Graduate / SOP for epidemiology PhD admission [4]

I would appreciate if you could make any comment on my SOP.

prompts are as follows:
1) What is it about epidemiology that appeals to you?
2) What have you done to prepare yourself for training in epidemiology?
3) How will you use your training in epidemiology?
4) What area(s) within epidemiology do you wish to emphasize and why?
5) Any additional information about your interests, prior background or special circumstances that may be helpful to the Admissions Committee in evaluation of your application.

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I am currently pursuing a research career in epidemiology, especially cardiovascular disease (CVD) epidemiology. Specifically I am interested in understanding the epidemiological features of CVD morbidity and mortality in high-risk populations of specific metabolic phenotypes, and to predict the risk of CVD among general and high-risk populations, in addition to exploring the interaction between genetic and environmental factors in CVD prevention. I look forward to working with such outstanding faculty members as Dr. A, Dr. B and Dr. C whose research experience in CVD epidemiology would be invaluable to my desired career.

As a medical student, I was interested in social science and history as much as medicine. I took many related lectures and attended fora in those areas. My interest developed into investigating the social impact of medicine and impelled me to join and contribute to a university club that discussed current health problems in X society. After deep reflection, I resolved to dedicate my life to researching public health problems over purely personal ones, and my interest in public health led me to focus on preventive medicine. At graduate school I had the opportunity to familiarize myself with the concepts in public health by taking several courses related to epidemiology and health care management. While serving as a public health doctor for military servicemen in a rural clinic, I had the chance to apply my knowledge of public health to the real world. My patients included many elderly people with a clustering of diabetes, abdominal obesity, dyslipidemia, and hypertension, or so-called "metabolic syndrome (MetS)." Although the concept of MetS was not in popular at that time, In order to control these phenomena, I planned and conducted health promotion and disease prevention services on the population in cooperation with other health professionals. The proportion of villagers with higher blood pressure and waist circumferences decreased as a result of the services, and most patients were highly satisfied with the program. My personal experiences with the health promotion program in this rural area have narrowed my focus and guided me toward my major research field: the epidemiology and control of diabetes mellitus, hypertension and MetS.

In addition to my extensive collaborative clinical research work, I have participated in a community-based cohort study on type 2 diabetes, hypertension and MetS, involving about XX subjects over 40 years of age since X. In that study I have played an executive role in planning detailed study methods, and conducting data management and statistical analysis. Results of this study have been published in domestic and international peer-reviewed journals. Interestingly, these results reflected findings from another X study in terms of prevalence and characteristics of MetS, but were quite different from the results found in a U.S. population study. While I was considering possible explanations for these divergent conclusions in the two countries, I became curious about the genetic determinants of common complex-diseases such as MetS, diabetes, hypertension and CVD.

To deepen my understanding of the concepts of genetic epidemiology, I enrolled in the X Master program at X University. The coursework provided me with an important introduction to the concepts and applications of genetic epidemiology. After completing the master's program, I continued my genetic epidemiology research with Dr. X in the Division of X at X University. I had the opportunity to continue my training in data management, statistical analysis and interpretation of results on the genome-wide association data. However, as a preventive medicine physician, I feel it necessary to take more advanced coursework based on an epidemiologic perspective, in order to develop a more substantial knowledge and to gather the effective tools for conducting epidemiological studies that contribute to disease prevention.

In the Epidemiology Ph.D. program, I am looking forward to studying epidemiological methodologies in depth through coursework, and being actively involved in the cardiovascular epidemiologic research. I am strongly interested in the assessment of cardiovascular risk in persons with an abnormal metabolic phenotype to prevent CVD. The best example of these high-risk groups is MetS, characterized by the clustering of traditional and emerging risk factors for CVD. In addition, I have keen interests in other types of abnormal metabolic phenotypes such as metabolically obese but normal weight (MONW), hypertriglyceridemic waist (HTGW), and sarcopenic obesity. These phenotypes are highly significant in terms of rendering the early detection of high-risk CVD cases and providing appropriate preventive interventions leading to the reduction of CVD morbidity and mortality. My continuing research experience explores the characteristics of MetS, MONW, and HTGW, using data from an ongoing community-based cohort study begun in XXXX, and a nationwide X cross-sectional survey. It was through observing the association of these phenotypes and incidences of hypertension, diabetes, and chronic kidney disease that I became enthusiastically interested in finding the link between these phenotypes and CVD outcomes such as coronary heart disease and stroke. It is my hope that the next step of my research will use a well-designed large scale cohort study such as the Atherosclerosis Risk in Communities (ARIC) Study.

CVD risk prediction is another fascinating research area for me. An appropriate risk prediction tool may provide useful clinical information for identifying cases at high risk of developing CVD, and finding those cases requiring more intense preventive interventions. Although several risk scores including Framingham risk score have been proposed for predicting CVD susceptibility, it has been criticized that they have some limitations in terms of predictability, clinical utility, and applicability to specific risk groups. Among diverse approaches to develop CVD risk prediction model, I am especially interested in exploring the role of novel markers including inflammatory or prothrombotic markers. After an extensive review of all the peer-reviewed relevant literature over the last ten years about the association of theses markers with MetS in my previous master's studies, I would now like to apply that knowledge to develop a substantive CVD risk prediction model. To validate a CVD risk prediction model that includes novel markers, as recommended by the American Heart Association in 2009, the value of new markers of cardiovascular risk needs to be assessed on the basis of study design, statistical methods and clinical implications. In this respect, I need the systematic and rigorous academic training you offer in advanced epidemiologic methods to further my abilities in this area of epidemiologic studies.

In addition, based on the knowledge of genetic epidemiology I gained in my master's program, I would like to be involved in genetic epidemiologic research to elucidate the interaction of gene and environment in developing CVD. Well designed population-based or clinical epidemiological studies on gene-environment interaction may provide information on genetic polymorphisms predicting responses to lifestyle interventions, and also explain how lifestyle interventions may adjust gene expression. This may contribute to disease prevention and targeted intervention in high-risk genetic subgroup populations that can be applied in the clinical or public health practice to prevent CVD in terms of personalized risk assessment.

To investigate these questions, the Ph.D. program in epidemiology at the XXX School of Public Health will be the ideal program for me in terms of strengthening my academic background in CVD epidemiology and providing me with exposure to a variety of advanced epidemiologic methodologies to solve my academic questions based on real data. I have enormous enthusiasm about the prospect of continuing my education at the XXX School of Public Health, where I hope to take the next step toward realizing my ambition: the elimination of CVD in the world.