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Ayushi Pandya chose healthcare administration after firsthand experience in India and the United States exposed her to the complexity of healthcare systems and the pressing need for strong leadership. She started her career following in her parents’ footsteps in rural hospital care in India, absorbing a passion for service: “As a kid, I have seen them serving in the community and somehow I inherited those things and values in myself... I pursued admission into medical school with aim of making meaningful impact.”
However, her medical internship revealed persistent, systemic problems—resource scarcity, transportation hurdles, and inefficiencies—which sparked an interest in non-clinical solutions. The COVID-19 pandemic, and her move to the U.S., intensified this resolve. “During my internship I witnessed many challenges... That led me to think on the nonclinical side of healthcare. COVID-19 further uncovered challenges, and that solidified my intention to work or contribute toward the non-clinical side.”
Key motivators for her transition:
Exposure to rural healthcare’s unique needs and limitations
Recognition that systems leadership was critical to solving deep-rooted issues
Pandemic-driven insights on the global nature of healthcare challenges
Ayushi’s journey included strategic education, early U.S. healthcare exposure, and leveraging networks—a roadmap for other international graduates.
After moving to the U.S., she participated in a physician observership to understand the structure of American hospitals. She then applied to multiple MHA (Master of Healthcare Administration) programs, ultimately choosing Rutgers for its broad curriculum and supportive community: “I chose Rutgers because the program offers a vast variety of courses and emphasizes development of competencies. The guidance and support provided by the student counselor were instrumental.”
Her search wasn’t easy: “I have applied so many programs I forgot my counting… I chose Rutgers because of the curriculum and proximity to my family, but also because of the guidance I received.”
Apply broadly: Ayushi applied to “as many programs as I could,” emphasizing that volume matters.
Prioritize programs with strong support systems: Personalized guidance during the application process made a tangible difference.
Seek real-world exposure: Early observerships and administrative roles helped bridge clinical and administrative worlds.
The Guthrie Administrative Fellowship is a two-year, project-based program that immerses fellows in both operational and strategic aspects of a multi-campus, rural health system. Ayushi describes it as transformative: “This is a two-year program... The first year includes quarterly projects in inpatient, outpatient, quality, and business operations. The second year involves a yearlong project.”
Multi-campus exposure: Guthrie includes six hospital campuses serving both Pennsylvania and New York communities.
Rotational structure: Fellows rotate through projects in quality improvement, business operations, supply chain, and patient experience.
Strong mentorship: “We all share one office... Second-year fellows are mentors to me. If I have questions, they always guide me and support me.”
Leadership development: Regular access to operational council meetings and senior leadership.
Focus on rural healthcare and community impact
Cross-state service area providing diverse challenges and learning opportunities
Intimate, collegial fellowship culture fostering both support and independence
Professional relationships—built during her administrative assistantship at St. Luke’s and nurtured through her fellowship—proved essential for Ayushi’s career development.
“I feel like [St. Luke’s] was a great opportunity for me, even for making connections… My mentor helped me a lot even with finding these administrative fellowship programs.” These connections didn’t just help her find the Guthrie opportunity—they shaped her career outlook.
Build and maintain relationships: Stay in touch with mentors and peers—these can be gateways to new roles and honest feedback.
Find a mentor: Ayushi credits specific individuals with guiding her to the fellowship path and providing ongoing support.
Engage with your cohort: Collaboration, not competition, is central to the Guthrie fellowship: “We have a very friendly office culture... We talk with each other, and the second-year fellows mentor us.”
Ayushi’s transition from the Indian to the U.S. healthcare system was both challenging and enriching. While she found many similarities, “US Healthcare System more focused toward preventive care while Indian healthcare system more focuses on acute care and treatment.” She credits her MHA program for bridging the gap: “Rutgers did a great job giving an overview of U.S. healthcare structure. I didn’t face many challenges while pursuing the course.”
Her key adaptation strategies included:
Immersing in U.S.-centric education and work roles
Seeking feedback and support from faculty and peers
Staying open to learning about new operational and policy approaches
Fellows gain experience in quality improvement, operations, patient experience, and supply chain management, developing both technical and leadership skills. Ayushi has focused her current projects on quality improvement: “I’m working on quality projects, and I really like it... Healthcare quality, patient experience, supply chain, or operations are all areas I’m interested in.”
Analytical skills through real-world data projects (e.g., Community Health Needs Assessments)
Communication and leadership via direct exposure to senior decision-makers
Cross-functional collaboration by rotating between departments and project teams
Direct exposure to leadership is frequent: “We have operation council meetings twice a week, and we are part of them… Those meetings are instrumental in developing leadership skills.”
Guthrie’s rural setting is central to both the challenges and rewards of the fellowship experience. Ayushi appreciates the sense of community and the natural beauty: “The area is pretty rural, but there are so many good places around—lakes, hiking places, cities like Binghamton nearby.”
Rural health systems offer:
Unique challenges: Resource limitations, population health disparities, and geographic barriers
Greater impact: Fellows see the results of their work in tight-knit communities, often serving patients with limited access to care
Lifestyle considerations: Access to outdoor activities and a lower cost of living
Ayushi’s perspective: “If Guthrie is offering something, I would like to stay here because it serves rural communities. I always have a soft corner for rural communities.”
Chronic diseases, especially diabetes, stand out as the most pressing healthcare issue Ayushi has observed in the U.S. “Chronic diseases are very broad here compared to India… Diabetes is the number one cause of death in the United States according to CDC.”
She notes that:
The U.S. system’s focus on preventive care is vital, but chronic disease rates remain stubbornly high.
Her fellowship and MHA education have prepared her to tackle these issues head-on, especially by working with community health data.
“We are actively looking into the healthcare data—what’s the diabetes rate this year, blood pressure rates in the community… We try to reach out to people and see what are the gaps and how we can resolve those.”
Ayushi’s top advice is to research programs thoroughly, actively engage in professional activities, and build both technical and leadership skills through every available opportunity.
Her actionable recommendations:
Research accredited programs: Look for programs with a wide variety of courses and electives.
Engage in extracurriculars: “Engage actively in activities and subcommittees, attend conferences, and participate in case competitions.”
Network strategically: Pursue internships or jobs aligned with your career goals to deepen real-world understanding.
Utilize resources: Certifications from Coursera, LinkedIn, or other platforms can strengthen your application.
On the application process: “Give yourself two or three months to thoroughly research. I also recommend getting certificates—those are nice resources for bolstering your resume.”
Ayushi’s experience highlights the competitive, but navigable, nature of fellowship applications—especially for international candidates. She applied to 17 programs across multiple states, interviewed with eight, and credits her organizational rigor and persistence for her success.
“I put a whole Excel sheet with a list of hospitals, always making sure if I got an interview to write it down. Follow-up is important—every time check with the administrator, send a thank you note… Those small things are really helpful.”
Research and identify programs (2-3 months)
Apply to many programs (expect to apply to 10-20)
Prepare standard materials: Resume, personal statement
Expect multiple interview rounds (including in-person)
Follow up consistently and thoughtfully
Professional organizations and digital tools play a key role in the journey to an administrative fellowship. Ayushi recommends:
ACHE (American College of Healthcare Executives): “They keep me updated with healthcare challenges through flyers, magazines, and articles.”
NEFAS System: For centralizing fellowship applications
Excel and tracking tools: To stay organized throughout the process
She also suggests becoming a student member of professional societies, attending local and national conferences, and pursuing entry-level certificates for foundational skills.
The Guthrie Administrative Fellowship exemplifies how project-based, rural-focused fellowships can prepare leaders for the evolving landscape of U.S. healthcare. Ayushi Pandya’s story illustrates that success is built on perseverance, continuous learning, and genuine engagement—with mentors, peers, and communities.
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