Key Takeaways
- Two-year administrative fellowships with multiple preceptors provide superior leadership training by balancing rotational exposure with deep, project-based engagement.
Health administration fellowships serve as pivotal launchpads for emerging leaders in healthcare. They immerse early-career professionals in the dynamic world of hospital administration, providing unparalleled, hands-on experience while bridging the gap between academic theory and real-life practice. One such prestigious program is the Administrative Fellowship at Duke Regional Hospital, part of Duke Health, in Durham, North Carolina.
In this article, we spotlight Lauren Gregory's journey—from her initial interest in healthcare to her current fellowship role at Duke Regional, a community hospital within the Duke University Health System. Lauren's story shows how early experiences, thoughtful planning, and a strong sense of personal "fit" can catapult graduates into transformational roles in healthcare management.
Lauren Gregory originally believed she would pursue a career in physical therapy. "I was very dead set on becoming a physical therapist when I started college," she recalls. However, after taking a few prerequisite science classes, she realized that her interests were evolving. Rather than focusing on direct patient care, she discovered she was drawn to operational and strategic challenges in health administration.
Lauren had grown up in Richmond, Virginia, and decided to do her undergraduate work at Appalachian State University in Boone, North Carolina. She was recruited to run track and field—a passion that taught her valuable skills in time management and goal-setting. However, when the COVID-19 pandemic swept across the globe, most in-person college experiences and athletic events were halted. Lauren returned home to Richmond, finishing her undergraduate degree in Psychology with a minor in Human Resources Management. This blend of psychology and HR would eventually shape her unique viewpoint in healthcare administration and her pursuit of fellowships.
When she decided to pivot from physical therapy, Lauren sought out new experiences that would offer a birds-eye view of how healthcare systems work. She completed a summer HR internship at the Master Center for Addiction Medicine in Glen Allen, Virginia, where she began to understand the indispensable role of regulatory compliance and workforce development. "I got to do a lot of work with the Joint Commission," Lauren explains, noting it was her first exposure to critical accreditation and regulatory demands.
During this internship, she also played a leading role in establishing a diversity, equity, and inclusion club aimed at both staff and patients. This work, she notes, showcased how a workforce that mirrors the patients' background can lead to better patient experience and outcomes—particularly important in addiction medicine, where patient vulnerability is high.
Eager for more operational experience, Lauren completed a 12-week internship with Covenant Health in Knoxville, Tennessee, while pursuing her Master of Health Administration (MHA) at Virginia Commonwealth University (VCU). This role placed her at both the flagship hospital and a unionized hospital within the same system, exposing her to clinical operations, budget management, and the challenges of workforce planning. Notably, she and her team successfully reduced the use of travel nurses by 20 percent, a major accomplishment given the staffing complexities that arose with COVID-19.
For many who complete an MHA, the next step might be to leap straight into a managerial or consulting role. However, Lauren had a unique advantage: VCU's MHA program spans three years, and in the third year, students are required to complete either a fellowship or a residency. This structure helped her bypass the question of if she should pursue a fellowship and instead focus on where.
Yet Lauren is quick to point out that not all healthcare administrators have a program designed this way. She emphasizes the importance of external resources such as the National Administrative Fellowship Network (NAFCAS) and organizations like the Association for Healthcare Administrative Professionals. These avenues provide guidance for students and recent graduates who might otherwise struggle to find structured fellowship opportunities for career development in healthcare management.
The fellowship application season can be daunting. Lauren applied to about 14 national fellowship programs, receiving six or seven final-round interviews. However, she is adamant that a scattershot approach isn't always the best strategy. "Sometimes more is not always better," she advises. "I focused on places I could really see myself thriving long-term."
Lauren shares that she and her fiancé, who has been her partner since high school, wanted to settle in Virginia or North Carolina. This geographic filter helped narrow her choices to fellowships on the East Coast—particularly those with robust, structured programs. She also strongly preferred a two-year fellowship over a one-year experience, wanting an initial year to gain a lay of the land followed by a second year with deeper engagement in key projects.
Lauren ultimately chose the Administrative Fellowship at Duke Regional Hospital, part of Duke University Health System (DUHS). Several factors influenced her decision:
Duke Regional's fellowship balances rotations with project-based work. This dual structure introduces Lauren to various departments, from clinical operations and human resources to quality improvement and performance excellence. She points out that her current projects do not always align with her immediate rotation focus. "It's really taught me how to juggle multiple priorities," she says, emphasizing the importance of time management and adaptability.
The program's flexibility also allows her to explore areas that interest her deeply. Given her history in HR, Lauren remains passionate about workforce strategy—particularly in retention and workplace culture. But she is equally enthusiastic about the hospital's operational pillars, such as patient flow, staff scheduling, and supply chain issues.
In addition to being an outstanding institution for a fellowship, Duke Regional Hospital is located in the heart of the Research Triangle (Durham, Chapel Hill, and Raleigh). Lauren highlights the benefits of living in this vibrant region. "You get the city feel and the suburbs, too," she says. On weekends, she can venture into Raleigh for cultural events or unwind on the beaches of Wilmington, just two hours away. She also enjoys the short drive to the mountains of Boone—where her college years began.
Durham itself is a diverse and rapidly growing area. For food enthusiasts, the city's culinary scene is a pleasant surprise, offering globally inspired restaurants, local breweries, and everything in between. Sports fans can revel in the excitement of Duke basketball, or enjoy the city's thriving arts and music venues. These features make the region a perfect landing spot for those seeking a well-rounded lifestyle that fuses cultural richness with career growth in healthcare administration.
Lauren's guidance to aspiring fellows (or anyone navigating the early steps of a healthcare leadership career) boils down to two core ideas:
Looking back, Lauren's main takeaway is that you shouldn't shy away from fewer—but highly targeted—applications. She found that once she zeroed in on a select group of potential programs, the interviews felt more meaningful and genuine.
Lauren Gregory's path serves as an inspiring roadmap for students and professionals contemplating the fellowship route in healthcare administration. Her journey—shifting from a potential future in physical therapy to a leadership role in hospital administration—illuminates the diversity of thought and experience that organizations like Duke Regional Hospital and Duke University Hospital actively seek.
The Duke Regional Fellowship stands out as one of the top administrative fellowship programs, known for its two-year length, multiple preceptors, robust alumni network, and a strong sense of community cohesion within Duke University Health System. As an academic medical center, Duke offers unparalleled opportunities for learning and growth. Add to that the dynamic backdrop of the Research Triangle, and it's easy to see why this program attracts ambitious individuals ready to make a mark on healthcare.
For anyone teetering on the decision to pursue a health administration fellowship, Lauren's advice is clear: Go for it. The structure, mentorship, and professional opportunities provided can be a powerful catalyst, setting you up for a lifetime of leadership experience in a constantly evolving field. And if you find yourself lucky enough to match at a place like Duke Regional, you'll not only land a first-rate education—you'll also join a longstanding tradition of innovation, service, and commitment to improving the health of entire communities as part of Duke Health's mission.
<p>you clearly have the capabilities to get into a fellowship it's now just putting in that work for your application process your letters of recommendation your personal essays and just making sure that you're applying to places that you can see yourself going into the [Music] future good evening everyone it's rangi Shaw with the fellowship review through the American Journal of healthcare strategy today I am so thrilled to be joined by Lauren molland Lauren thanks for coming on the show yeah thank you so much for having me yeah so we're really excited to you know dig deep and learn all about Duke but before we get to the fellowship I'd love for our listeners to know a little bit about you where you're from your educational background and what do you do now yeah of course well hi everyone again my name is laoren Mulholland I'm a originally from Richmond Virginia but I decided to do my undergraduate degree at appalachin State University which is located in Boon North Carolina and I was recruited to run for their track and field team so I did that for a little bit of time before Co decided to hit the country and kind of you know spread everyone out so I decided to go back home but finished my bachelor's degree there in Psychology with a minor in HR management and then immediately after undergrad I decided to go um to VCU or Virginia Commonwealth University to get my master of Health Administration and then now I'm doing a two-year fellowship at Duke Regional Hospital which is in Durham North Carolina how exciting and I love that you highlighted your HR background definitely a unique path for people in this field so I'm sure we will dig into that as well um and also a little bit about North Carolina later in the episode um such a cool state to uh to live in and be a part of but before we get to all that fun could you please share with our list ERS you know you've had a variety of internships early on in your career um so would you maybe share a little bit about your HR summer internship as well as the administrative um internship that you did yeah of course I mean going into undergrad I was really dead set on becoming a physical therapist and then I took a few classes and realized oh maybe this isn't you know the route for me and so during the summer between my Junior and Senior year of undergrad I wanted to kind of get a little more experience in help care but maybe not on the clinical side of things so I found an internship in Glenn Allen Virginia it was at Master Center for addiction medicine and I did some HR work for them and got to do a lot of work with the Joint Commission so that really opened my eyes up to a lot of the Regulatory and compliance things when it comes to healthcare admin and then kind of going into my master's program I was like you know I want to do something during the summer between my first and second year and I decided to apply for an internship in Knoxville Tennessee with Covenant Health and the 12we internship actually was between two hospitals within the same system one at their Flagship and the other one was at their unionized hospital so that experience was very interesting to see how both are run but also governed at the same time and so with both of those I was able to do some projects that had to do with clinical operations and general operations one being having to reduce the excess usage of travel nurses and we were able to reduce it by 20% by the time that I left in August so I was very fortunate to have both of those experiences kind of come together and make me where I am today and and wanting and what I want to pursue for my career yeah absolutely and how how cool that you got to do both of those things and you know with the hr1 I I'd love to highlight to our listeners and please jump in if you have more things to add I think why it's so unique to have a background in HR is it really helps you appreciate the recruiting hiring and onboarding process a lot more um because you know I I do hear sometimes where they're like oh like this process took so long but I think good organizations have solid foundations for their Recruitment and onboarding to make sure that it's a pleasant um experience for the organization but also for the candidate yeah no I I completely agree with that I think the biggest thing that really opened my eyes during that experience was just making sure that even though we want to take care of our patient we need to make sure that our staff is also being represented to our patient population and so during my time at Master Center I was very focused in on diversity equity and inclusion and so helping the um Chief Human Resources officer there create a diversity Club not just for the staff but also for patients as well we wanted to show them that we were providing Equitable care to them because that patient population is so vulnerable and that's also why I wanted to go somewhere like Duke Regional because we're taking care of the sickest people in Durham North Carolina and so just having that experience really has helped me you know within the first four or five months of my fellowship now so it it's it's enjoyable but also making sure that orientation and onboarding process is as smooth as possible that's what gets your employees to stay and so I hope I can bring some of those tools and resources to do creal in the future yeah absolutely and and to your second internship that you shared about um how incredible to see that % reduction and I think you know with covid there was a surge in the utilization of travel staff um and of course now hospitals have it seems that they're moving away unless it's absolutely necessary so what a great skill for you to have to not only work with kind of the HR piece of onboarding employees in general but then also you know um scaling down from travel nursing contracts and travel employees to full-time you know the employees that are uh career-based yeah for sure absolutely and so now you know let let's talk about the journey kind of during in after graduate school um when we get our master's degree you know I ask all my guests this there's lots of Pathways that you can take you can go the healthcare Consulting route you can go Fellowship you can go just traditional career um what motivated you and how did you find out about what a fellowship was and why did you decide to pursue that as a opposed to the other opportunities yeah of course so something that's unique about vcu's program is our mha program is actually three years long instead of two years so I'm I'm actually considered still an mha candidate and so our third year we're required to do a fellowship or a residency and so when applying to mha programs that was something that really stood out to me because I was like I want something that's guaranteed I want something where I can still be considered a student but also a full-time employee as well and get that real life experience so that's kind of what opened my eyes to what a fellowship or to what a residency is but I know other students out there that might not have a similar program like that it can be challenging sometimes to find resources and opportunities and so you know this podcast and even some other groups like national Administrative Fellowship Network which I'm actually the regional chair for the east side of the country you know we really want to make sure that we're providing that guidance to students that are coming into mha programs and showing them that there are still opportunities out there for them to get that real life experience while they're still pursuing their education yeah absolutely and thank you for highlighting that and and digging you know even deeper into then you came to the decision of completing an administrative Fellowship tell us more about what the application cycle was like for you what the interview was like for you and to the extent what you want to share you know um you know how many you apped to how many on-sites you had um and you know regionwise did you focus mostly on the East Coast or were you open to kind of all over the US yeah of course I mean I was very fortunate again with vcu's program they had some organizations that are specifically tied to VCU where they were just interviewing students in my cohort and so that allowed me to kind of see some opportunities not just in Virginia but in Northern V Virginia and a few other states across the country but when I was going through the process I definitely wanted to apply to National fellowships and so I was mostly uh focusing on the East Coast I'm actually engaged um to my fiance that I've been with since um I was a junior in high school and so we were really thinking about where we want to settle down and kind of you know start our family and so I was thinking of Virginia and North Carolina just because we both went to school in the state and so I apply to about I would say 14 National fellowships and I got either six or seven final round interviews and I really you know one of my biggest decision criteria when was not just the location but also the opportunity as well I wanted something that was two years instead of one because I felt like that first year I could kind of build a foundation and then that second year I could really dive in and you know still be considered a fellow but be given more responsibilities and opportunities to kind of prove myself in my new role yeah absolutely and how sweet that you know your um fiance and you have been together for so long what a what a sweet story and you know one thing I'll say from that is something you highlighted maybe unknowingly even that I encourage fellows to think about is the location it is important where you end up picking your fellowship site you will you know there's a very high chance you'll stay there post fellowship and who knows that could end up being a decade or the rest of your life so you have to pick wisely um for sure and you know you kind of created a perfect segue for my next question um but then you come to Duke and you know you obviously had an incredible Fellowship season so congrats and kudos for that you're at Duke um tell the people who are interested in this specific Fellowship you know uh you said it was two years but is it Project based do you have other co-fellows um what is the structure of this Fellowship yeah of course I I would say Duke's Fellowship is very unique unque compared to other Health Systems across the country so from my perspective as a Duke Regional fellow there's only one of me but we're actually going to start recruiting every year now so in the past we've recruited every other year but our coo and president this year we're like you know what I think we're actually going to want to start a pipeline of having someone like always be here with the second year and then the first year so we'll always have someone to um we'll always have a first year with a second year but would say it's kind of a mix of project base and rotation so I'm currently rotating right now but I'm also working on projects that have nothing to do with the rotations that I'm in so it's kind of a unique opportunity to kind of teach myself time management skills like what am I doing in my rotation and then what projects am I doing right now and so kind of to bring Duke all together um there are five different opportunities within Duke's Health System you have the main hospital you have Duke Regional you have our integrated practice you have primary care and then you also have our revenue cycle fellowship and so even though a lot of us are by ourselves we do come together as like one or two cohorts and we kind of you know create a really good bonding experience because even though we're at different places we all still work for the same health system so I've met and created a lot of friends with some of the seconde fellows at some of the other locations and then also the first year fellows as well so I would say that makes us us really unique in that even though we're all kind of separated we still come together at the end of the day to do what we need to do to make Duke University Health System the best that it can be and I think one thing I also want to kind of call to attention is the fact that there are so many of you and and you know you have the opportunity to have co-fellows and make sure that the process overall is not lonely so I always appreciate when people say oh I you know even though we're at separate hospitals or we're in separate Ro ations I still have co-fellows so it makes the I personally I think it makes the whole process less isolating for sure um because the fellowship is such a unique opportunity um within any health system yeah um and so kind of uh looking towards more details about the fellowship you know who is your preceptor what is their position within the health system and then to take it a step further could you also speak about the mentorship and the ability to have lifelong mentors um even after the fellowship within uh the health system yeah of course so another thing that makes Duke regionals Fellowship unique is I actually have three preceptors I have one main one and then two secondary so my main preceptor is uh Jason Carter our chief operating officer and then my two secondary preceptors are our Chief Human Resources officer and our president and so I use each of my relationships with them very differently I use Jason as kind of like my executive coach coach I'm bouncing ideas off of him what projects do I need to get done and then with the Chief Human Resources officer that's more just like a sounding board like you know this is what's going well this is what could be better what could I be doing better what am I doing well and kind of just having that relationship based type of connection and then with our president that's really just to get updates like what's going on in the health system what can I be doing to kind of you know put myself in a position where I can make Duke better so I use all those relationships very differently and it's it's really interesting to kind of see how some of my friends who are at other fellowships they just get one but I get these three personal connections with three very different people and that kind of goes into the mentorship as well you know they all have very different leadership styles and I've been able to kind of pick and choose what I want to use in my toolkit once I get in a position like they're in now and so there are so many great leaders that have either been at Duke for a very long time or have kind of you know bounced around and have now landed at Duke and so just kind of getting to learn from those individuals you know how they've gotten into the positions that they're in today and what I can do to make myself a better leader has been very valuable and even with my co-fellows at other locations you know I love hearing what they're working on and what we can do together to kind of propel ourselves forward yeah that that definitely makes Duke a very unique place to be and I think you touched on this a little bit um but another kind of component to fellowships is fellow retention and you know kind of like the fellow family if you will so what is that environment like do you have the ability to connect with former fellows who've now gone on to build their careers at Duke and is there a pipeline for mentorship within the fellowship Network as well yeah of course I mean something that's you know crazy about Duke they're one of the oldest administrative fellow sh in the country we have fellows dating back to like the 1980s which is crazy to think and so there is that pipeline there that I can go on LinkedIn or you know I can go into one of our internet pages and see who's been a fellow before and see if they's still at Duke and I can connect with them and you know ask them hey could we find a time to chat I'm a current fellow right now I'd love to hear about your experience and what you're doing now and everyone is willing to say yes so that pipeline is there in those connections are there as well and it's it's very fluid and easy to make those connections with other individuals across the organization yeah I love that um and you know I I really appreciate you kind of setting the stage um especially with you being at Duke Regional um another component of fellowships like we talked about already on this episode is living you know um yes you'll be working 40 hours a week or whatever it may be at a health system but you do have to go home home um you know you do have to have a community and a life outside of work so you know tell our listeners what it's like being in um North Carolina and kind of what what the lifestyle is like you know also please feel free to highlight what your favorite part is um anything to look out for as well yeah I mean you know coming from Richmond Virginia I would say Durham North Carolina is very comparable to any little city if anyone out there you know doesn't live in like Charlotte or Dallas or anything like that it's a little smaller but you still get a city feel and you also get the suburbs feel as well so I kind of live a little bit outside of the Research Triangle just because that's the kind of Lifestyle I wanted to live but I'm still close enough to go to the city and then not just with Durham but Raleigh's 20 minutes South Chapel Hill's 20 minutes south I could go two hours to Wilmington North Carolina I really feel like it's a hot spot to get whatever type of atmosphere you like whether you like the beach whether you like the city or even if you want to go to Boon North Carolina that's only 3 hours away from Durham so you get every type of feel that you want to have and so again that was a really big push as to why I wanted to go somewhere like Durham so I've really enjoyed my time here I've I've got to have a lot of new foods a lot of good restaurants and also a lot of cool experiences like Duke basketball or Duke football game so I'm very excited that I'm going to be able to experience that at least within my first two years here at Duke yeah absolutely and and you know I will say the Research Triangle is a part of the country that is booming it's growing um not only Healthcare but the tech companies are also building tons of sites in that area so I think you're surrounded by a lot of intellectual people and then on top of that I will say having been there um the food is underrated they have great food options in the Research Triangle yeah they have everything you you can imagine like any type of ethnic food that you want to have like it is there and in my opinion I think it tastes great so I it's it's wonderful to have all those opportunities to kind of you know try different foods from you know maybe different parts of the country that you might have not got to try before I would say Richmond is very localized in the type of food that they offer and so I really am excited that I kind of get to expand my palette a little bit while being here as well yeah absolutely and then you know I I've enjoyed our conversation so much and I've uh I know that the listeners will benefit from it but before we sign off you know my last question always to all my guests I want to ask you too you had an incredibly successful um Fellowship application cycle I would say I mean out of the 14 you applied you basically got 50% interviews so what is that piece of advice that you want to leave with people interested in fellowships and moreover is there something you would do differently if you had the opportunity to go back and redo the application cycle yeah I mean I would say this is a piece of advice and something that I would do different it's it's just a trust in yourselves you know you've done the work you went through undergrad you're going through your Masters you clearly have the capabilities to get your personal essays and just make Mak future I think some people get sidetracked a little bit of I need to apply to as many as possible to make sure that I have a shot of getting in somewhere but sometimes that that's you know sometimes more is not always better and so I was being very intentional with applying to places that I could see myself instead of trying to expand my number as much as possible but again I I really think it just goes back to just believing and trusting in yourself because once you get that first round interview you you've done the hardest part you did the you did the background work and now you just have to speak to it so I would say to anyone who's thinking about applying to a fellowship you are capable and whatever happens is it's it's going to happen and if it might not turn out how you want it that that's okay that might not be the best fit for you because fellowships are all about fit and I'm very fortunate that Duke was my fit so yeah yeah absolutely what great advice and and I think you know how I'll kind of close off is just echoing some of the things that you said um getting from a paper application to the first round oftentimes is one of the most difficult parts of the journey because essentially you have to articulate on paper why you would be a good fit for that fellowship and then you get to the interview and you can actually like talk in your body language and your interest is uh much easier conveyed verbally so I appreciate you highlighting that and and you know what you're absolutely right fellowships Are One path to success they are no in no means the only path to success for mha students so you know I really appreciate you highlighting everything but especially both of those things um and I know that this episode will be so helpful especially for those interested in Duke in the Research Triangle so I just want to thank you for coming on I know it's later for you in the evening but I really enjoyed our conversation today yeah of course and I really enjoyed you know getting to meet you and hearing about some of your experiences you know prior to our episode but I really appreciate you inviting me to this and I can't wait for everyone to hear about what we had to say today yeah absolutely</p>
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