Postgraduate Fellowship Compensation Survey
From ACHE's Division of Research
In 2002 and 2006, ACHE conducted studies of compensation for postgraduate fellows. These replaced the use of anecdotal information for benchmarking compensation by existing and potential sponsors of such fellowships. Both health administration students, faculty and fellowship sponsors benefit from understanding compensation trends and having current information. Accordingly, ACHE conducted another compensation survey in 2010 to provide more current information for all the concerned parties.
ACHE's Division of Research selected individuals in the ACHE membership database who had identified themselves as fellows when they completed the job title portion of their initial membership application or when they completed the update to their affiliate directory profile in early 2010. Staff then manually sorted the list to exclude academic faculty (teaching fellows), researchers (post-doctoral researchers), practicing clinicians and armed forces managed care fellows. After this sorting, there remained 315 individuals who by title, degree and name of employer appeared to fit a profile consistent with that of a typical administrative fellow.
In February 2010, staff updated the 18-item questionnaire previously employed in 2006 to obtain information regarding postgraduate fellowship base income, incentive compensation, employment benefits, and demographic information about the fellow and the sponsoring organization. As in both earlier studies, the instrument was converted to an Internet-based questionnaire. An e-mail cover letter was sent to the 315 individuals in our population. The cover letter contained a link to the online questionnaire.
Wave Number One of the emails was sent to all 315 individuals on April 1. It produced 126 usable responses. Staff sent a second wave on April 12. It produced another 55 usable responses. The total was 181 usable responses for a response rate of 57 percent.
A nonresponse analysis was conducted which is presented in Appendix A. Nonrespondents were similar to respondents in regard to their gender, highest degree attained and field of highest degree. However, respondents were more likely than nonrespondents to have been recent graduates, to reside in the west and to be current Members of ACHE (as opposed to having allowed their membership to lapse).
Characteristics of Respondents and Work Arrangements
As shown in Table 1, the median age of fellow respondents was 27 years old. The oldest fellow was 51 and the youngest was 24 years old. Nearly two out of three fellows were female. On average, fellows had acquired about two years of work experience prior to taking their fellowship.
Most fellowships are established for one year—68 percent of the respondents worked under this arrangement. However, 40 percent said they were committed to their fellowship for more than a year most of whom expected to work for two years. About 60 percent of the fellows were hired expecting to continue their employment with that organization after completing the fellowship. The remainder did not have such expectations.
On average, fellows state they work approximately 54 hours per week—48 hours in the office with the remainder occurring at sites away from the office and at home.
Characteristics of Sponsoring Organizations
The majority of fellows take their positions in hospitals—especially hospitals that are part of health systems. In fact, nearly three out of four fellows work in either a system hospital (55 percent) or at system headquarters (19 percent). (see Table 2) Sixteen percent are based at freestanding hospitals and 10 percent work in other settings such as, a medical group, a professional association or a continuing care retirement community.
Two-thirds of fellows work in not for profit organizations, five percent work in investor owned settings and almost all others work in governmental organizations (18 percent federal, 8 percent non-federal). Seventy-two percent of fellows are employed in urban settings; another 23 percent are in suburban settings. Only five percent classify their location as rural. Over 60 percent of fellows work in very large organizations with annual revenues in excess of $200 Million.
Fellows’ Compensation, Incentives and Perquisites
Table 3 shows the distribution of fellows’ base income (not including income from other work such as consulting, teaching or publishing). The median income of fellows in 2010 is $49,800. Four percent report earning less than $40,000 per year and 15 percent are paid $60,000 or more; however, nearly three-fourths earn between $45,000 and $60,000 per year. About one-fifth reported that they were eligible for incentive pay or bonuses and 46 percent indicated that their compensation could be otherwise increased. Of those eligible for incentive/bonus earnings, over half faced accomplishing a combination of individual and corporate objectives to qualify for the incentive. In terms of benefits apart from salary and bonus, about 90 percent of fellows receive paid holidays and paid time off. Almost 80 percent receive full payment for their travel costs associated with professional development and 60 percent receive full payment for tuition costs associated with professional development. Other perquisites such as life, disability, medical and dental insurance are more often partially than fully paid. About half of employers do not reimburse fellows for association dues; however, 42 percent of employers paid for such dues fully.
Comparison With 2006 Survey Findings
Since the previous survey conducted in 2006, the percent of females in fellowships has decreased slightly and, correspondingly, the percent of males has increased. In 2006 two-thirds of fellows were female compared to just fewer than 60 percent in 2010. In addition, as the proportion of fellows in government-controlled organizations grew from 22 percent in 2006 to 26 percent in 2010, those in not for profit healthcare organizations decreased from 72 percent to 66 percent. Not only has fellows’ median base compensation increased nearly 14.2 percent ($43,604 versus $49,800), but there also has been a noticeable improvement in fringe benefits that are fully paid versus those being partially paid. The improvements are most noticeable for medical, dental, and disability insurance. For example, 43 percent of fellows in 2010 received fully paid disability insurance when in 2006 only 29 percent received this benefit.
This survey of fellowship was designed to assist fellows and their employing organizations to learn about demographic and educational characteristics of individuals taking on such pre-professional roles in healthcare management as well as the types of organizations willing to provide such individuals with needed managerial experience and the level of compensation they offer.
We anticipate continuing to conduct surveys like this in future years to track changes in the composition of the fellow cohorts, the types of employing organizations offering such opportunities and the resources that are committed to the fellowship experience.