If you didn't complete an administrative fellowship right out of residency, you might worry that the window of opportunity has closed. But I'm happy to reassure you that fellowships aren't just for kids or new attendings.
I was an Assistant ED Medical Director with several years of experience when I became a Vituity Administrative Fellow in 2016. But this whirlwind year has taught me that I still have endless room to grow.
It's also moved my career forward further and faster than I could have imagined. Here's my story.

Growing Tomorrow's Leaders

Helping to start a geriatric ED at Saint Agnes Hospital in 2015 was one of the best experiences of my career. It made me realize that I'm probably a Vituity lifer. As such, I wanted to find more ways to get involved, share what I'd learned, and develop as a leader.
This led me to Vituity's Administrative Fellowship in Emergency Medicine. The yearlong program provides a wealth of hands-on business and leadership training. Fellows receive both classroom instruction and mentoring by executives. They also attend leadership and committee meetings, educational events, and learning collaboratives.
For me, one of the best parts of being a fellow was the chance to immerse myself in Vituity culture. It's inspiring to see how our leaders really put patients at the center of every decision. The fellowship also showed me the depth of expertise and resources available to me as a leader.
Finally, the mentors cared about me as a person. They helped me multiply my strengths and showed me what I could bring to the Partnership. For my fellow project, they encouraged me to create a toolkit that would support geriatric ED startups.
I figured I'd enjoy my fellowship experience and hopefully become a Medical Director in a year or two. So what happened next surprised me.

Big Developments

In 2016, Viuity received an RFP from a health system in Columbus, Ohio. Mount Carmel St. Ann's has always been known as a great community hospital. But after a recent expansion, their ED was serving a larger region and seeing 73,000 visits a year.
It seemed like a great opportunity. Because I'm interested in leadership (and based relatively nearby in Baltimore), our business development executives invited me to get involved. We quickly submitted our proposal.
I sat in on many of the meetings with hospital administrators as they shared their vision and goals. While St. Ann's had many strengths, leaders were keen to take their performance metrics to the next level. They were impressed by what Vituity had accomplished for other hospitals.
In the end, we signed a contract. What's more, I was thrilled to be appointed incoming medical director. What an honor!

Starting Up

If I've learned anything over the past few months, it's that an ED startup is truly a team effort. Our contract with St. Ann's officially starts on July 1. However, the incoming Medical Director, Regional Director, Advanced Provider Site Leads, and Vituity Practice Management Consultants visit the hospital months ahead of time to lay the groundwork.
In many ways, this startup is ideal for my first. The ED team is fantastic, and there's a good working relationship between medicine and nursing. Also, most of the existing providers joined Vituity. This really helps with continuity and keeps things the department humming along through the transition.
But even an ideal startup is a lot of work. I think it's safe to say I'm using all of the skills I'm learning in my fellowship. As incoming Medical Director, I meet regularly with St. Ann's administrators, nursing leadership, and the heads of various departments. My jobs at this stage are to build supportive relationships, gain buy in for Vituity programs, and model the Vituity culture.
One of our goals with every startup is to foster a sense of ownership across the ED team. This starts with mentoring the ED leadership. We also run our department meetings in a way that encourages everyone to be heard. Our message is that we're all responsible for steering our ED in the right direction.
The startup phase is also a key time to model the Vituity culture. We show the team what trust, respect, and transparency look like in action. And as medical director, it's important for me to model servant leadership. Because if I’m not willing to come in and work overtime or overnight, I can’t ask anyone else to do it.
Another goal at this stage is to foster collaboration with hospital medicine, surgery, ancillary services, and other key stakeholders. The ED can't function in isolation. We absolutely have to work with other departments in order to deliver seamless care. The more we communicate about what we’re doing for patients, the more efficient we are and the safer we are.
Finally, this is the time to gain buy in for change. When introducing our Vituity processes, I show our team how they will make our jobs easier and our care better. Change can be tough. But at the end of the day, most clinicians want to do what's best for patients.

Right for You?

As my fellowship year draws to a close, I'm filled with gratitude for all it's given me. Without this fellowship and the preparation it provides, I don’t think I’d be here at St. Ann’s serving as a startup medical director. I wouldn’t get the joy of mentoring a medical staff and helping them understand the strengths they bring to the table.
Could an administrative fellowship be right for you? If you're interested in growing as a leader and learning the business of medicine, you should definitely check it out. And remember, you don't have to be fresh out of residency to benefit!

Visit our website to learn more about Vituity's Administrative Fellowships in emergency medicine, hospital medicine, and anesthesiology (coming 2018).