Key Takeaways
- Administrative fellowships within rural health systems offer accelerated leadership development by providing rotational exposure to operations, quality improvement, and senior strategy.
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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.
<p>[Music] all right hello everyone this is Cole from the American Journal of healthc care strategy doing the leaders of tomorrow with aushi alushi why don't you go ahead and introduce yourself thank you so much call uh I'm very excited to be here so hello everyone uh my name is Pia I'm an administrative fellow at gri Robert parer hospital that is in seor Pennsylvania so a little bit about myself I completed medical school back in my home country India then I did uh Masters in healthcare administration at rudgers University and along with that I was working as an administrative assistant at St l hospital that is in Allentown Pennsylvania and I joined go three uh six month before it is last July so journey is going so far so good excellent we're so happy to have you on I really appreciate you making time to join with your busy schedule so tell us about kind of what inspired your journey back in India what was the reason that you kind of wanted to go into the medical field to begin with oh that's a really interesting story so uh my parents they work in the roller hospital and somehow as a kid I have seen them uh serving in the community and somehow I inherited those things and values in in myself and that uh and motivated by this I pursued admission into medical school with aim of making meaningful impact and uh I completed my medical school I was so excited working in the community but during my internship I witnessed many challenges in healthc care system such as scarcity of of resources transportation problems and all those things L me think on the nonclinical side of healthcare simultaneously I moved to United State uh I was exploring new avenues those aligned with my life goals and at that time covid-19 pandemic occurred and uh that further uncovered challenges in health care and I again saw uh scarcity of resources so that solidified my uh intention to uh work or contribute myself towards non-clinical side so that is the whole reason and the story of my transition from Clinical to non-clinical side excellent because I know and I think that's a great great story with you know how a lot of imgs they come over from the US and either they have the choice of doing the US residency here and going through internship here or they have the choice of kind of going another way but I like how you stayed in healthc care and you kind of focused on what you saw now when you came over to the United States to begin with you did do a physician observership right yeah I did that observership it is like to get to know about us Healthcare System and Hospital structure how it's operating so those kind of thing but it was for like I think one or two months uh Max but uh yeah I did that opportunity and it was nice observership in terms of understanding about health care in USM and then after that you started applying for the mha programs right that's true and then with the mha programs how many did you apply to was the application process challenging and then what led you to go to ruers so I have applied so many programs I forgot my counting but uh yeah I have applied as much as I could but I choose Rutger's program because of reason first is was uh I drawn towards the programs curriculum which is which offers um like vast variety of courses and emphasize on the development of various competencies and the Programs El active options those provide excellent opportunity for person to Showcase their talent and acquire new skills so that is the first reason and additionally uh the location the that is like proximity to my extended families uh and uh they I I heard so many good things about rudgers University and specific program so that solidified my choice and moreover uh during the application process uh the guidance and support uh provided by the student counselor was instrum were instrumental and they navigate me throughout the process so uh those are the reason why I choose Rodgers as a VI CHD program so it is pretty important then that other programs kind of take note and provide that counseling to students as they're applying for the program uh because that's one of the big things that made a difference for you when you were in the program do you feel like was there lots of challenges with the US Health Care system that you had to kind of adapt to that were different from the Health Care system in India I don't think so because there are so many similar but of course uh us Healthcare System more focused toward preventive care while Indian healthare system more Focus toward acute care and acute treatment but uh I think um Rodgers program did a very great job in terms of uh giving some overview and uh how the US healthc care structure and all those things so I think I didn't have those kind of challenges uh while pursuing the course great that's great and then during your program you were an administrative assistant at St Luke's so tell me a bit about what you know made you want to choose this facility St Luke's and then also what made you want to be an administrative assistant and how that's helped you kind of for your future roles so I was actively looking for uh other part-time uh job or the healthcare position where I can see and actually work in the real world and see the dynamic of the administrative uh Healthcare so uh I applied multiple hospitals and uh fortunately I got chance into uh red um St l hospital and that how I started working there and I I feel like that is really great opportunity in terms of even making connections so I I think that it's been a great opportunity for me did you make lots of uh connections that you're still in touch with from your time there yeah I still touch with them so uh Sandy yed if uh you are listening to this podcast then she is my mentor and she helped me a lot even with finding these administrative fellowship program so nice so you kind of made these connections built these relationships and it helped you get your fellowship program that you're in now that's excellent exactly that's really cool and then so you are in your administrative fellowship program now how is that going can you tell us about who it's with and what it's like sure so uh currently I'm pursuing administrative fellowship program at gri hospital that is in the S and whoever might not know about the gri hospital then it is on the north side of the PA and located uh like on the border of Pennsylvania and New York so we have currently six Hospital campuses and serving in the New York Community as well as Pennsylvania community so uh this is like a two years progam program uh that include uh first year include quarterly project like in inpatient outpatient quality and business operation and the second year involves a yearlong project so I feel like through this program uh I had chance to work on different project and that provides me an opportunity to observe effective leadership skills and I feel like this experience is very instrumental in terms of fostering Independence as my management skill is growing and evolving so now after your fellowship do you want to stay with Guthrie are you looking to move around what is your plans post Fellowship so I'm still uh exploring where I can end but of course if gri is offering something then I would like to stay here because gri serving ruler communities and I always have a soft corner for the ruler communities so I'm really looking forward to where I can stay but uh that is the one of the reason why I apply for the uh administrative Fellowship programs because I wasn't sure after my Master's Degree like where what should I can do and my mentor suggest me to apply for the this kind of program so throughout through the various project I have chance to look into okay what are what is this Department doing and how they're structures so uh that is the one of the reasons so I'm literally in the exploring phase of right now so nice that's that's really cool I I know a lot of our past Fells have talked about the same thing they weren't sure exactly what area they've they've done what are some areas that you like that you've explored so far so I like um So currently I'm working on quality project and I really like it so one is health Care Quality patient experience supply chain or the operation so those are the four areas in my mind so um let's see that's great yeah supply chain is an interesting one I've I haven't talked to too many people who do that one so that's really unique and then of course quality is excellent I love quality myself it's a very you know seeing the processes improve and the metrics get better is really enjoyable with the fellowship are you the only fellow or are there multiple fellows now we have uh first year fellow and second year fellow so first year it's usually three years or three fellows or four fellows we have so it is multiple and do you kind of collaborate with them do you work with them do you you know are you friends with them how does the relationship work actually we all share one office so it is good like we have we like very friendly we talk with each other and second year for fellows those are mentor to me if I I have any questions or anything then I can easily reach out to them and they always guide me support me so uh it's like good culture here and you said it's pretty rural uh in that area right so how do you how do you like the area is a nice area you said you'd like to stay there right yeah so the SE is pretty ruler but there are so many uh good places around it like Sia Lake uh finger legs and there are so many other uh good cities like Binghampton is nearby it's like 30 minute drive so it's that that's not bad yeah so there are so many good places here where we can hang around or go so nice that's excellent it sounds like a really pretty area as well yeah and there are so many good uh hiking places as well so I'm gonna put you on the spot a little bit with this question but based off your experience in India your experience kind of in the US so far what do you think one of the biggest issues in healthcare at large is in the United States that's very interesting question but uh I can feel that chronic diseases those are very broad here compared to uh India yes diabetes is the number one cause of the death in the United State according to CDC so I think chronic disease are the uh number one or leading here and more pronounced compared to India but we are doing preventive care and looking more towards how we can prevent those kind of things so I think we are working towards it but uh that is the one thing that I can see a major uh Gap so if we think about kind of the diabetes that you were talking about the chronic diseases at large being a really major concern do you feel like your mha program and your fellowship is preparing you to fix some of these issues yeah sure so uh currently I'm working so along with my this uh administrative fellowship program I also work with the chna that is Community Health need assessment and we are looking uh actively looking into the healthcare data like okay uh what's the diabetes rate this year what are the blood pressure rates in the community so we are actively looking around those areas and we we can also do like meetings and try to reach out to people and see what are the gaps and how we can resolve those or mitigate those challenges so that's impressive yeah so you're ready you're ready to kind of get out there and you're already making an impact which is great to see that you're not you know sitting behind a desk I guess but you're actually getting out there uh what is some of the bigger personal challenges if any that you've faced during your fellowship and then how you know the preceptors or your fellow students help you to overcome them some students have said it was public speaking others have said it was leadership you know so what what have been some of your struggles so sometimes it is hard to uh reach out to the leaders because those are very busy in their schedule as well right so earlier I was only contact them through email uh Outlook email then my preceptor guide me or suggest me to reach out through teams or do like teams call or get back like get out and just knock their door so those kind of things are really helpful like to get prompt response for anything because emails are like uh important but somehow uh some sometimes they are busy and they miss some emails so that was the one thing that I overcome have you had lots of exposure to senior leadership have you met with some of the the senior official shows at at kri yeah so we have like uh uh twice a week Monday and Thursday uh operation council meeting and we are part of them so we can uh stay there and see how they are talking and how they are taking decision so those kind of thing we have a chance and I think those are very instrumental to develop a leadership skill definitely that's a it's been hugely impactful for me as well as when I can actually see how these individuals interact with each other it helps me understand how I'm supposed to act so right and how we can solve those kind of problem like if I was in this kind of situation then how should I take decision and those kind of things exactly exactly since you've kind of been you know you you're very successful you've have had all these successful outcomes what would you recommend to earlier individuals you know if you could kind of go back through the process all the challenges you've overcome what would you you know any advice you would give to any graduate students maybe even individuals coming from India what would you know what would you tell them I recommend to do thoroughly research of the program like any accredited program who provide V variety of uh courses and elective programs so uh that is very important also uh engage actively in various activities and subcommittees also in the case competition attend conference because those are very important to build Network and also develop small leadership skill also if they can pursue any internship or the job that align with their career goals because those kind of experience will enhance uh the understanding of uh administrative dynamic in real world so I would suggest those kind of thing to anyone who would like to pursue MH definitely definitely you mentioned some of these conferences what are some of the ones that you've kind of gone to I was part of a so uh as a rudgers university they all encourage us to be a party part of like as a student member or uh and and they have like I think New Jersey conference as well new NJ a I think yeah there's the NJ a and then there's the uh h l or the Delaware Valley AC as well I'm part of the Delaware Valley one so AC is great yeah that's excellent organization so you got a lot of benefit out of it so we got um flyers and magazines and uh they have like nice articles in it so they keep me updated with the healthcare challenges so I think that is very helpful nice that's great advice so if anyone is kind of looking at maybe getting involved then the a would probably be one of your when your top recommendations all right that's excellent so when you were researching for these programs this will be kind of one of the last questions I don't want to take up too much here your evening but when you're researching one of some of these programs are there any specific tools that you used how challenging was that search you know how long should if I was a graduate student or a um an undergraduate looking to go to grad school how much time should I set aside for looking for these programs you know months weeks what does that look like I feel like uh give like three two or three months to like do thoroughly research and uh I also recommend to get some certificate like corser LinkedIn those are the nice resources to get get like basic certificate about healthcare administration and healthare safety those kind of AD certificate also helpful to get admission so uh those are my recommendation but uh uh yeah that's good what was your other question I think you asked a two or three question yeah sorry uh yeah know the length and then and then how difficult it was uh and then you also mentioned kind of with the the at bolstering the resume I think is is an excellent tool when you're looking for Fellowship as well though how did you find the fellowship how did you learn about it that that's a really good question because I was struggling and I really shout out to Cheryl Igan if she's listening to this podcast because she really helps me with whole process I wasn't familiar with how to apply for uh even administrative fellowship program but there is a nefas system where we have where most of the hospitals and most of the programs are in the Navas and we can apply through the nafcas but every program has little bit different uh kind of process uh in terms of application but there are two rounds of inter interviews uh if you are selected in first round then they will give you opportunity for the second round and that would be in person so anyone can see the hospital culture and the area around it so um that is the whole process and for the application we need a normal resume personal statement and yeah those are the things that we need so it's pretty simple process but very difficult to and tiring process I can see right right how many programs or how many fellowships I guess specifically how many fellowships should potential fellows apply for I applied for like 17 program so 17 Jersey from New York New Jersey to North Carolina I applied all the programs okay so that's good advice too because you don't want to only apply for a few and then not get one and then how many interviews did you end up doing I got eight interviews and yeah that's a that's a really good return rate on on find 50% return rate that's pretty good I know men students uh they get like you know half a percent or something so no but I did like very hard work on that I put whole Excel sheet with whole uh list of the hospitals and always making sure if I got interview then write it down if I did call and I think followup is important to like every time check with the administrator like hey I really like the program and give a thank you note those kind small things but but I think those are really helpful excellent that's also very very good advice because that can make the difference between you know getting an acceptance or not getting acceptance I found sometimes not just with fellowships but also with employment sending that thank you note you know following up kind of learning more about the organization is is really important so really excellent advice you've shared with all of us I really appreciate your time is there any other comments or or anything you'd like to share no uh I just would I would like to thank you thank you for organize this and thank you for giving me chance of course of course I appreciate it and we hopefully will stay in touch and maybe we'll help you back on in a little while as you kind of progress through your career sure sure</p>
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