COVID Concerns Slash Leadership Internships and Fellowships

Educators worry that the very leaders who will define post-COVID healthcare leadership won't have quality experience during the crisis.

In most years, June would be a busy month for thousands of future healthcare leaders as MHA graduate students would begin summer internships at hospitals and health systems. The COVID19 pandemic has forced almost half of those health systems to withdraw those internships for safety, financial or bandwidth issues.

With no clear end in sight, educators worry that the very leaders who will define post-COVID healthcare leadership won’t have quality experience during the crisis itself.

“It's a gigantic missed opportunity,” says Andrew Garman, Director, Rush Center for Health System Leadership at Rush University, and professor of health systems management. “We've got a whole generation of future leaders on the sidelines, and that's not where they should be at this point in their learning, career development and experience. We're losing a huge opportunity to transfer knowledge.”

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Mark Herzog, retired CEO of Holy Family Memorial in Manitowoc, Wisc., and adjunct professor and Executive in Residence at the University of Michigan Health Management and Policy Program, agrees.

“Beyond the obvious importance of beginning careers,” says Herzog, “this crisis presents opportunities for knowledge and skill development that will absolutely be needed again down the road.  Some of these early careerists could be the leaders who really make a difference in future outcomes because of the fresh perspectives to problem solving they represent.  This is the big picture, and everyone benefits by extending internship and fellowship commitments.”

Nitasha Kassam, Program Manager for the National Council on Administrative Fellowships in Chicago, says a April survey of 42 member health systems found that 52% still plan to offer a summer internship program in 2020, with 33% of respondents not offering any program, and 14% unsure. That same survey of 27 graduate programs said that 67% had seen summer internships canceled.

The April survey also found that 88% of administrative fellowships—entry-level positions for 2020 MHA graduates--were going ahead as scheduled for 2020. Another survey in May found that number had dropped to 82%.

The operational and financial issues are legitimate and complex, Garman says. Many health systems have partitioned their executive and administrative teams away from clinical teams to protect both, so being able to keep the interns and fellows safe is a major factor. Housing for interns is also an issue, as they often find group housing. Finding the money to pay interns--nominal as it may be in a normal year—also becomes more difficult as many hospitals have seen pay cuts, furloughs an even layoffs as their operational revenues have dropped.

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“Interns may get overlooked because they are not in the organizations yet and mat be pretty far down the list of concerns and considerations,” Garman says. “But this is a once-in-a-lifetime learning opportunity for these students. They are desperately wanting to take in everything they're learning and apply it to improving and helping the health systems. And these interns really can help the health systems. I worry that many of them will end up in the gig economy doing whatever they can for the summer versus building their skills and contributing to the health systems.”

One option might be virtual internships, but the NCAF April survey found that only 24% of fellowship and internship sites would consider a virtual option. The NCAF is asking health systems to reconsider virtual options or other contingencies that would preserve the experience for graduate students in 2020.

“Find an option that would work for your hospital, your health system, as well as the student,” Kassam says. “Develop some sort of virtual internship option or a hybrid that would allow students to still gain that experience. Or consider looking at a fall internship model so that the internship experience is not lost completely.”  Interested health systems are encouraged to access the free guides to fellowships and virtual internships provided on NCAF’s website.

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Garman says a few MHA programs have lined up alumni and philanthropic support to provide stipends so their student can still work in healthcare. Whatever the result this summer, Garman and Kassam are hopeful that 2021 fellowships return to normal. The May survey found that 78% of their member fellowship sites are proceeding as planned for 2021. The fear is that without support, these programs may lose ground in their goal of bringing more talented and diverse leaders into healthcare.

“A lot of these fellowships were set up explicitly with goals like diversifying senior leadership teams’ gender or ethnic composition,” Garman says. “Curtailing administrative fellowships could slow down progress in creating more diverse and equitable leadership broadly across the health systems, which would be really unfortunate.”