Key Takeaways
- Prioritize developing leaders with frontline operational experience to ground high-level strategy in the reality of patient care delivery.
Administrative fellowships are often portrayed as linear ladders—grad school, fellowship, promotion, and permanence. Rachel Gerhardt, MPH’s path is proof that great careers are rarely straight lines. She began on the phones and at the front desk of Boston Children's Hospital neurology clinic, earned her MPH at night, jumped into a Johns Hopkins Medicine fellowship, took an interim leadership role earlier than planned, chose exploration over early title, led operations at UPMC through COVID, and now steers system integration strategy at Beth Israel Lahey Health in Boston. Along the way, she kept coming back to one north star: values. As she puts it, “the MPH…aligned with my values,” and later, “the value of the fellowship is…you do get to experience every area.” This is the story—and the playbook—behind her rise from patient services to system strategy.
Rachel Gerhardt is a Boston-area native who launched her career at Boston Children’s Hospital as a patient service representative in the neurology clinic; that frontline role—and the people she met—set everything in motion. In her words, “I ended up…starting at Boston Children’s…in June of 2013…doing a lot of scheduling…answering the phone…that first point of contact for patients.” She didn’t know healthcare administration was a career. “I had no idea what I was getting into,” she admits, but proximity to patients, nurses, and physicians gave her a panoramic view of access, quality, and cost.
That day-to-day exposure did two things:
-It revealed how much administrative work shapes the care experience. -It showed her leaders’ typical educational paths, nudging her toward graduate school.Crucially, a supportive preceptor opened doors: “My preceptor…said, oh, you should apply to these entry level positions at the hospital.” If you’re early in your journey, emulate that: shadow operations, ask naïve questions, and notice which degrees and roles keep appearing in the org chart.
Because it aligned with her values and practical reality. Rachel chose BU’s part-time MPH to keep earning, keep learning, and build toward leadership. “I needed to keep working full-time, so I was looking for a program that I could do part-time,” she explains. The content matched her interests—child development, community health, the social determinants, and the (still relevant) Triple Aim. “The MPH…aligned with my values…what I was interested in,” she says.
The cadence was gritty and sustainable:
-One class at a time → then two → then three when possible. -Commuting from clinic to campus: “I would take the bus from Children’s over to BU…sometimes I would walk…[and] slowly chipped away at my MPH.” -Three years of persistence, plus relationships with faculty she still keeps today.For rising leaders, the lesson is simple: choose a credential that fits your life and mission. Value alignment beats brand-chasing. And don’t underestimate the compounding power of steady progress.
She found fellowships the unglamorous way: by searching. “Honestly, I came across fellowships by just doing my own research…on the BU Public Health website,” she says. What sealed it was access and breadth. “There was just an opportunity to explore so much as part of a fellowship and to interact with the executives of a hospital…mind-blowing.”
Her “why” mixed ambition with curiosity:
-Accelerate development through rotations across operations and strategy. -Build executive visibility and mentorship. -Pressure-test passions before specializing.Rachel compiled a national list—academic medical centers, children’s hospitals, coast to coast. If your program isn’t hands-on with fellowship prep, adopt her approach:
-Mine your school’s career site and alumni networks. -Identify faculty champions (Rachel later found Prof. Chris Lewis at BU). -Cold-reach programs early; track deadlines, formats, and criteria. -Practice telling your story—values first, résumé second.It was rotational, relationship-rich, and—by chance—accelerated. She began with exposure to Hopkins’ Children’s Center because of her background. Then timing created an opportunity: “Toward the end of my first year, the assistant administrator…was leaving…[and] I was approached about stepping in interim to that role.” She said yes.
That meant true accountability: inpatient operations for a 205-bed children’s hospital, leading director-level teams, and learning at the steepest possible slope: “I jumped into that role as the interim assistant administrator…overseeing the day-to-day operations…[and] I learned so much.”
Should you take an interim step-up if it truncates rotations? Rachel’s answer is nuanced:
-Yes, if it gives first-line leadership experience you don’t yet have. -Yes, if the window won’t open again soon. -But… keep checking against your original “why.”Which leads directly to her next move.
Because her “why” demanded exploration, not early anchoring. “I decided to pursue a fellowship to really get exposure to the full health system,” she says. “The value of the fellowship is not just that you get a job…it’s that you do get to experience every area…if you take advantage of it.” She recognized the risk of being typecast as “pediatrics ops,” however prestigious.
So she pivoted—intentionally—toward enterprise strategy. “I met with [Dr.] Lisa Ishi…a newly SVP of health system operations…working directly with [the] president of the health system…And I said…‘I want to work with you.’” That choice—hard in the moment—maximized learning, diversified her network, and broadened her brand.
Takeaway: When an early title conflicts with long-term range, you’re allowed to choose range. You can be loyal to your organization and still loyal to your development.
That community accelerates growth and resilience. Rachel says it plainly: “It was the best decision I ever made… I loved Baltimore.” Her small class (three fellows) became an immediate support system—dinners, scooters (it was the year they hit the city), and rec-league sports. The point wasn’t nightlife; it was belonging. “We really just created this great network of people…you have to put yourself out there.”
If you’re relocating for a fellowship:
-Treat social planning like project planning—make the list, set the cadence. -Join a league, meetup, or volunteer shift within 30 days. -Cross-pollinate with other fellowship programs at conferences; the national network is real. -Remember Baltimore’s nickname: Charm City—and go find its charm blocks.Geography isn’t destiny, but choosing to build community is a leadership act. The relational capital you bank outside work pays dividends inside it.
COVID’s timing, a cross-city relationship, and a compelling role at UPMC all converged. “Turning [Hopkins offers] down was the hardest decision…,” Rachel says. But the method mattered as much as the outcome: “Talk to your people about it…be open…you don’t really want anyone to be shocked.” Her mentors modeled healthy sponsorship—supportive even when her path diverged.
Her rubric for good mentors is worth copying:
-They can be disappointed and still champion you. -They separate institutional preferences from your best interests. -They stay in your corner after you leave.And if someone weaponizes your choice? That’s data. “Those aren’t the mentors that you want in your life.”
UPMC gave her scope and stewardship. She entered as a director of operations with direct reports—through the chaos of early COVID—and later became division administrator for General Internal Medicine. The people side was the crucible: “Managing people…is the most challenging thing.” That’s why early management reps matter for future executives.
She also rejects a false dichotomy: “You don’t have to pick [ops or strategy] and you can go back and forth.” Operations is strategy-in-action; strategy without operational empathy is theater. For fellows and early leaders:
-Seek roles where you own a P&L slice and contribute to system priorities. -Ask for projects that tie capacity, access, and patient experience to growth and quality. -Measure your success by changed outcomes, not just completed tasks.In short, become bilingual. Speak both Gemba and boardroom.
Family, mental health, and timing drove the move; professional fit sealed it. “It was really a personal reason,” Rachel shares. With a young son, no nearby family in Pittsburgh, and the pull of home (and Baltimore as a close second), she and her spouse chose proximity over continuity. The happy complexity: “I married that fellow…we now have two children.”
Professionally, Beth Israel Lahey Health offered enterprise strategy during a pivotal phase. “I am now more in a strategy role…working across the health system,” she explains of her Director of Integration remit within a relatively new, 14-hospital system that merged just before COVID. Like a mini-fellowship, she works with senior leaders on “where we’re going, how we’re getting there, and what it looks like.”
For executives, that translates to:
-Post-merger integration: governance, operating model, and service line alignment. -Access and growth: site-of-care strategy, capacity management, and referral pathways. -Outcomes and experience: standardization that respects local realities.The throughline remains values and relationships—plus the humility to let life stage influence strategy stage.
Be authentic, be curious, and do the work. “People just at the end of the day wanna connect with like a real person…so just like be yourself,” she says. That doesn’t mean passivity; it means initiative with humanity. “Make an effort to get to know people. Make an effort to get to know your organization and put yourself out there.” Authenticity earns trust; effort earns opportunity.
Practical ways to operationalize that:
-In interviews/personal statements: share what you value and why. -In rotations: ask for feedback, volunteer for the messy projects, close loops. -With executives: come with a point of view and a question—not just a calendar invite. -With peers: build the dinner list, organize the run club, be the glue.And when choices get hard? Return to your “why,” as Rachel did—repeatedly.
Here’s a quick checklist distilled from Rachel’s journey:
-Frontline first. If you haven’t worked in access, ambulatory, or inpatient flow, find a way to get close. It sharpens your empathy and your strategy. -School–work fit. Choose programs that match your life and values; part-time doesn’t mean part-quality. -Research like it matters. Fellowships won’t find you. Build a tracker; start early. -Titles aren’t trajectories. Take interim roles for reps, not résumé lines—and be willing to pivot back to your plan. -Mentors who stay. Be transparent with sponsors; retain the ones who honor your goals. -Ops ↔ Strategy fluency. Learn to toggle; seek roles with both execution and design. -Community is a competency. Your off-hours network sustains on-hours performance. -Life stages count. Family, health, and place are strategic variables, not afterthoughts.As Rachel reflects, “It’s not that easy…there’s definitely hard moments,” but alignment beats autopilot.
If you remember only one thing, make it this: careers compound when values lead and curiosity drives. Start where patients are; study what aligns; use fellowships to widen—not narrow—your horizon; say yes to reps, no to boxes; and keep choosing the mentors, moves, and cities that let you be both human and high-performing. Or, as Rachel puts it, “be yourself…work hard…put yourself out there.” Do that consistently, and the path from patient services to strategy becomes less a leap and more a series of intentional, values-backed steps.
<p>I think people just at the end of the day want to connect with like a real person. Um, and so just like be yourself. Try to get to know people and keep an open mind. Um, but you know, work hard too and you know, make an effort to get to know people. will make an effort to get to know your organization and put yourself out there. [Music] Good evening everyone. My name is Rashangi Sha and I'm here um with the American Journal of Healthcare Strategy with our fellowship review podcast.</p> <p>After a long break for the summer months, I'm so excited to be back and recording with current fellows as well as former fellows. And today we have the absolute privilege um of join of speaking with a guest who is post fellowship and has an incredibly accomplished career. Rachel, welcome to the show. >> Thank you so much for having me. >> Yeah, we're so excited.</p> <p>We'll jump right in, but very first, can you give our listeners just a brief overview of, you know, who you are, where you're from, and where you currently are. >> Yeah, sure. So, I am Rachel Ghart. Um, I am originally from Western, Massachusetts. Um, I will get into more detail, but just very high level, I started my career working. Um, when I first graduated, um, from undergrad, I worked at Boston Children's Hospital.</p> <p>While I was there, I went back to school part-time to get my master's degree and have a masterers of public health um from Boston University School of Public Health. Um and then I did a fellowship at Johns Hopkins Medicine after my time at Boston Children's. I've moved around a bit. I ended up in Pittsburgh and then I moved back to Boston just about a year and a half ago now.</p> <p>Um and I'm currently working at Beth Israel Lehey Health and I am a director of integration um working across the health system. How incredible. I'm very excited to get into all the parts of your journey and the various health systems that you've worked at and the cities you've lived in. Um, but first I want to start with the education piece. Tell us about just high level, you know, um, maybe what stood out to you about getting an M.</p> <p>PH at Boston University and just overall what was your grad school experience like assuming you may have gone to grad school um, pre-COVID. Yes, I I did go pre-COVID. Um, so yeah, I I think I have a bit of a unique story of sort of how I got here. So, as I said, you know, I started working right away when I graduated undergrad and um I went to Tus University outside of Boston. I did not know what I wanted to do.</p> <p>I had actually done an internship my senior year there at Boston Children's Hospital and it was actually in their social work department. I didn't know that's where I was going to be for that internship. Um, but then I needed a job when I was graduating and my preceptor at the time, you know, said, "Oh, you should apply to these entry- level positions at the hospital. Again, I had no idea what I was getting into." Um, so she sort of referred me to um the neurology department.</p> <p>They had an opening as an ambulatory service representative. I again had no idea at the time what that position entailed. I remember like asking in the interview if I was going to be working with patients or if I was going to see patients. Um, but long story short, I ended up um, starting at Boston Children's. That was in um, June of 2013. Um, and I was a patient service representative in their neurology outpatient clinic. So, I was doing a lot of scheduling.</p> <p>I was answering the phone, sort of that first point of contact for patients as they called in. um doing insurance referrals, um sending messages to the nurses, doctors, um NPs, and really had a lot of exposure to um healthc care access and some of the challenges that patients were experiencing. And I didn't know that, you know, I didn't know healthcare administration was a career at that time to be honest. I knew I liked working with people.</p> <p>I really felt like that hospital environment once I started working there was really great and I really enjoyed it. But again, I didn't know sort of what what the next step was if I wanted to keep working in this field. So I started to do some research on my own and I was sort of looking at other leaders in the hospital that had different degrees.</p> <p>And I realized if I wanted to keep working in a hospital and work my way up in hospital administration, I probably was going to need to go back to school. So that's sort of how I got to the graduate school piece. Um, and then for me, I needed to keep working full-time. So, I was looking for a program that I could do part-time. So, my goal was to keep working at Boston Children's, um, start taking classes, sort of work towards that. Um, I really fell in love with the M.</p> <p>PH program at Boston University. Um, one, I could go part-time, but the M. PH for me was really something I was passionate about. I I had actually in my undergrad majored in child development and community health. So, I I had sort of that piece and that background and was really interested in social determinance. and again had had now some exposure to sort of healthcare access and quality and cost and some of the challenges and the triple aim was like a big thing that was talked about.</p> <p>It still is I know but that was a big hot topic at the time too. Um so the M PH to me just aligned with my values and what I was interested in and what some of my previous education had been in. Um and so it just fit and made sense that I could sort of keep working where I was and um I started to take classes at night. I took one class at a time because I was nervous about how I was going to make that work with working full-time and taking classes, but I slowly ramped up.</p> <p>I think the most I took was three classes at once. Um, but I would I would take the bus from Children's over to um BEu School of Public Health or sometimes I would walk if the weather was nice and I sort of just slowly chipped away at my M. PH and um it took about 3 years. But I had a unique experience since I was there part-time and I sort of would pop in at night and then I would be gone and you know during the day I was working but um I loved it.</p> <p>I'm still in touch with some of the professors there and um really had a great experience. >> That is so incredible. And a couple of things that I do want to highlight from your response for our listeners, you know, um number one, the value of having a good preceptor who's willing to refer you and guide you in the right direction.</p> <p>It seems like early on in your career at um Boston Children's, you know, you had someone who was kind of guiding you in a way and maybe helping you get a little bit more aligned um you know, with the path that you were meant to be on. Um and the other thing in that role, it seems, you know, um there's a lot of value in being in those frontline roles where you can truly see, you know, what our staff are seeing when it comes to providing patient care.</p> <p>So, I think, you know, I I would urge our listeners to not shy away from roles that are outside your comfort zone that maybe require you to talk to patients and also talk to physicians and and clinical staff. And so, I appreciate you highlighting that. And and the last thing I'll kind of point to just to reiterate is you said something about how going to be while also working at Boston Children's aligned your values and it was it felt right.</p> <p>Um there's so much importance that I put on value alignment. And so for anyone that is going to decide on a graduate school or even going to decide on a fellowship, I think, you know, take that advice that Rachel said, um figure out what your values are and see if the program is going to align and get you to where you want to be, you know, after the program, five years down the line or even 10 years down the line.</p> <p>So, I so appreciate you um you know sharing all of that and you know that kind of brings us to your your time at Hopkins. Of course, you did incredible work at Boston Children's. Um before we even get into what you did um at Hopkins, you know, how did you find out about administrative fellowships and then after you found out about them, what was your why or what really drew you to pursuing one? Yeah. So, you know, again, I'm very thankful for the job I had at Boston Children's.</p> <p>If I hadn't had that job, I never would have realized healthcare administration was even a career path, and I'm really grateful to to the points you said that I did have that work experience first and sort of understood what was happening day-to-day um in some of these outpatient settings. So, you know, I think as I was wrapping up my M PH um I was starting to think about sort of what was next for me. I was feeling a little stagnant.</p> <p>you know, I had been at at Children's for about five and a half years at that point in different roles, um, including my internship time. And I was just thinking, you know, what's next? Like, I've I've only also on the personal side lived in Massachusetts. I had nothing besides my family tying me to Massachusetts specifically. And I was sort of getting this like itch to maybe really like go somewhere new, which was I'm very much a homebody.</p> <p>So, this was like really different for me to to say like I might leave here. like maybe I want to go do something different. Um, but honestly, I came across fellowships by just doing my own research. So, it was it was a different time. Like people weren't posting on LinkedIn when they got a fellowship. It was it was not like how it is today. And honestly, that was only seven years ago or maybe nine years ago when I applied, but um it was very different.</p> <p>And so I I did find something honestly on the BEu public health website. I found like a link about administrative fellowships. I did all of my own research. I started reaching out to different programs and like making a list. And I think what drew me to it was, you know, I've I've always been very ambitious. I've always had high goals about where I want to be and what that looks like. I was a college athlete. I was a national champion when I was in college um at my sport.</p> <p>Like I've always sort of set that bar high for myself that I really want to be, you know, performing the best, be the best that I can be, and always look to keep climbing.</p> <p>And I was reading about an administrative fellowship and just felt like that also to your point about values like aligned with my values and also was an incredible opportunity to really advance your career in healthcare administration and give you exposure to so many different parts of running a hospital and hospital operations and strategy. Like it wasn't just sort of you know keeping you in one bucket.</p> <p>there was just an opportunity to explore so much as part of a fellowship and to interact with the executives of a hospital like to me was mindblowing. Like I remember seeing the CEO at the time of Boston Children's Hospital occasionally walk through the lobby and I would be like starruck because I would see this person walk through the lobby like oh my god she's the CEO of this hospital.</p> <p>And then to fast forward to a fellowship where you actually are interacting with and meeting and talking to and executives and they know your name. I mean that is an incredible opportunity that I don't take for granted and I'm very appreciative of. So that to me like that whole package is what really made me want to pursue a fellowship in the first place. Um and then I you know I didn't really know where I wanted to go.</p> <p>Um, but I sort of compiled a list of academic medical centers all over the country to be honest. Some children's hospitals because I did feel strongly about working in a children's hospital, but I also liked sort of the academic teaching mission too. Um, so I I looked all over the country to be honest. I had a couple Massachusetts places, but um sort of compiled my list of, you know, from California to the East Coast basically. >> I love to hear that.</p> <p>lots of similarities actually between your journey and my journey. I am also a homebody and so I totally understand that. Um, one piece of thing that I do want to call out from your response especially for our listeners, you know, various graduate programs will have a different level of involvement when it comes to helping students acquire fellowships. But, you know, you called out a really good thing. You found it on the BU website.</p> <p>And so I just want to urge our listeners to refer to your career services, refer to your school's websites. Um if they are a little, you know, less hands-on when it comes to fellowship um help, there are other resources. Of course, listen to our podcast, you know, go on LinkedIn. There's often people who will offer free help um for fellowship review of resumeumés and and you know, personal statements.</p> <p>So, even if you don't know, the point is even if you don't know a lot about administrative fellowships, there's a lot of resources out there to guide you as you navigate a very competitive cycle. Um, and >> yeah, go ahead. >> One thing to that, so you know, again, I was unique. I found that on my own, but there there usually is someone to your point like there was a professor, I'll call him out because I still am in touch with him and he's great.</p> <p>Professor Chris Lewis at BEu who actually was who I should have talked to about applying to fellowships. I just didn't know that. So to your point, it's really important like do your research, but ask around too because usually there's someone that you know can help you and and sort of give you that guidance and connection. And eventually I got connected to Professor Lewis and he did help me once I started getting interviews.</p> <p>So I just want to make sure that I share that I did have, you know, that support once I realized I should be talking to someone. No, absolutely understand. And I'm sure your professor will appreciate the shout out. Um, you know, I also want to dive just a little bit deeper now, you know, after understanding your why into your experience at Hopkins. And so, you know, you had a unique experience. Um, you were in a way doing two roles, um, as we kind of chatted offline. So, how did that happen?</p> <p>And, you know, what stuck out to you? What are some things that stuck out to you about the Hopkins Fellowship in general? >> Yeah, so definitely like the the experience I had there, you know, looking back, it never goes exactly how you're planning it to go and you don't really know exactly what's going to happen, but um you know, I was super excited that it was a 2-year fellowship and that I would be rotating around, you know, the health system.</p> <p>um because I had some children's hospital experience coming into the fellowship. I did get sort of paired my adviser was the um chief administrator of their children's center which is their children's hospital. Um so I did start initially to spend a lot of time in the children's center at Johns Hopkins.</p> <p>um you know that had pros and cons which I can talk about later but um I I initially thought like wow this is great like there was an assistant administrator um which was a pretty common role that a lot of the fellows at Hopkins went into post fellowship but it wasn't something that was on my radar like during fellowship or after you know or or immediately after um however some of the fellows also at Hopkins had opportunities to do intramanagement roles usually Usually that happened more towards their end of their second year of the fellowship and then would sometimes lead into you know that ended up becoming their role post fellowship.</p> <p>Um I think I was just in a bit of a weird unique position and it was all sort of about timing. So I I did start my fellowship normally. I started doing rotations. I spent time in the children's center but then I went other places too and did rotate around the health system.</p> <p>But then I think it was towards the end of my first year um the assistant administrator of the children's center was leaving to take a different job and so I was approached about stepping in interim to that role and honestly I I felt conflicted because if you had asked me 7 months before to me that was like my dream job post fellowship but then I was really enjoying also like rotating around and seeing all these other things but I did decide to take that interim role because one, I had never been a manager.</p> <p>I didn't have that management experience yet and that role doesn't open very often. So, um, you know, I really jumped on that opportunity. One, you know, they thought of me. They asked me if that was something I was interested in doing and if I liked it, you know, there was a high likelihood that I would end up officially like applying and then that could be my postfellowship job. It just happened earlier in the process which I think caught me off guard a little bit.</p> <p>Um, but I jumped into that role as the interim assistant administrator, which really was overseeing the day-to-day operations of their children's hospital, um, on the inpatient side, and it's a 205 bed children's hospital at the time. Um, so, and I was directly supervising different directors in in that area as well. So, um, at the time I'm now I'm like, wow, I had no idea what I was doing. I should never have been in that position, but I learned so much from that experience.</p> <p>Um, and you might ask me this more later, but I ultimately decided to not take that position and do something else. Um, which, you know, maybe was a little controversial, but that's sort of how I was in my experience. So, um, I didn't stay in that position. I ended up, um, deciding to pursue something else, but I learned a ton from from taking that opportunity. >> Absolutely. Absolutely.</p> <p>And I think you know the fact that you were uh given something like that so early on speaks to the value and you bring and the caliber. So knowing you in this little bit of time it doesn't seem shocking at all.</p> <p>What what I want to highlight is a lot of it is timing right fellowship there is a certain level of structure whether it's rotational or a project base you never really can anticipate and things like this happened I think more than people realize I know several fellows that you know like two months into their role they were offered something incredible or they you know they were on month eight of 12 months and they received an offer um so it's really important to, you know, trust the timing and know when to kind of take these opportunities.</p> <p>Um, but you left a little bit of a mystery. So, you know, you said you didn't stay in the role for too long. Um, so what was that something that you ended up leaving for? >> Yeah.</p> <p>So I my struggle you know I again I was very grateful for the opportunity and I was learning a lot but my struggle that I kept coming back to was that I decided to pursue a fellowship to really get exposure to the full health system and learn and see as many different areas of a hospital and health system that I could. And the struggle and like internal struggle that I had was that now I was in an interim role and so I was in one place.</p> <p>I didn't sort of complete the fellowship in the sense that I had more places that I was supposed to rotate to. I had more areas of hos the hospital and the health system that I wanted to see. So I started to think a little bit of like okay what was my reason for doing a fellowship? Did I do it just to like get a job or did I do it because I really wanted exposure to like every possible thing I could?</p> <p>And this is really where I think you know the value of the fellowship comes in because the value of the fellowship is not just that you get a job. It's not just like oh people think of you and you get a job. it's that you do get to experience every area if you want to and if you take advantage of it of the hospital and health system if you're in a in a program that rotates at least through through everything.</p> <p>So I started to feel like I was sort of maybe shortchanging myself if I didn't take full advantage of doing that. Um and as fellows and at Hopkins, you know, our different classes, we actually did um like lunches or dinners with different executives. So we would we would sort of reach out and meet with different people and it was just three of us at the time that were in our fellowship class.</p> <p>So it was really small and intimate and when we would do that I would think like oh maybe I should try to like meet with that person or maybe I should try to work with them or maybe they have a project that would be something that would be interesting to do. And I just my brain started to think like you know what I don't want to pigeon hole myself here. And I've had this children's hospital experience. I'm now the interim assistant administrator of the children's hospital.</p> <p>Everybody is sort of thinking of me as children's hospital which is not a bad thing but again I had to come back to like what was my reason for doing a fellowship and it was an amazing job but that it was only a year in not even and I wasn't ready to say oh I'm just going to stay here for the rest of my time. Um and I so I decided to totally go a completely different route and um at the time she was or she still is Dr.</p> <p>Lisa is the she's now actually the fellowship um director but at the time she was um a newly SVP of health system operations and we had had dinner with her and then I met with her one-on-one because I was just fascinated by what she was doing and she had never worked with fellows before. It was a new role that she had just been in maybe a year and she was working directly with Kevin Sour the president of the health system and I met with her and I said Dr. Dr. Ishi, I want to work with you.</p> <p>Um, and that was it. And I started working with her. And so I basically chose, you know, that over staying in my interim role. And I just I wanted more exposure. I wanted to learn more. And it was really one of the best decisions I made from from what I learned working with Dr. Ishi. >> Um, thank you so much for sharing that.</p> <p>you know uh early on you spoke about values and so the underlying lesson from I think this response from you again and a good lesson for future fellows current fellows is really always go back to your why and figure out if your experiences are actually meeting your why and your values so I I absolutely appreciate you sharing that and also probably took a lot of courage I'm sure it was a very difficult decision at the time you know to have this incredible experience but then to wrestle with well it's not really meeting what I thought I was going to do or what I want to learn you know and so I that that's very authentic of you to share um and so I hope the people listening can take away that you should always go back to your why and you should always make sure that you know you're gaining the most out of an experience as unique as a fellowship um and you know you of course uh did your time at Hopkins before we you know transition to where you went next for fellows that are currently interested in doing the Hopkins fellowship.</p> <p>You know, of course, fellowship is a big part of your life, but so is living outside of work and building communities and, you know, experiencing um the city. And so tell us, you know, maybe outside of work, uh, what was something that was your favorite part about living in Baltimore or even just, you know, something that people wouldn't necessarily know about the area? >> Yeah, I it was the best decision I ever made.</p> <p>And I will always say this, like doing a fellowship in general was the best decision I ever made.</p> <p>Um, but I loved Baltimore and I think I you know I was and not I think I was very fortunate that my fellowship class um I was with two other fellows Daniel McFarland and Jay Spafford we were really close like right off the bat you know we had all moved to Baltimore without really knowing many people and I think that is what's a unique and cool thing about the fellowship is that usually not always but usually people are are coming from you know out of state or out of town and are just looking toort sort of meet people and explore the city and that even when we went to conferences like that's what I found from other fellows at different programs too was there was just this immediate bond of like you know you are doing this experience together and so we quickly started spending a ton of time together like we had a list of all the different restaurants we wanted to try we were going out together all the time we were um scooters like were new in Baltimore that was like when scooters had just been introduced and so we were like scootering around the city all the time together.</p> <p>Um but I think it was just like immersing yourself in the city and in the culture and um again like we that was big just like going out to dinner, exploring new places. Um when one of us met somebody else you know through a different way like we were just sort of bringing everybody together. Um, I joined one of like the sports leagues in the city with my co-fellow Jay too and we did kickball and I think we did flag football too.</p> <p>And so we met a bunch of people that way and then it just sort of like grew like everyone that was sort of in our fellowship family and extended friends and we really just created this great network of people. Um, and it was really just you know you have to put yourself out there trying something new.</p> <p>It was sort of ironic because in Boston at the time, the same when I was living in Boston, the same sports league existed, but I was like, I never would have done that if I was still living in Boston. It took like moving to a new city and just meeting new people and totally being outside of my comfort zone to do that. And so I just would tell all fellows like take advantage of the city or town wherever you are, what you're where you are, and like just go explore it. Like find your co-fellows.</p> <p>If your co-fellows end up not being your people, then like meet, you know, meet people a different way, like do different activities in the city that you're in and just find people that way. But I feel like that's a unique part of the the fellowship is that you do get to meet people um and just sort of explore this like new place, too. >> Oh, absolutely. Um I I love getting your take on Baltimore only because I feel that, you know, the East Coast is stacked with incredible cities.</p> <p>you know, you of course have Boston and New York City and even Pittsburgh. Baltimore is not one that comes up, I think, sometimes in that circle of maybe more popular cities, if you will. So, I think this brings uh to light a a a new experience and also the fact that, you know, if you step outside of your comfort zone in a new city, you can truly find something that you will enjoy, whether it's food or sports. And so, I appreciate the plug for Baltimore.</p> <p>Yes, they call it Charm City and it and that's the nickname for Baltimore and it's very true. Like it it really is a really awesome place to live and I miss it a lot. So yeah, >> good. I'll definitely have to I've been to the East Coast a ton, but Baltimore is not a place that I've had the chance to experience. So maybe maybe in the near future.</p> <p>Um a and so now tell our listeners, you know, before we get to the fun stuff of what you do currently, um there was one other organization that you had quite um a a long and incredible experience at. So where did you go after your fellowship and after your time in Baltimore? >> Yes. So I um I did not stay at Johns Hopkins after my fellowship, which again never like I in a million years never would have thought I would have left.</p> <p>Um I will say like and I'm going to share this a little more than you asked because I think that's a big reason that you know current fellows or people looking for fellowship look at is you know okay did you do your fellowship there and then did you stay or why did you leave um my second year of fellowship at the end of that year is when covid hit so that was definitely something that influenced some of that um I will also say on a personal note you know I had started um dating uh admin administrative fellow at UPMC and he was from Baltimore.</p> <p>We met at ACE in Chicago. So very like very funny administrative fellow connections, right? Um but he was at UPMC and I was in Baltimore both doing administrative fellowships. And at the end of our fellowship, we just honestly were sort of figuring out like is he going to move to Baltimore? I was like I'm not moving to Pittsburgh. I'm not going to Pittsburgh. I'm not going to UPMC. I love John's Hopkins. I'm staying here. Um, again, I think some COVID pieces of that played into my decision.</p> <p>>> Um, I did have a couple of offers to stay at Johns Hopkins, I will say, and and turning those down was hardest decision I've ever had to make. Well, not ever, but in that context. Um, really hard decision to make, you know, the decision that I was going to leave. Um, and everyone was very supportive. Um, you know, I can remember specific conversations with some of my mentors at Hopkins.</p> <p>And I think that also showed, you know, really how important those relationships are and finding some good mentors because the people that you want in your life and the mentors that you want to support you and to go to for advice, none of them are going to be mad that you're leaving or not taking a job or hold it against you. They might be disappointed and sad and want you to stay or want you to pursue that opportunity, right?</p> <p>But if there was someone that maybe gave you some negativity for a decision you made or sort of cut you off or was going to hold it personally against you, those aren't the mentors that you want in your life. Um, that was a bit of a lesson learned there, too.</p> <p>I mean, I I sort of knew that, but it was very clear, you know, the people that I had surrounded myself with were really supportive mentors and encouraged me and understood why I was making the decision that I was making and we talked about it openly. And I will say that I have talked to some fellows since then. That is my other biggest piece of advice. If you are planning to potentially leave after your fellowship, talk to your people about it.</p> <p>Talk to mentors, seek their advice, be open about it. you know, you don't really want anyone to be shocked and surprised. It's it was really valuable to again the people that I trusted and was close with and in my mentors and executive leaders, I was honest with them and said, you know, I am interviewing here and this is what I'm looking at and you know, we talked very openly about it before I made that decision. So, um I just wanted to add that because I think it's super important for fellows.</p> <p>Um so, I made the decision in I guess it was in May of 2020. That's when I made the decision to accept the job offer um at UPMC and you know it was it was a great pitch that UPMC had too. So I you know I flew to I flew to Pittsburgh and met with a bunch of leaders at UPMC actually in March of 2020.</p> <p>So like many co stories that I can share about that time but anyway um I met with um Mark Sevco who was the at the time the president of the children's hospital there and was the director of the fellowship program and you know they really were going to sort of treat me as one of their past fellows essentially and provide some of the same opportunities.</p> <p>Um, I met with, you know, everyone I met with was wonderful and the job itself was also part of my decision process because it was putting me into a director of operations role where I was going to have direct reports and again I really believe that management piece is very crucial especially when you're earlier on in your career and you just need to understand like what it takes to manage people and it's very challenging.</p> <p>I think it is the most challenging thing if you're managing people and that the people part is what takes most of your time. Um, but I'm really grateful that I had that opportunity to sort of be thrown into that, you know, managing physicians, managing staff, having those direct reports also at one of the craziest times, you know, as COVID is like still sort of new and going on and what does that look like?</p> <p>Um but was really you know that was a big decision piece for me too was like what is the job going to offer me in my career growth and you know my trajectory of where I want to go. There's a lot of talk of like picking between operations and strategy and which one do you like you have to know if you want to go into ops or strategy and that always confused me because I was like why can't you do both? Why do you have to be one or the other? Why can't you like why can't you do both?</p> <p>And now I can say like you can do both. And honestly like operations roles also have strategy pieces to them. So you don't have to pick and you can go back and forth. And that's like my other thing I always tell people if I talk to them of you know you don't have to know I only want to do operations or I only want to do strategy. So anyway that's how I got to UPMC. Um and then I moved on to a larger role there.</p> <p>I was the um director of operations and then division administrator right before I left um of general internal medicine. So it was a much bigger scope than what I initially had when I started. Um and I really enjoyed that role and again learned a ton working in a department and managing people and and understanding operations. >> Oh my gosh, how incredible. So much great advice in that response.</p> <p>And if if there is one response that I can steal and just plaster everywhere for it would be everything that you said um you know uh so a couple things that I want to call out. Um number one didn't know AC was able to also sponsor a love stories. So >> yeah about that. So >> look at that. I feel like it's a win-win for everyone.</p> <p>Um but no one thing that you said you know you said you left after your fellowship and this is where I urge f people who are currently interested in applying for fellowships to speak to fellows cuz when you look at a website and when you see former fellows and you see Rachel's name or somebody else's name and you see that the fellowship year was whatever 2018 to 2020. I'm just making things up. And then immediately after you see, oh, this person is not or did not stay or is not at the org.</p> <p>Sometimes this is a lesson for me today as well. It's not the whole picture. So, as we learned from what Rachel shared with us, you know, life happens.</p> <p>Um, and so sometimes it's just important to connect with a fellow, cold email them or message them on LinkedIn and say, "Hey, was there a reason that, you know, you left um or was it an experience that you had to get insight?" So I appreciate you, you know, painting that picture for people because I will be honest when I was looking for fellowships, I definitely looked at people who were the most recent fellow and whether they stayed or not. And again, it was half of a picture.</p> <p>So appreciate you saying that. Um, and the other thing that I want to call out is the maturity of the mentors that you told after or during your fellowship that, hey, I love Hopkins, but there are life things happening where, you know, I I'd love to stay, but I'm also open to, you know, another city. And and, you know, I think you you said it best. You don't want mentors in your life who are not going to support you or not going to understand where you're coming from.</p> <p>And and, you know, two things can be true at once. someone can absolutely adore you and be sad that you're leaving, but not be angry and, you know, give you the wings to fly and take off and do what you need to for your personal and professional life to merge. Um, so I I think, you know, you it seems like you had some incredible people in your life at Hopkins who truly understood your why and and let you grow and let you kind of do your thing.</p> <p>So, I I love hearing people who are like, "Yeah, they they let me do my thing and here I am." Um, and you know the other thing about uh what you said in your roles um as you progressively progressively moved up at UPMC again I just want to highlight Rachel already said this but people management is so important and the earlier on in your career that you can get it. I think it adds a lot of value to your skill set to your learning and then to your resume.</p> <p>Um so people who are going to the fellowship route, current fellows, um or you know starting their fellowship already or soon this summer, you know, keep an eye out for what where you can get some people management experience because it does add an added layer of value to your resume and your to your skill set opening up new opportunities post fellowship and you know later on in your career.</p> <p>Um and so you know you obviously made quite an impact at all the organizations that you have been a part of but you know you did give a little bit of a hint in your last response um saying you left UPMC as well. So you know what where are you now and what do you do? >> Yes. So I am I am back in the Boston area. Um, again like I've this is my theme like I never thought I was coming back when I did. Like I never thought I was going to any of these places when I did.</p> <p>Um, so to your point, you know, life happens, but I'm back in the Boston area. Um, I married that fellow that was the UPMC fellow and we now have two children. Um, and so, you know, we had we had our son actually in Pittsburgh and it was a it was really a personal reason for why we moved back here. So, um, just realizing again life choices and neither of us being from Pittsburgh, we didn't have family that was immediately close by to help with child care and, you know, to see our son.</p> <p>And I just felt like if my family was going to grow or if we had a second kid, we needed to be closer to family. Um, and we honestly, you know, we actually looked at Baltimore, too. My husband again is from there, so we and I would go have gone back there in a heartbeat, too. So, we did look at Baltimore. We looked at Boston and ultimately, you know, um we ended up coming back to to Boston. My husband actually got the job first. He's at MGH and then I landed at Beth Israel Lehey Health.</p> <p>And again, very hard decision to leave UPMC. You know, we both were doing well. Like I could have stayed in the job I was in. I wasn't necessarily ready to leave that job. Um it was really just again a timing thing and and sort of life. Like we we had just bought a house. s like we didn't think we were going to leave, but ultimately this has really been a great decision to come back and be closer to family.</p> <p>And again, I think, you know, your personal and your your mental health and your well-being is just as important in all of this. And so, you do have to figure out like what makes sense for your life. And your life is going to evolve. I I started my fellowship seven years ago, so it's going to change and the decisions you make are going to be influenced by different life factors. So that's ultimately what brought us to Boston. Um but I'm at Beth Israel Lehey Health which is a a newer system.</p> <p>Um they they merged actually right prior to CO um but are still like CO sort of delayed some things and so it's a 14 hospital um health system around the Boston area and I am now more in a strategy role. So if you think of like operations, you know, true operations, I am now in a I guess a true strategy role and I work across the health system and I'm actually again similar to a fellowship, you know, I'm working now again with the senior and executive leaders of the health system.</p> <p>Um, and that was a a big draw to me um for me to this role was sort of okay, I've done that operations work, I've done some of that management, I you know, I've worked in a department.</p> <p>I really like seeing the broad picture across the health system and sort of like where are we going, how are we getting there, what does it look like and I think I'm I'm really most passionate about some of that strategy and that vision and um was very fortunate to to connect with someone again there was a personal or a professional connection that actually like connected me to someone um so like use those connections once you are in this world there's it's a small world and people know people um and I had a very informal conversation first, which ultimately led um to getting this job offer when I was moving back here, which was really great.</p> <p>So, that's where I'm at now, and I'm currently on maternity leave. So, >> well, well, I appreciate you doing this with me while on leave, but you know what I'll leave with the listeners for from that experience of leaving UPMC and coming back to Boston. Um you know I I do believe that when one good thing comes to it has to come to an end for another blessing to come in or for another good positive cycle to start.</p> <p>Um and yes it's absolutely difficult but you are the prime example of yeah you can find the balance of having jobs that you love but finding that peace whether it's mental peace or just peace in knowing that you are balancing your personal life. you have the ability to put your family first to a certain extent. And so as our fellows grow out of their roles, you know, you will wrestle um our listeners, you know, you guys will wrestle with the decisions that life will throw at you.</p> <p>But you, again, this episode is very big on values and you have to go back to your values. If being near your family is something that's important to you, you know, put in the effort to make that come true, um where you can work and also have that family life that you desire. And of course you seem to have done that so so well. Um >> it's not that easy. Just to throw it out there like there's definitely hard moments. Nothing is nothing is perfect.</p> <p>There's been many hard decisions but um just to like give people the real of it you know it's it's really challenging but I think you just you sort of make that decision and you work through it. >> Oh absolutely absolutely. Um, you know, and kind of my last question to really close us out, you have shared incredible experiences and advice, but what one piece of key takeaway would you want to live with leave with our listeners, right?</p> <p>Like so far in your career, what is a piece of advice that has gotten you this far and helped you get successful? >> Yeah, I think you know the biggest thing for me is really being your like true authentic self. I say this like whether you're interviewing for a fellowship, you know, writing your your personal statement for a fellowship or once you're in a job and you find yourself as a manager, right?</p> <p>And you may be maybe you're a younger manager as I was and everyone around you has way more work experience, right? But people relate to that if you're real. And I think we can you can tell if somebody is sort of putting on a facade or, you know, not being their true self. And I think people just at the end of the day want to connect with like a real person. Um, and so just like be yourself. Try to get to know people and keep an open mind.</p> <p>Um, but you know, work hard too and you know, make an effort to get to know people. Make an effort to get to know your organization and put yourself out there. Um, but just be real. And I think at the end of the day, that's really how you end up connecting the most with people. >> Absolutely. Absolutely.</p> <p>such incredible advice and I hope our listeners can get a lot of great advice from this episode but also see how Rachel highlights that you know um you can find your way to and through a fellowship in very unique ways. There's no cookie cutter path. I think you're the perfect example because there is a perception of you know I'm going to go to undergrad. I'm going to go to grad school. I'm going to do a fellowship and then I'm going to stay there for x number of years.</p> <p>And I think this episode really challenged that norm in a positive way. And so for anyone listening, I hope you know that there are unique ways that you can end up exactly where you need to be. Um, and Rachel, I just I again want to thank you. There's a time difference between us. You're on leave. Um, you've taken the time to share your incredible journey and I know there's so many good things um for you in the future. And so, thank you for your time and your incredible advice this evening.</p> <p>Thank you so much for having me. It was great to chat with you about all of this. I love it.</p>
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