How Mayo Clinic trains administrators, 40 years and counting

Mayo Clinic has been training future healthcare leaders through its administrative fellowship program since 1983. Over the past four decades, less has changed than one might think. 

T'Nita Walker, the fellowship program's director and the associate administrator for individualized medicine, was an administrative fellow herself in 2006. The program boasts a high retention rate: 81 percent of fellows have continued to work at Mayo Clinic post-fellowship. Within the past five years, that number has risen to 95 percent. 

Administrative fellows receive a personalized experience; there were six fellows in Ms. Walker's cohort, and she was the only one on the Arizona campus. The mentorship each individual received was invaluable, Ms. Walker said. 

"I sit here today as the leader of the fellowship program because I had really, really, really strong mentors," Ms. Walker said. "I had leaders that were super busy, their calendars were filled, there's not enough time in the day. Yet they took time out of their calendar to spend with me, to guide me, to coach me, to brainstorm with me, to be a shoulder that I needed if I was struggling with a certain scenario. That mentorship element was absolutely essential for me as a fellow." 

There are a few core rotations that Mayo considers essential for all administrators, regardless of where they aim to land post-fellowship: HR, finance, strategy, clinical operations, educational research. Otherwise, the program is largely customizable depending on the fellow's interests — or knowledge gaps. 

"One of the rotations that I vividly remember, I was actually scared of," Ms. Walker said. "I felt like I didn't understand the language, the subculture, if you will, of information technology, but I sure knew it was going to be important to our future, because we had an electronic medical record. So I actually asked if I could complete an IT rotation, and thankfully, I had really great mentors and preceptors that helped ease my comfort level in that space." 

The program encourages fellows to get out of their comfort zone and take hands-on leadership opportunities. Their clinical operations rotation is oftentimes an interim leadership experience, like a managerial role, according to Ms. Walker. And fellows are offered "stretch assignments," such as committee work, based on their interests or organizational needs. 

Mayo recently threw an anniversary celebration for the program, and Bob Fleming — Mayo's chief administrative officer in 1983 and an essential part of the fellowship's launch — was in attendance. He noted parallel themes between the program's conception and where it is today, according to Ms. Walker. 

"The stability and framework, the rotations that I described, maybe some of the names have changed over the years, but those key elements have remained the same," Ms. Walker said. "We've also been able to recognize that the landscape of healthcare has changed significantly over the years, I would say in an even more rapid fashion since COVID. We've been able to make sure that we've kept up with having our fellows rotate in the new, emerging areas, to make sure that they stay strategically aligned to the organization." 

Those new areas of focus include "platform" — an area built on creating a business model of different products, solutions and technologies — the Center for Digital Health, and the Cancer Center, which is one of Mayo's most important strategic initiatives. 

But one thing that won't change in the next 40 years is the production of well-rounded, nimble leaders — hopefully, leaders who want to plant roots with the organization. 

"We've worked really hard as a fellowship program to make sure that we keep those core essential elements that are critical for all leaders, regardless of what area they choose to work in after their fellowship. We've tried to preserve that and ensure that our fellows obtain that rotational experience," Ms. Walker said. "But we've also really worked hard to be agile and respond to the needs of not just healthcare but of Mayo Clinic as well, and put our fellows in a position where they can rotate in areas that are aligned strategically with where the organization is going."

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