Exploring obstacles to success for early careerists in healthcare leadership.

Abstract

INTRODUCTIONA young man of Caribbean descent from a two-parent home attended a top-tier pre-med program, majoring in science and language. After graduation, he worked for a year and was quickly promoted into a leadership position. Discovering his natural leadership abilities, he began to explore a career in healthcare management.He was surprised to learn that his alma mater offered a master of health administration (MHA) program and enrolled immediately-no one on campus had spoken with him about healthcare administration when he was an undergraduate there.During his time as an MHA student, the young man was accepted to a 10-week internship through the Institute for Diversity in Health Management's Summer Enrichment Program-it was his first experience working in a hospital setting. As a result of his limited exposure to prior healthcare leadership roles, he was later denied acceptance to paid administrative fellowships at two top medical centers.Compare this young man's experience with that of a minority administrative fellow candidate who had attended a top-ranked graduate school, aced her health system fellowship interviews, completed her fellowship program early, and accepted an impressive position at the health system. The difference between the two is that she comes from a well-educated, influential family that boasts multiple generations of physicians and CEOs. From an early age, she was exposed to healthcare topics in conversations around the dinner table and in social and civic gatherings, with her parents' friends and associates-all this enculturation prepared her to understand the context of healthcare delivery and access. The young man, on the other hand, lacks influential family and friends who could have introduced him to the healthcare leadership context early on.Considering that the U.S. population is shifting from a white majority to a minority makeup, healthcare leaders from diverse backgrounds will be essential to delivering culturally appropriate care to the chronically ill and the burgeoning elderly population and addressing the shifting health needs of our population. Yet the lack of exposure to the healthcare environment is but one-albeit a crucialobstacle that many early careerists face as they launch their careers. Will we have enough diverse, qualified leadership talent in the pipeline to run our complex, dynamic organizations?ISSUES SURROUNDING STUDENT PREPAREDNESSThe good news is that the healthcare management field is attracting online, evening, and part-time students in addition to those in traditional, full-time master's programs, which are expected to yield an increasingly diverse talent pool. But my 20-plus years of experience as the head of a search firm known for specializing in, and committing to, mentoring, coaching, recruiting, and placing diverse talent has shown me that obstacles remain for students from diverse backgrounds. For several years, my firm helped recruit minority postgraduates into a competitive, two-year, paid administrative fellowship program for a large health system in the Midwest. We found that selecting even a cohort of seven fellows was challenging. Of the more than 50 postgraduates and early careerists who were vetted, nine were invited to participate in onsite interviews and complete a competency inventory assessment. Unexpectedly for many of the candidates, the overall evaluation scores revealed deficits in communication, analytical, and critical thinking skills-all areas that are vital to effective leadership. The candidates, having performed well in graduate school, were disappointed with the outcome and questioned the validity of the scores. It further confirmed my previous observation that there exists a disconnect between some graduate program requirements and curricula and those of today's health system.Quality of Unaccredited Health Administration ProgramsThe recent proliferation of health management programs includes many that lack Commission on Accreditation of Healthcare Management Education accreditation, graduating students who are inadequately prepared. …