Key Takeaways
- Administrative fellows with transferable skills from healthcare IT and project management backgrounds can drive significant operational change and cross-functional alignment.
What sets the Children’s Hospital Wisconsin Administrative Fellowship apart, and what drives candidates like John to pursue it?
Children’s Wisconsin is unique—it’s the only institution in the state entirely focused on the well-being of children. As John puts it, “Children’s Wisconsin is the only freestanding independent pediatric institution in Wisconsin, and we are the only organization fully dedicated to the health and well-being of kids.” That exclusivity isn’t just a selling point for parents; it’s a north star for fellows seeking purpose in their careers.
For John, the motivation to work in pediatric healthcare was deeply personal. “I was a kid in the hospital—I had a two-week NICU stay, a couple of surgeries before the age of five, and then some postsurgical implications that kept me in and out of the hospital even through elementary school.” Those experiences solidified his resolve: working with children, specifically in healthcare, wasn’t just a career option—it was a calling.
Children’s Wisconsin is the sole pediatric-exclusive health system in the state, making its fellowship especially attractive to mission-driven candidates.
Lived experience as a patient can uniquely inform administrative leadership and empathy in pediatric care.
The hospital’s independent status fosters a culture tightly focused on child and family-centric care, a differentiator in a healthcare landscape dominated by large systems.
How do undergraduate experiences and early professional roles shape future healthcare leaders?
John’s journey into healthcare administration didn’t start with a straight line. During his undergraduate years, he co-chaired the Children’s Miracle Network Dance Marathon, a fundraising effort for children’s hospitals. “Myself and a friend of mine were the co-chairs of that while I was in undergrad…a 12-hour fundraising activity where folks pledged to stay on their feet, raise money at that time for Sandford Children’s in Fargo, North Dakota.” This formative experience anchored John’s dedication to children’s health.
After undergrad, John took a five-year detour into healthcare IT, working at Epic Systems as a project manager for the Cupid module, which supports procedural cardiology documentation. His role saw him collaborating with major systems like the Franciscan Missionaries of Our Lady Health System, Cleveland Clinic London, Mayo Clinic, and RWJ Barnabas. “Those are some of the big projects that really shaped my experience working there, and a lot of the relationships that I had and still have came from working on those projects.”
Hands-on fundraising for children’s health set the foundation for mission alignment.
Healthcare IT project management cultivated skills in system implementation, change management, and cross-functional teamwork.
Building relationships across national and international health systems proved essential, both professionally and personally—“Quite a few of my friends now are still from there, and my wife’s friends that she made while she was working at Epic.”
Why would an established project manager leave a lucrative healthcare IT career to pursue an MHA and administrative fellowship?
For John, it wasn’t about chasing titles or short-term salary gains—it was about impact and alignment. “One of the goals of going to grad school and getting the MHA degree, then the fellowship, was to be able to build some of those longer-term relationships and have some of that longer impact in one specific focused organization.” The transient nature of vendor-client work in IT, where even deep connections last only a couple of years at most, left him craving continuity.
Importantly, he acknowledges the financial sacrifice. “Salary was a component of that…I did have the opportunity to work in grad school, did a little bit of consulting…just to have some income.” But the central motivator was, and remains, pediatric healthcare: “It was really the alignment with pediatric healthcare that was driving me to make that career change.”
Desire for deeper, longer-term impact in a single organization, not just as a vendor.
Mission alignment—the opportunity to focus on pediatric health, which has been a lifelong goal.
Willingness to sacrifice short-term income for long-term career satisfaction and purpose.
How did John’s administrative residency at Intermountain Healthcare set him up for the Children’s Hospital Wisconsin Fellowship?
Not all residencies are created equal, and John’s experience at Intermountain Healthcare’s Primary Children’s Hospital was both competitive and transformative. “They take 14 administrative residents each year…you’re placed specifically in one of their hospitals or regions. I applied specifically to work with their children’s hospital, Primary Children’s, because of my interest in pediatric health.” The ability to work on high-impact projects—such as improving transitions of care from pediatric to adult health services—gave him firsthand exposure to complex, multidisciplinary challenges.
This project, he says, required “proposing a programmatic approach…with a lot of support from Intermountain as well as Primary Children’s—they partner with the University of Utah.” The residency not only sharpened his operational skills but also tested his personal resilience. “I wanted to see if I could hack it…It was so personal to me…I wanted to make sure I could go and that that emotion—that I was able to feel it and be connected to the work but also not let it overwhelm me.”
Competitive placement with specific focus on pediatric institutions.
Cross-institutional collaboration with the University of Utah and Intermountain leadership.
Project work centered on transitional care—a “pain point” in pediatric health systems nationally.
Personal growth: “It gave me the confidence that yes, this is personal to me, but that’s not a bad thing—that can be a really good thing as well.”
What is the application process for the Children’s Hospital Wisconsin Administrative Fellowship, and what challenges do candidates face?
John was unequivocal: “Children’s Wisconsin was my top choice because it was the pediatric institution in Wisconsin, and Wisconsin is where we wanted to be for our life.” The application process was high stakes, not just professionally but personally—location and institutional mission mattered for both him and his wife. The anxiety wasn’t just about getting any fellowship, but about landing at the right institution: “If it’s not where I end up going, what am I going to do?”
He also highlighted a common dynamic in healthcare administration: competing with friends and peers from graduate programs. “That can be anxiety-inducing because you know them well through coursework or other components.” Fortunately, he avoided direct competition from within his own cohort for Children’s Wisconsin, though he acknowledges the complexity this can introduce for many applicants.
Mission and location alignment were decisive in program selection.
The process can feel high-pressure given the limited number of fellowships and the personal stakes involved.
Peer competition is real, especially among top graduate programs, but not always a disqualifier.
John considered skipping the fellowship entirely, given his prior experience, but ultimately chose it for the breadth and depth of exposure: “I’ll advocate for people doing a fellowship—my experience has been great…I’ve been exposed to so many different projects.”
Given prior healthcare industry experience, is the fellowship still valuable?
John’s verdict is clear: “I do because I wanted to change career paths…I didn’t want to be just in healthcare IT…The experiences I have gained through this have allowed me to pivot in different ways.” Even for seasoned professionals, the fellowship offers structured opportunities to develop relationships, broaden organizational understanding, and build skills not always accessible in vendor or siloed roles.
“The organization—Children’s Wisconsin—has been so supportive in me exploring different areas…Very frequently those skills are asked to be drawn on because they are unique or because the project management components are needed in any sort of work that you’re doing.”
Yet, he’s nuanced in his advice. For those who are deeply committed to a specific technical or clinical path—such as the lab or pharmacy—the fellowship may not be essential. “If somebody…wants to stay in the Toe Clinic, I think a fellowship is a great opportunity. But for those with a focused clinical path, it may not add as much value.”
Professionals seeking a pivot into leadership or broader administrative roles.
Those who value project management, organizational change, and cross-functional exposure.
Early careerists or industry veterans wanting to build relationships and navigate healthcare complexity.
Less critical for those committed to deep technical expertise within a single function.
How do fellows translate diverse professional backgrounds into impact at Children’s Hospital Wisconsin?
John’s story exemplifies the value of adaptable skills. Project management, change management, and stakeholder communication—all developed during his time at Epic—are indispensable in his fellowship. “The merch that I have is from a UWM campus improvement project—a project I worked on to help activate and transition into the new Skywalk building on campus. That has nothing to do with healthcare IT, but it is project management and change management and relationship building and staying organized and being tenacious.”
Children’s Wisconsin supports fellows in exploring new domains, and the skills developed in one context often prove essential in another. The takeaway: administrative fellowships reward those who bring a mix of expertise, flexibility, and curiosity.
How is pediatric healthcare administration unique—and what should leaders know?
Pediatric care is not adult care “scaled down.” The focus on families, unique legal contexts, and specialized physiology all set children’s hospitals apart. John explains, “Kids are not just little adults—they’re kids. Their bodies are different, their anatomy is different, and how their physiology changes how we treat them as well.”
The family is central. “The parent is a huge component…patients are never just themselves—they exist within that larger infrastructure, and that really starts at the family level. We just see it a little bit more specifically, especially if you’re caring for a three-year-old because a three-year-old can’t care for themselves.”
Family involvement is fundamental—not just for support but as a legal and clinical necessity.
Care transitions (from pediatric to adult services) are major pain points, requiring systemic solutions and cross-institutional partnerships.
Communication and empathy are paramount, both for patient outcomes and staff cohesion.
In a competitive, mission-driven space like pediatric healthcare administration, the Children’s Hospital Wisconsin Administrative Fellowship is more than a resume line—it’s a launching pad for leaders who want to shape the future of children’s health. The program rewards those who combine personal motivation, relationship-building, and a willingness to pivot and learn. As John Smith-Wiehe demonstrates, drawing on diverse experiences—whether from IT, fundraising, or direct patient care—enables fellows to deliver real value in dynamic, high-stakes environments.
<p>[Music] hello everyone this is Cole from the American Journal of healthcare strategy and here with me is John John is an administrative fellow at the Children's Hospital in Wisconsin John please introduce yourself yeah thanks so much so as Cole mentioned my name is John Smith Wei I am the second-year administrative fellow at children's Wisconsin uh children's Wisconsin is the only freestanding independent pediatric institution in Wisconsin uh and we are the only organization fully dedicated to the health and well-being of kids uh in in Wisconsin obviously we have lots of Partners in that but that is our our chief Mission and uh we're solitary in that in the state we're so happy to have you here you have a huge wealth of experience I'm going to just kind of dive in right away I want to ask I noticed that you were the co-chair of of a program associated with the Children's Miracle Network back in 2013 so that would be during your undergraduate years did you identify that you wanted to work with children back during your undergraduate or was it something that you kind of stumbled into what did that look like yeah good question so it actually goes back all the way to my very first days uh around so I was a kid in the hospital I had a twoe niku stay couple of surgeries before the age of five and then some postsurgical implications that kept me in and out of the hospital even through uh elementary school so working with kids in Spec specifically with kids Healthcare has been a goal of mine since um I graduated high school I actually started my undergrad anticipating to do healthcare administration uh and got a little bit knocked off that path through some coursework that I was doing around Neuroscience uh and I thought that that meant that my path in healthcare was over uh but at the same time started working with uh as you mentioned with Children's Miracle Network so if if folks don't know Children's Miracle Network is a National Organization that raises money for children's hospitals they have some uh College programming uh it's called Dance Marathon myself and a friend of mine were the co-chairs of that while I was in undergrad uh we put on a fundraising activity um 12 hours where folks pledged to stay on their feet raise money at that time for Sandford children's in Fargo North Dakota that's excellent and and what great experience as well I mean that's and so your experience actually is very interesting just in general looking at your resume because you had a fiveyear gap between you know your undergrad and grad not only did you already have impactful experiences during undergrad but then you have this five-year Gap where you're working with epic Cupid um not a lot of people will probably know exactly what module of Epic that is so can you explain what that is and then specifically what projects you worked on lot Epic yeah definitely so yeah I worked at Epic as a project manager doing implementation for Cupid which is epic's procedural Cardiology application what that means is uh if you ever have an interaction with a cardiologist where they're taking images of your heart or doing a stress test or if you're working in the in the cath lab or the echo lab or excuse me EP lab that was the software that I was working with so that module of Epic integrated with other pieces of software uh in order to get all of that data into epic and then uh set up the text nurses and cardiologists to do their documentation associated with that care um at that you know through those experiences some of the projects that I I worked on uh were large health system projects in Louisiana with Franciscan missionaries of Rady Health System also had the opportunity to um do some work with Cleveland Clinic out in London actually spent some time with them trying to localize uh our processes to the London Market um I had the opportunity to work with Mayo Clinic on their first upgrade after they had implemented uh and then the last project that I was on before I ended up taking the the grad program route was with RWJ Barnabas out in New Jersey um those are a couple of the big projects I was able to you know work on some other things here and there but I think those are some of the the big ones that that really shaped my experience working there and and a lot of the relationships that I had and still have came from working on those projects well so you still have these relationships you know five 10 years down the road yeah definitely uh especially from that first project a lot of the people uh that I was working on down in Louisiana were in a similar position as me from both their legitimate position at Epic as well as it was their first role out of either Underground grad school so we're in very similar stages of life um had the opportunity recently to go to a couple of their weddings they've been they came to mine and actually quite a few of my um quite a few of my friends now that I haven't been there uh that are still from there are my wife's friends that she made while she was working at Epic so definitely um great experience both from a professional and personal perspective that's excellent did you meet your wife at Epic Yeah we actually met we actually met in Louisiana on a work trip we didn't work together but she was coming down to to help out a mutual friend and that mutual friend played Matchmaker a little bit for us so here we are sevenish years later so uh lots of lots of uh good things came out at that time in my life oh congratulations on all that that's incredible and very important for for our early kind of cours to be attuned to how important those relationships are why did you leave epic if you can don't mind me asking it it seems like that' be a large salary cut going from essentially you know whatever it was to zero and doing the mha program what drove you to do that yeah definitely so I think going back to uh when I was in undergrad and had that desire to do healthcare administration and sort of took a took a detour from that it was still something that I was interested in and specifically Pediatric Healthcare because of those experiences that I had uh when I was a kid so the desire to go to grad school was both from a um I wanted to maybe leave Healthcare it as specifically as that was and and broaden some of the work that I was doing I also wanted to get out of some of the vendor uh relationship and get a little bit closer to the delivery so while being the vendor and and having those relationships and building those close relationships with it team and and some of the clinicians was great um those relationships really only were you know could be nine months longest I think was maybe two years and so that impact that you have is really um brief and it's really large but then it it can fall away and so one of the goals of going to grad school is um and getting the mha degree and then the fellowship was to be able to build some of those longer term relationships and have uh have some of that longer impact in in one specific focused organization so um I'll be honest though I mean salary was a a component of that I did have the opportunity to work in grad school I also um did a little bit of Consulting while I was in grad school just to uh have some some income um uh but it it was really the alignment with Pediatric Healthcare that was driving me to to make that career change that makes a lot of sense so it really wasn't necessary shift for you then and and so you went through your mha program it seems like you did well there I noticed in the mha program you got the inter or the admin The Residency the administrative residency at Inter Mountain Healthcare but specifically with the Children's Hospital I want to ask was it challenging was it competitive to get that residency at that specific location that's my understanding yeah you know one of the great things about inter is they take 14 administrative residents each year or at least they did the year that I was there and you're you're placed specifically in one of their hospitals or one of their regions and so I I had applied specifically to work with their their children's hospital Primary Children's um because of the interest in in Pediatric Health and um my understanding is it it was competitive I I was um really lucky that that was where I was able to do that administrative residency partially because my sister-in-law and her husband lived in Salt Lake City and still do and so I was able to spend time with them while I was there um which was also a huge draw for me to be able to spend okay I'm going to spend 12 weeks somewhere um can I spend some time with with my family as well um so that that was great incredible experience working with Primary Children's uh one of the one of the projects that I worked on while I was there was taking a look at transition of healthcare actually from a pediatric institution to uh adult Healthcare and some of the challenges that patients and families uh feel when they're going through that so um the project that I worked on was proposing a programmatic approach to that with a lot of support from uh from Inner Mountain as well as uh at Primary Children's they partner with the University of Utah and so it was a good collaborative experience across uh across that institution and and seeking to find ways to help kids uh get the care that they need when they are no longer kids and so it's a it's a fairly sizable Gap right now in the services that patients and their families experience uh when they're being seen by a pediatric institution versus a institution that is uh focused on kids and adults it can be pretty different um and there's some hesitation even on the adult provider side to caring for some of these conditions that kids are bringing with them from childhood so trying to make those bridges uh was was really a key component so great experience with Primary Children's um really grateful for the opportunity to to spend my summer there and the other component of that I'll just be vulnerable here is you know I'd had this goal of working with Pediatric Healthcare since I was basically 17 or 18 and at that time that I was there I was you know a little bit older maybe I think I must have been 27 I wanted to see if I could hack it basically you know it's it was so personal to me right such a such a large part of my life growing up to be a kid in the hospital have the surgeries have inpatient stays that I wanted to make sure I could go and that that emotion uh that I was able to feel it and be connected to the work but also not let it overwhelm me and I was really grateful for the that opportunity in that more contained experience of you know this is 12 weeks you're going to get thrown in it's going to be potentially intense but um as a as a precursor to then what I was looking for in my fellowships um or in the fellowship process so uh really grateful for that experience for giving me that that lens and that contained experience to process some of that from a personal perspective definitely and seeing where you are now I'm assuming assuming it went it went well yeah definitely and it gave me the confidence that yes this is personal to me but I'm you know that's not a bad thing that that can be a really good thing as well uh and so my time now obviously with uh children's Wisconsin I'm in the Pediatric Health Care uh world and and continuing to planning to continue to uh be in that space moving forward so um it w went really well there were some hard moments there are still hard moments right um but I think that uh uh those can be important moments too with that transition project that you worked on it is interesting because I remember when I worked in neurology um we would have lots of of young people who even before 18 they would have to transition out of chop and then especially the more severe cases then they would have to come to our neurology clinic and and it really was mostly Cent around adults and it's interesting some of them like one of the older uh neurologists who'd been around for many years he was the one who saw most of the children he was really good at fixing these issues but it was different like none of the staff was used to it and I know people think it's simple but it's things like you know our Wheelchairs and our chairs in the like everything is very it's just very different and and when you go to somewhere like chop or I'm assuming at the Children's Hospital you work at now everything is much more centered around children and not just children but also their parents their families yeah I think that's a key key differentiator right you know both legally but also in the sort of daytoday management of the the diseases or or situations or whatever else the the patient and their family may be coming to seek services for the parent is a huge component in that and I think that's you know it's interesting I I think about even my parents right now and and their parents they're a huge part of the care for their parents now as their parents are advancing in age and so it doesn't really ever go away I don't think but the focus on it and and this may be you know forced by the fact that it's a legal thing right is that kids are are not their own Guardian there's a there's a different relationship there uh in information sharing and and those components but I think you know patients are never just themselves right they exist within that that larger infrastructure and and that really starts at the family level um we just see it a little bit more specifically especially if you're caring for a three-year-old because a three-year-old can't care for thems so definitely the the but all of those other components right whether it's um developmental or uh different ways that even drugs or treatments interact with kids is different because they're not just little adults they're kids right so their bodies are different their Anatomy is different right and and how they how um how their phys uh anatomy and um in anatomy and physiology there we go got there changes how we treat them uh as well so it's not just the the context right but it's also legitimately different in their uh in their treatment and it's hard to know that unless you've kind of I guess been in a situation like you're s and then had that experience cuz you know from my perspective I mean I wasn't in the hospital a lot as a kid really at all and then now I'm an adult and it's you know I don't have children yet was originally Premed several hundred shadowing hours U when it comes to Pediatric it's like oh my goodness it's going to be a nightmare because it's going to be all different numbers all different and it's like you can't like you're saying you can't just reduce it mathematically it's like oh this is a completely different ratio we're using and the physiological reasons aren't what you'd expect you know so it is really like I might I would complain to my wife i' say oh we have a pediatric you know thing we're shadowing so I'm not going to be able to to guess any of the answers yeah so it's it's very different and then so you you know went through your your residency and you worked on great projects and then you go to the fellowship what was that application process like was it you know really like anxiety ridden or or how did that go yeah you know one of the things that was important to me and my my wife now was um was not only my my career but her career as well and so and and our community so I primarily applied to residency or excuse me fellowships based on um based on location as well as based on uh you know their uh what kind of Institutions they were so children's Wisconsin was my my top choice because it was the Pediatric institution was in is the Pediatric institution in Wisconsin and Wisconsin is where we wanted to be for our life and so the anxiety was if this is my top choice and it it is the choice that checks all of the boxes if it's not where I end up going what am I going to do uh and so I I had applied to some other institutions in Wisconsin you know considering not only my what I wanted to do but what we wanted to do you and I'm grateful for those experiences um but I'm really grateful that you know I was able to land at at Children's Wisconsin I'll say you know one of the things that I think can be really challenging in in those experiences is feeling like you're competing with your friends right or or peers and I know that some of my peers from the from the University of Minnesota grad program um they they would go to interviews and it would be you know people from our program who would be sitting there with them or um going through the exact same experiences and that can be anxiety inducing because you know them well through coursework or or other components I I was lucky in a way in that from from what I know I did not have other people competing from within my own program for the children's Wisconsin uh fellow ship I know I had applied alongside some others to some other programs that I I applied to but I think it's that can be challenging to navigate those social uh Dynamics and and definitely anxiety inducing I'll say though you know generally one of the things that I considered a lot was whether or not I was going to even do a fellowship given some of my work experience and some of the some of that that I I felt like I could draw from in order to to have this next the next role out of grad school that it was definitely you know I it was something I wanted to do but it didn't feel like the only option that I had which I think helped frame my my experience as I was going through it and I think that's important you know I'll advocate for people doing a fellowship obviously I've been in a two-year one experience has been great I've been exposed to so many different projects I think if that's not a path that somebody's comfortable with I think that's also totally legitimate and something that we can we can um encourage people to do as well especially given uh whatever their background may be or whatever their interests may be because there those are varied I want to ask do you think it was worth it going through the fellowship considering your experience I I do because I wanted to change career paths right I I didn't want to be just in healthcare it or in you know doing epic work for the rest of my my career and so I think the experiences that I have gained through this have allowed me to sort of pivot in different ways that being said I think the organization children's Wisconsin is is has been so supportive in me exploring those different areas but very frequently those skills are are asked to be drawn on because they are either unique or the project management components of that are are needed in any sort of work that you're doing that I find myself drawing on those experiences frequently um in ways that are really good and I don't think I don't think I could be doing the work that I'm going to be doing or hoping to be doing without the fellowship experience mostly because of the relationships that I've built and the being able to navigate I'll just give the example here um the merch that I have is from a u Milwaukee campus Improvement project and specifically a project I worked on to help uh activate and transition into uh the new Skywalk building on campus that has nothing to do with Healthcare it right but it is project management and change management and relationship building and staying organized and being tenacious which are all things that I did at Epic but in the under the guise of healthcare it implementation right that experience and and the success that I was able to achieve through that um has helped set me up to then craft some new A A New Path in in children's and not just step into maybe something that already existed because I was able to have that new experience and draw on the previous experiences that I had so definitely valuable I think if somebody is I know people at Children's who have been in their careers maybe in the lab or in the pharmacy and they're interested in continuing in the lab or in the pharmacy uh and they're they're pursuing or have completed their mha I'm not sure that a fellowship would help with those specific situations right they have that they have that specific career expertise already and they're getting that degree to sort of round out some of the areas that maybe they haven't been exposed to but they're they're sticking right they have their path they're passionate about that they have that expertise I think that's incredible and i' I'd um encourage them to stick in that way I've also given feedback to people even in the last couple of weeks so if this if you don't want to stay in we call it whenever we draw for just a generic example we call it the Toe Clinic if you don't want to stay in the Toe Clinic I think a fellowship is a great opportunity that's extremely valuable actually that's exactly what I was going to ask you next anyways and you had answered it is how you drawn past experiences and and then about that transition but thank you so much for joining with us couldn't be more appreciative this are great insights our audience is going to really enjoy this yeah well happy to happy to be a part of the conversation if folks are interested in connecting on LinkedIn or otherwise and are are interested in chatting about Pediatric Health Healthcare in general or even just you know the experiences that I've had going from sort of Industry to grad school and then into nonprofit happy to talk about that as well I'm sure they will we'll definitely have your you know your LinkedIn attached to this because I'm sure people would love to connect with you awesome well Cole thank you so much for setting this up really appreciate it and um yeah looking forward to further conversations in the future yeah thank you</p>
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