Getting Started: Designing a Fellowship

So you've decided to offer a Fellowship. Now what?

The next step is to determine the specific nature of the fellowship. This section covers:

Choice and Role of the Preceptor
Duration and Structure of the Fellowship Experience

Choice and Role of the Preceptor

In addition to specific expectations based on the structure of the fellowship, there are a number of general expectations for fellows.

One organization states that "the fellow will take part in active, hands-on, substantive projects that foster development of verbal, interpersonal and analytical skills and the opportunity to translate academic theory into practice." The fellow is expected to prepare two papers dealing with professional  values, keep a journal, make journal club presentations, engage in professional education and work on independent and team projects.

Other organizations specify expectations for the fellows in terms of competencies:

  • Demonstrates knowledge and understanding of the healthcare industry and the components of the organization
  • Communicates information effectively using the appropriate level of judgment, accuracy, and courtesy with internal and external constituents
  • Exhibits accuracy, attention to detail, consistency, and ability to meet multiple deadlines in all work efforts
  • Demonstrates ability to synthesize information (quantitative/qualitative) and complete components of preliminary and final reports, including spreadsheets and financial analyses (if applicable)
  • Demonstrates ability to work independently and to collaborate in group settings
  • Exhibits a willingness to take on leadership and non-leadership roles and responsibilities
  • Possesses effective management skills

Organizations also may want to consider the ACHE Competencies Assessment Tool based on the Healthcare Leadership Alliance model.

Duration and Structure of the Fellow Experience

Postgraduate administrative fellowships typically last from 1 -2 years. Some fellowships are 13 months with a one month overlap between fellows that allows the outgoing fellow time to orient the new fellow. The Methodist Hospital System (Houston) has an eighteen month fellowship with overlapping cycles (1-2 fellows begin in June/July and 1-2 fellows begin in December/January).

Most fellowships include multiple components:

  • Exposure to executive leadership and decision making processes
  • Departmental rotations and shadowing
  • Responsibility for specific projects (including cross divisional team projects)
  • Professional development (lifelong learning) and professional ethics
  • Community and civic activities

Regardless of the specifics, the overall structure of the fellowship opportunity is designed to allow the fellow to observe, learn and do, as well as be acculturated into the profession. For example, one administrative fellowship is designed to combine leadership development, project management and career development activities. The criteria for deciding upon potential projects include:

  1. Operations improvement
  2. Project management
  3. interim management opportunities
  4. System-wide/strategic initiatives
  5. Leadership development

In addition to rotations and projects, it includes the opportunity to be an "administrator-on-call," paired with the regularly scheduled executive who acts as a shadow administrator.

Another organization provides a detailed description of its program which involves two simultaneously occurring phases. During the orientation/rotation phase the individual  spends time in operations, corporate services, legal, finance and their foundation, and meets with medical staff officers. The implementation/performance phase focuses on project assignments, attending educational conferences and site visits, as well as attending Board meetings and management meetings and retreats. The expected frequency of the various meetings and the basic agenda for rotations are also outlined, as well as features such as a reading list of management books (e.g., Good to Great and Tipping Point) and a timeframe dividing activities into eight week segments.

Still others include an explicit section on community/civic activities, as well as a section on responsibilities to the profession of healthcare management. Those responsibilities include an expectation that the fellow will "uphold the values, ethics and mission of the healthcare management profession."