school there, and seeing who would be a coordinator, or a mentor, an advisor for my PhD. I never thought I would move from Romania. Never.

Lauren Lavin:

Yeah. All the way over here.

Daniela Moga:

Never thought about that. But again, coming at the University of Iowa, and kind of getting a sense of what’s happening, I was like, “I like that. I would love to be able to pursue my PhD in epi.” Because, again, I felt like there were more opportunities outside of being just focused on infectious disease. Not that there’s anything wrong, I didn’t feel like I would find my niche, it didn’t really resonate as well with where I was and what I wanted. I always was drawn more towards chronic diseases, and I didn’t want to do hospital infections and all that. I felt like it was kind of somewhat I could do. And so University of Iowa had more opportunities in the chronic disease space, and so…

Lauren Lavin:

You decided to do it.

Daniela Moga:

I decided to do it, and it wasn’t until a fellowship in pharmacoepidemiology became available that I actually applied. I was accepted. I can defer coming for a few years, ’cause I didn’t know whether I’ll have funding. And at the time, my son was little, I was like, “I cannot just move him, and we’ll figure it out.” That was a place where I was like, “We need to be a little more prepared.” But opportunity came with the fellowship in pharmacoepi, that Dr. Chrischilles, Betsy Chrischilles was leading, that keeping… Maintaining my University of Iowa email address, I was getting information, and it came, and I was like, “I wonder if I would qualify for that.” I immediately emailed the department, I was like, “Do I meet the requirements? Can I apply for this?” Obviously that’s not a guarantee that you’ll get it, but if you don’t apply, then obviously-

Lauren Lavin:

You won’t… Yeah.

Daniela Moga:

… there’s zero chance. I applied, and got one of the fellowships, which provided me with the opportunity to actually come. And it was a fast move, fast-paced. I learned about the fellowship, I think it was probably June of 2007, and I had to be here August, 2007.

Lauren Lavin:

Yeah, August.

Daniela Moga:

So it was fast-paced. But it worked.

Lauren Lavin:

But it worked, and you’ve had a pretty rich career after that. So you published over 60 peer-reviewed articles, and then five book chapters, many of which focus on adverse drug reactions and medication effects on cognition in older adults. So what drives your research in the areas that you’ve chosen since you’ve been here?

Daniela Moga:

The field of pharmacoepidemiology was one, when I learned about it, I was like, “This is the perfect path for me.” Because I felt it really was a nice blend between my medical background and epidemiology. If you think Venn diagram-

Lauren Lavin:

There’s a good overlap.

Daniela Moga:

… great overlap. So I felt like my medical training would really help me appreciate the field more. And it happened in 2005, when I was here, I took a clinical trial course, and so we were learning about clinical trials, we were learning about all the evidence generated, and I was… It kind of one of those things where, like, “Well, clinical trials are great, but there’s quite a bit of space that’s not filled.” And so I felt like pharmacoepi is what can… Even before it became the thing that’s now with real world evidence generation and all of that, all the fancy words, I just felt like that’s a place where I can actually make a contribution. And I think a lot of my decisions, and even one regarding, like, “Do I do hospital epi versus something else?” Was like, “Can I, Daniela Moga, make a contribution? Not just be in a field because it’s trendy or whatever. What will be my contribution?”

Lauren Lavin:

Yeah, absolutely.

Daniela Moga:

Trying to define that niche, I felt like pharmacoepi provided that opportunity. I came, and I joined in that path. So being on a pharmacoepi fellowship, it kind of drove some of the coursework that I had to take, and I started to build appreciation to what’s needed. And one of the populations where a lot of the [inaudible 00:21:31] in what we know from clinical trials is the older adult population. There are others, but it just felt like between chronic diseases, my interest in chronic diseases, pharmacoepi, the older adult population was another one player that had a good overlap.

And then opportunities working with Dr. Chrischilles, some of her work was really focused on cancer patients. Again, older adults more often than anything. It kind of evolved. It was opportunities that matched some of my interests. Maybe if I was working with somebody that did heavy pediatric, maybe I could have found that, and now am exposed into the pediatric world through my students. So I learned about that, and appreciate the differences in tackling research questions in that population versus the other. But it kind of went finding overlaps, and seeing how they align with what I was developing a passion for that drove me on this path.

Lauren Lavin:

Absolutely. You’ve also taken up a leadership role in the International Society for Pharmacoepidemiology, which is well-recognized, and especially your involvement in research guideline development. How have you seen this work impact the field globally? And what is the work that you do within [inaudible 00:23:03]?

Daniela Moga:

Okay. We call it ISPE. It’s one of those things where being involved in a professional organization is almost a must. You are in academia, you want to know what’s happening in the field, and professional societies offer these types of opportunities, they all have annual meetings where you can learn about what’s the newest thing. I explored other professional societies, and ISPE one where I felt like home. I really enjoyed the fact that it’s very focused on good science, good pharmacoepi science. I love the fact that the membership of the society is very diverse, not only thinking in terms of geographic, and anything else you can think in terms of diversity, but diversity with regard to the sector where people work. So we have a very great representation of academia, industry, regulatory, anything has a place. I really, really appreciate… And everybody, no matter where they come from, their focus is on good pharmacoepi science.

Lauren Lavin:

That’s important.

Daniela Moga:

Exactly. And so that gets to the question about guidelines development and all of that. And I think pharmacoepi, even though it’s not necessarily always termed this way, you have fancier and trendier words now, real world evidence, real world data, all of that, the basic, the bottom line is pharmacoepi. You can have the fanciest statistical methods, if you forget the basics of good pharmacoepi research, thinking about definitions of exposure, the basic epi in the pharmacoepi context, the evidence you generate is not what should be implemented in practice. I think the pandemic also brought more attention to all of these things that are important, and we as pharmacoepidemiologists have been using for a long time, big data, but it also revealed how important is to know how to use those data.

Lauren Lavin:

You can have a lot of data, but if you don’t know what to do with it, it’s useless.

Daniela Moga:

Exactly. Exactly. It’s useless, and not just useless, it can be harmful.

Lauren Lavin:

Yeah, it can be dangerous.

Daniela Moga:

Exactly. The society offers a space, and it’s well-recognized, to allow a voice to be heard, and I’ve been working… And this is one of the things I love about being part of this society, and taking more on a leadership role, is having the opportunity to work from… Again, with people from all of these backgrounds that can make an impact on the regulatory aspect of medication use. Or not just medication, it’s also devices, and anything that can be captured and evaluated through these types of studies in different parts of the world. And so the society, if you have something out there, and it says, “Endorsed by the society.” Has a different impact, than saying, “Daniela Moga came up with these guidelines.”

“Who’s Daniela Moga? Why do I care?” But if you have a well-recognized society that’s endorsing the work of a very diverse group of pharmacoepidemiologists, then that’s different. And so you feel like you can actually make an impact in the field, and in driving the evidence that’s being generated.

Lauren Lavin:

Absolutely.

Daniela Moga:

We’ve worked on things that we know are now part of the discussion with… Taking evidence coming from epidemiologic studies into drug approvals, changing on drug labels and things like that. They are more and more open to accept evidence coming from epidemiologic studies than years ago to complement what comes from clinical trials.

Lauren Lavin:

Yeah. That makes sense.

Daniela Moga:

So in touching the surface with the reasons behind… I’m really passionate, and I really enjoy working as part of the society, but I think it boils down to being able to do something that you feel is meaningful.

Lauren Lavin:

Absolutely. And can you, for our listeners, maybe just define pharmacoepidemiology, just in case people aren’t familiar?

Daniela Moga:

If you think what epidemiology is, is the study of anything in populations. And with pharmacoepi, when I teach pharmacoepi, Intro to Pharmacoepi, it’s basically a blend of two worlds. And two words, you have pharma, comes from pharmacology, and epi comes from epidemiology. And so you have the study of the medications, and it’s kind of expanding to include any types of interventions. It could be medical devices, or anything else, in large populations. And it goes from description of intake utilization at the population level, trying to identify whether there are certain factors that drive using one group or another, to really evaluating outcomes with regard to that particular medication, medical device use in populations. So that’s the nuts and bolts.

Lauren Lavin:

Perfect.

Daniela Moga:

It’s kind of epidemiology applied to a specific field. So we have occupational epidemiology that focuses on some certain… Of exposure. So it’s really the exposure that’s the difference.

Lauren Lavin:

Perfect. I think that helps us maybe make sure we’re all on the same page. I have one follow-up question to your work with ISPE. What are some of the initiatives or guidelines that you’ve helped to develop during your time with them? And how do you think they’ve contributed to the field?

Daniela Moga:

That’s a great question, and some of them, I think it will be a while until we see the full impact. We’ve worked with… And I say we because I was part of large groups, and we have special interest groups in the society, and some of the work has been with… There is one on competitive effectiveness research, so we develop guidelines related to the integration and synthesis of evidence coming from non-interventional studies or non-clinical trials, and how do you integrate information coming from clinical trials with those from observational studies. And providing guidance, because again, when you want to make impact at the population level, it’s that generation of evidence. And it’s not just one study and one study only that will be… I mean, some studies are so influential that they will change practice, but most times, you need a body of evidence. And it’s guidance on how do you integrate, and how do you tease out good observational studies from not so good observational studies? And how do you separate, and how do you make decisions about integration?

And I guess in terms of what we see as impact, we see that lots of papers discussing evidence generation are starting to cite our work, and it drew some attention. And so people are starting to think about those, and starting to apply our framework, which is, I guess, a sign, an early sign of the impact. I think in the future, seeing the framework being used, really, in regulatory decisions would be a next step.

Lauren Lavin:

That would be really rewarding.

Daniela Moga:

Yes, definitely.

Lauren Lavin:

Yes.

Daniela Moga:

And then another one we’ve done, and we are seeing some of that work being considered when designing studies using electronic health records, which, again, the pandemic opened more research-

Lauren Lavin:

Absolutely.

Daniela Moga:

… and there’s… In the U.S., in pharmacoepi, we use a lot of claims data. EHR is kind of up and growing, but they are completely different. And so they both have strengths, they both have limitations, and unless you are able to integrate both data sources, you have to be aware of what can you do with EHR versus not. We worked on developing guidance about using, and things you need to consider when even deciding whether EHR data is the best data source to answer a certain question. It all boils down to, “Is the data source a good fit to answer your research question?”

Lauren Lavin:

Yeah, and that’s a question we’re all asking. You know?

Daniela Moga:

I know, I know. And that’s one of the reasons we felt like this guidance was needed, it’s because you have so many… Now so many people working on the use of this data, and it’s more like… A lot of it is, “Oh, I have this data. I wonder what can I do?” And it is more like, “Oh, I can use it for this, for this, for that.” And without really thinking about that fit.

Lauren Lavin:

Right.

Daniela Moga:

And again, it’s not black and white.

Lauren Lavin:

No.

Daniela Moga:

It could be great for something, it could be really bad for other things, and it could be like, “Maybe it’ll provide some valuable information, but we might not go full extent with what we can claim.”

Lauren Lavin:

Right. Which is why guidelines help.

Daniela Moga:

Yes.

Lauren Lavin:

Absolutely. So what else are you working on research-wise right now that you’d like to share?

Daniela Moga:

So since I did with my current job at University of Kentucky, which has been 12 years now and counting, there’s been quite a bit of, again, changes, which, I guess, it keeps things exciting.

Lauren Lavin:

Absolutely.

Daniela Moga:

I am embracing more and more things that are not your typical pharmacoepi. You have your data, which is really what I was planning to do when I first started in my faculty position. I’ve done quite a bit of intervention work, so I expanded from pure pharmacoepi to actually developing and implementing interventions to improve on medication use in older adults. And then now, I’m adding more of the qualitative data and qualitative studies, which, it’s been frightening to embrace that path, it’s so much easier to crunch the numbers, and see what the numbers tell you. But lately, I’ve been appreciating more and more the stories behind the numbers, and I see more and more the limitations of just focusing on numbers, and big sample sizes that come from, I don’t know, either EHR or claims data, to allow one to appreciate the value of a smaller study that gets very rich data from a handful of people, and learning from their experience. We have a study now where we are recruiting participants from Eastern Kentucky, which is one of the… It’s actually defined as a hotspot for insomnia, so there’s a lot of insomnia-

Lauren Lavin:

Oh, interesting.

Daniela Moga:

… happening there. And it’s a combination of quite a bit of… So we will have lots of data to analyze, we’ll have lots of numbers, but also qualitative information through interviews. And I will not claim that I know how to deal with, but I have opportunities, and I have collaborators with background in sociology for instance, that’s their bread and butter, but I’m embracing that more, and I really, really appreciate the value of that, and trying to merge the two, and really approach things from a mixed methods type study, where you have the richness of the data, but then really, not having one quantitative and one qualitative, but how can you get the two to work together, and provide the best story for whatever you’re studying.

Lauren Lavin:

A very well-rounded picture.

Daniela Moga:

Exactly. Exactly. So that’s one thing that I’m more and more excited, and as always, medications are part of it, and with insomnia, medications have an important-

Lauren Lavin:

Absolutely.

Daniela Moga:

… role there. So we are collecting information on what people use in general, what medications they use in general, but also whether they use anything to treat their insomnia, and how appropriate that is. Those medications are kind of tricky. Typically, you don’t recommend them to be used long-term, and often, they are. And it kind of ends up into a cascade, where they are taking medications that are not really helping, but then you keep adding, and you develop polypharmacy, which triggers inappropriate medication use, which triggers lots of other things. And those have been things that I’ve been working on, but it’s really building, and kind of adding a little more to my portfolio, because I’m growing the appreciation.

And I think after being in the field for so long, you kind of start to see where the methods you’ve been using are not fully providing the right answer, and you know something is missing. So that’s a place where you stop and think, “What can I add?” And it doesn’t have to be, “I will be able to do it.” But, “Who can I partner with so we can work together, and find that common interest that allows one to be more comprehensive.”

Lauren Lavin:

Yeah, that definitely, I think, comes with experience and maturity in the field.

Daniela Moga:

It does. And not to have students think that, “Oh, I need to know this.” No. It took me 12 years, or even more. You want to allow yourself to take one step at a time, and keep some focus, while at the same time being open to learn. And maybe at the place where you are today, you cannot do it all, but that’s one thing I would say, you don’t have to change the world tomorrow. You want to strive and add to the path of changing the world, and make it a better place. And you still can have a contribution, even if it’s not like… Turn the switch and it changes everything. Nothing changes in an instant-

Lauren Lavin:

No.

Daniela Moga:

… it takes time to build.

Lauren Lavin:

Yeah, it’s a slow path.

Daniela Moga:

It is. It is.

Lauren Lavin:

But you can add to it.

Daniela Moga:

It is. And I mean, we were all told, “You go and have an interview.” You have to be confident that you’ll be able to change the world. But I think it’s that external pressure that we all have on ourselves, and allowing ourselves to kind of take a step back and think, “Well, maybe one day I will change the world. I want to say that that’s what I’m striving for, and I’m going to focus one step at a time, while keeping my options open, allowing myself flexibility, and allowing myself to see the opportunities that will guide me on that path.”

Lauren Lavin:

Absolutely. I love that. Looking back at your career thus far, what are you most proud of? And what have been some of your biggest challenges that you think our listeners can maybe learn from?

Daniela Moga:

I’ll start with the challenges, and I think the challenges were really to accept that things don’t go the way you think they will every time, and accepting that that’s part of the journey, and keeping… I like to say keeping a positive spin, and I allow myself… Grief is not the right word, it’s kind of like being upset by something that didn’t go the way… But taking just a moment to be like, “I’m sad this isn’t…” Or, “I’m frustrated.” Or something. But then be like, “Okay, where do we go from here?” And I think it took me a little time, and at the beginning, it took longer to be able to reset myself and be like, “Okay, what am I doing next? And how can I go from here?” I think I’m doing better now, it takes a little less time. And I think it’s also kind of accepting that there are things I can control, and there are things that I cannot control.

Lauren Lavin:

Correct.

Daniela Moga:

And unless you accept that you cannot control everything, it’s going to be hard to be happy with anything.

Lauren Lavin:

Yeah, that’s just good life advice.

Daniela Moga:

So I’m applying these things in life and in my professional career. So I think that was the challenge, giving myself time to think, and talking to people, and learning from their stories, and seeing that not everyone… Even the ones that you see as the most successful people in the world, I can guarantee, they had at least one setback.

Lauren Lavin:

Probably more than one. You just might not see it.

Daniela Moga:

You might not see it. I can speak more to the academic world, because I’ve been in academia for almost my entire life. You look at CVs, that’s a measure of our success. You even mentioned the number of publications, I don’t like these metrics. I mean, I never look at the person, and kind of put the words on those numbers, but you see the success stories on their CVs. I personally started to put all the grants I didn’t get on my CVs.

Lauren Lavin:

For real?

Daniela Moga:

For real.

Lauren Lavin:

Oh my gosh.

Daniela Moga:

Because I feel like… And I have way more of those than the ones that were funded, because I think unless we are more open to showcase our setbacks, we are creating unrealistic expectations. And I think it was easier in the past, I mean, there are obviously great things that happened with the internet and all the stuff-

Lauren Lavin:

Social media.

Daniela Moga:

But at least at the time we didn’t have that. It was harder to see all the shine-

Lauren Lavin:

Right. People didn’t make this perfect facade as easily.

Daniela Moga:

Exactly. And you couldn’t just go online and see how successful one person is, you just couldn’t, you wouldn’t find that information. Now you can. And so if you start looking, and it’s like, “Oh my goodness, where I am, I will never measure up.” It’s hard to look down at yourself, and I think that that’s very important. I didn’t come up with this, I’m not going to take the credit, but I saw somebody doing that, and I’m like, “I like that.” I like to show even my students that… I mean, you might look at my CV and say, “Oh, you’ve been very successful.” I’ve had my own struggles. I have them every day. It’s not all shiny. So I think we need to kind of see that, and allow ourselves to fail. And failure is never fun. Nobody likes that. But you have to get up and keep going, otherwise… You set your bottom, and you cannot just stay in the bottom, you have to figure out.

In terms of what I’m most proud of, it had been actually not… It was more about the impact. And I do a lot of work with medication use, and I’ve done quite a bit regarding cognitive health. As we were doing a study, I’ve been doing lots of talks in the community, and talking to people about medication use, and educating them about how important it is for them to know what they’re taking, and why they’re taking them, and evaluate on a regular basis whether they need to take everything they were taking, and have conversations with.

So Alzheimer’s Association had been one of the organizations that I’ve worked with with some of these events, and I just went to an event in the community, didn’t even know that anybody would know who I was, and I had this lady come and talk to me, and said, “I attended one of your talks that you did at this nursing home, and I’ve been using the things you told us with all my friends, and all the places I work, and I was telling them about how important it is.” So to me, that was one of the proudest moments.

Lauren Lavin:

Absolutely.

Daniela Moga:

I even have goosebumps thinking about that, but it showed that the work that I’ve been doing mattered.

Lauren Lavin:

Yeah, on an individual level.

Daniela Moga:

And it mattered for the people that it was intended to reach.

Lauren Lavin:

Yeah, even more important.

Daniela Moga:

Yes. So a publication, it’s a publication. It might be in, I don’t know, JAMA, or New England, whatever impact… High impact journal, or it could be in a very low impact journal, again, we are measuring the value based on where it’s published, and it’s not that. To me, the fact that I had somebody come and say, “Your work is so important, and here’s why.” Mattered more.

Lauren Lavin:

That is the perfect note to end on. Thank you so much, Dr. Moga, for being here today. This was a great conversation, and I hope our listeners enjoyed talking to you as much as I did.

Daniela Moga:

Thank you so much. Really appreciated the invitation, and thank you for having me.

Lauren Lavin:

Thank you so much for tuning into this episode of Plugged in to Public Health. I hope you enjoyed today’s conversation with Dr. Daniela Moga as much as I did. If you found this episode insightful, be sure to subscribe and leave a review so we can continue bringing you more fascinating discussions from the world of public health. Until next time, stay curious, stay informed, and stay plugged in. This episode was hosted and written by Lauren Lavin, and edited and produced by Lauren Lavin. You can learn more about the University of Iowa College of Public Health on Facebook. Our podcast is available on Spotify, Apple Podcasts, and SoundCloud. Have a suggestion for our team? You can reach us at cph-gradambassador@uiowa.edu. This episode is brought to you by the University of Iowa College of Public Health.