Kate Mandeville speaks in a personal capacity. It was the worst of times. I was halfway through my PhD, had just acquired a needy adopted cat and my husband had a job tying him to London. Yet I had the opportunity to work for the World Bank for two years as a public health specialist as part of their Young Professionals Programme. This is a training programme for professionals from a diverse range of backgrounds including economics, engineering and public health. As the name suggests, it’s restricted to those who are “young” though – or at least young as flatteringly defined by the World Bank as under 32 years. I had always wanted to move between research and policy and was undertaking a policy-focused PhD using an economic approach favoured by the World Bank. Being able to see first-hand the needs of policymakers could only enhance the relevance of my research and would give me valuable experience at an international level – yet obviously wouldn’t help that much with finishing my doctorate on time. As an international organisation had officially confirmed that my middle age was fast approaching, however, I decided to take one last youthful risk. After discussion with the Wellcome Trust, David Mabey and my supervisors, I put my PhD on hold and on a wet September day in 2012 left husband and cat behind to move to the blue skies of Washington, D.C. I thereby entered the steepest learning curve I’d encountered since starting as a junior doctor. The World Bank is a development bank funded by member countries that gives grants or soft loans to the world’s poorest countries for key development projects. Many of these projects are in health, particularly strengthening fragile health systems such as those that contributed to the Ebola crisis in West Africa. I was working as a public health specialist in the Europe and Central Asia health unit, giving advice on projects mostly in the countries of the former Yugoslavia. Particular work that I was involved in included the introduction of social health insurance in Kosovo, reforming pharmaceutical procurement in Serbia, and forecasting the effects of the rapidly ageing population in the region. The transition from working on local health issues in one borough of London to giving advice to Ministers of Health on their national health policy was a little daunting, to say the least - but my UK specialist training in public health stood me in good stead. Another change was my colleagues: whilst the World Bank employs specialists in many different disciplines to work on these projects, it is primarily an economist-dominated institution. My knowledge of economics wasn’t that shabby after spending the last few years immersed in health economics tomes for my PhD, but I still had to become rapidly fluent in economist-friendly phrases in order to get my points across in the most effective manner. A final shift was moving from the introverted, informal academic culture in the UK to the slightly more extroverted corporate culture in the U.S.A. By the end of the two years, I couldn’t quite talk myself up with the same panache as my American colleagues, but I think I was getting a little better. I’ve now returned to LSHTM and my PhD, with plans to finish early next year. Despite the disruption to best-laid plans, I’m really pleased that I took up this opportunity. It’s opened my eyes to work in an international organisation and how the global health architecture really fits together. I’ve learnt about the political cycle and its impact on the needs of policymakers. Finally, I’ve learnt how to frame evidence in more effective ways for policymakers – and confirmed my intuition that an argument made for health in economics terms can be one of the most persuasive. I’m looking forward to analysing and disseminating my results on cost-effective ways to retain health workers in Malawi – and continuing to cross between policy and research.