Guidance for Enhancing your Career Through Fellowship or Master's Degree Programs

Have you been considering enhancing your career with a fellowship (e.g. Health Policy and Administration Fellowship or Health and Aging Policy American Political Science Association Fellowship)? Perhaps you have considered earning a MBA, a MHA or a Master’s Degree in Education? Several readers have expressed an interest in furthering their careers with additional education via fellowships or other graduate degrees.

To assist you in this endeavor, we asked those who pursued additional education the following questions:

  • How you came to the decision to obtain additional educational training via a fellowship in Health Policy and Administration?

  • How did you achieve this goal? That is how did you apply for this educational training and what requirements followed? (e.g. time, travel, cost).

  • What was the advantage in gaining additional training?


Building a Career in Health Policy and Administration

Jason Johanning, MD

There is a huge need for clinically informed people to lead the drive in healthcare. I was appointed by the Secretary of Health and I've always been interested in health policy and legislative work. I completed a fellowship in health policy at Yale University in the RWJ Foundation Clinical Scholars program and previously worked for Senator Harkin through the Kaiser Family Foundation. I think these experiences were all good training opportunities that gave me the chance to get experience, and also to build a network in the health policy world. There are a couple of key foundations that are very invested in developing health policy leaders.

The decision for me to pursue a health and aging policy fellowship was not necessarily something that I sought out like a typical MBA or MHA. Rather, the VA has a specific fellowship track for anyone interested in health and aging. So I myself was really somewhat clueless about health policy yet it seems that we are constantly on the front lines being affected by policy decisions and so I had a natural curiosity to learn about it as well as have a potential impact with regards to my focused interest of frailty and surgical decision making.

There was no specific major forethought regarding the fellowship program other than reviewing and confirming I had appropriate qualifications and the necessary support locally in place to pursue the fellowship. It was clear as a surgeon that I would need to perform a non-residential fellowship which would require a 6 week crash course in policy in Washington, D.C. and subsequently travel to and from Omaha, NE to Washington, D.C. throughout the rest of year.

Perhaps the most important part about my health policy fellowship was that I was passionate about our aging population and ensuring that patients’ goals of care and preferences are honored at the end of their life. With the quality work that we did in Omaha, people in Washington were fascinated that we could devise system-wide interventions to ensure that these goals of care were met. Additionally, the VA provided unique perspective in contrast to the private sector where the secondary gain to perform an operation is much different comparing the two healthcare systems. So short story is that I had a unique space to occupy and policy discussions in Washington and served as a content expert in the area of operations at the end-of-life and the impact of palliative care interventions and surgical patients. You can imagine that having shown palliative care can actually improve outcomes is potentially at odds with the classic death panel debate.

Anyone considering a health policy fellowship needs to consider several things before embarking on the endeavor. First and foremost, this fellowship like any other is reliant upon a mentoring relationship. I had the good fortune of being mentored by 2 outstanding individuals namely Tom Edes, Director of Geriatrics for the VA and Shari Ling, Deputy Chief Medical Officer in the Center for Clinical Standards and Quality. Your mentors in health policy need to be experts in their own right and I was lucky to have 2 of the very best exposing need to policy decisions both at the highest level in the VA as well as within the Medicare environment.

The advantages of this fellowship are many and as opposed to a classic Masters’ track program the benefits are potentially more along the intangible, but I can honestly say it is perhaps one of the most satisfying things I have ever done in my career. It introduced me to people who I can contact at a moment’s notice across the nation as part of the network to get things done. It also opened my eyes to the way health policy really works in Washington and despite what people may say, there are a lot of honest and hard-working people in our government system whose hearts are in the right place.

Lastly, I have learned that our ability his physicians to impact systems it at both the government and hospital level is vitally important and we as surgeons should have a voice similar to any other specialty.

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