From Administrative Fellow to Program Manager of Clinical Operations

In a recent episode of the Fellowship Review through the American Journal of Health Care Strategy, host Vrushangi Shah, MHA sat down with Madeline Cremin, MHA , a seasoned Program Manager at Mayo Clinic . What makes Madeline's journey so compelling is how she transitioned from her graduate school days at the 美国密苏里大学哥伦比亚分校 into a coveted hospital administrative fellowship at Nicklaus Children's Health System in Miami—and then on to a leadership role at one of the nation's top integrated healthcare systems, the Mayo Clinic . This conversation unveiled a trove of insights into the admin fellowship application process, the importance of mentorship, and adapting to new professional cultures and settings in healthcare management.

Below is a closer look at how she navigated these milestones, the lessons she learned, and the advice she offers to those aspiring to follow a similar path in healthcare administration fellowships.

1. The Educational Foundation and Early Healthcare Exposure

Madeline grew up in Chicago and eventually chose the University of Missouri (often referred to as "Mizzou") for her undergraduate and graduate studies. She began her academic journey in Health Sciences, later pursuing a Master of Health Care Administration (MHA). These years proved to be critical, as she dove into hands-on experiences that introduced her to the complexity of healthcare administration and the healthcare continuum.

One of her earliest roles was as a Care Transition Resource Specialist at MU Health Care, which gave her a foundational understanding of hospital functions, electronic health records, and institutional policies. However, it was her administrative internship—supported by MU Health Care—that truly allowed Madeline to test the waters of hospital administration and gain exposure to operational program development.

From this internship alone, she gained a taste for large-scale process improvement and strategic planning. The exposure to ambulatory care—often touted as the future of healthcare—reinforced her desire to play a larger role in health system operations and pursue an MHA fellowship.

2. Deciding on a Fellowship

While wrapping up her graduate program, Madeline wrestled with the question many MHA graduates face: Should she enter consulting, pursue a direct hospital operations role, or apply for administrative fellowships? She was drawn to the fellowship route by stories from peers and mentors who described it as a rare opportunity to interact with senior leadership, gain holistic organizational insights, and steer high-impact projects in healthcare management.

She also added that if she didn't secure a fellowship, she was open to exploring other options. However, once she fully committed to the application process, she realized just how rigorous—and rewarding—it could be. This led her to research what is an administrative fellowship and how it could benefit her career in healthcare administration.

3. Navigating the Application Journey

Madeline's organizational strategy was one of the key elements of her success in landing a healthcare administration fellowship at Nicklaus Children's Health System. She applied to roughly 10 to 15 fellowships, creating an Excel spreadsheet to keep track of deadlines, application requirements, and follow-up tasks such as reaching out to fellows on LinkedIn or attending informational webinars about top administrative fellowship programs.

Ultimately, her preparation paid off. She secured interviews and found Nicklaus Children's particularly appealing after visiting in person. She described how important it was for her to feel the culture firsthand, meet key leaders, and see the environment. It helped that the children's hospital exuded a sense of warmth, positivity, and mission-focused care, with a strong emphasis on community health and health equity.

4. Fellowship Format and Experience at Nicklaus Children's

Nicklaus Children's fellowship was (and still is) a one-year program, though the structure has evolved slightly since Madeline's time. When she was there, she was the sole fellow, shouldering all major projects that came through. Since then, the program has expanded to include two fellows who share responsibilities—a change Madeline sees as positive for healthcare admin fellowships.

4.1. Rotations and Projects

The fellowship was rotation-based with a heavy focus on projects, aligning closely with the typical administrative fellow job description. Early rotations allowed Madeline to orient herself, meet department heads, and explore service lines. Eventually, larger initiatives took center stage, where she found herself employing process improvement and organizational development tactics across the system, gaining valuable experience in project management and change management.

4.2. Mentorship Structure

Nicklaus Children's offered Madeline ample face time with C-suite executives, including the CEO and COO, as well as a Vice President of Quality who provided close mentorship. Yet, the structure was flexible. She was encouraged to seek out additional mentors on her own, which is a common feature in many healthcare administration fellowships.

4.3. High-Impact Projects

One especially memorable project tackled hand hygiene compliance. What began as a straightforward quality initiative soon turned into a systemwide overhaul, showcasing the importance of operational excellence in healthcare:

• Moving from clipboard tracking to a badge-sensor system for real-time compliance monitoring.
• Rolling out a new hand-hygiene product that staff felt comfortable using.
• Creating engagement strategies to ensure staff understood the "why" behind stricter compliance measures.

It was a microcosm of what administrative fellows do best: bridging clinical imperatives with operational realities, aligning departments with quality goals, and carefully managing cultural change so that improvements stick. This project also gave Madeline insight into value-based care and population health initiatives.

5. Living and Working in Miami

Another significant facet of Madeline's fellowship was relocating to Miami, which stood in stark contrast to her Midwestern upbringing. Though she had visited South Florida before, she quickly realized that "visiting" is different from "living."

She quickly learned that adapting to a new city is about embracing cultural differences, learning basic language skills (in this case, Spanish) to better connect with colleagues, and finding joy in local traditions—from food to community festivals. This experience proved valuable in understanding diverse patient populations and the importance of cultural competence in healthcare management.

6. Transition to Mayo Clinic

After completing her fellowship, Madeline leveraged her expanded network and newfound confidence to transition to Mayo Clinic as a Program Manager for General Internal Medicine. She credits both her academic background and fellowship experiences—especially the cultivation of relationships—as pivotal to this jump into a role focused on medical group operations and clinical service lines.

This transition showcased how administrative fellowships can serve as a talent pipeline for integrated healthcare systems, preparing fellows for roles in performance improvement and practice integration.

7. Advice for Future Fellows

Having weathered the highs and lows of fellowship applications, cross-country moves, and high-stakes projects, Madeline offered some final words of wisdom for those considering healthcare admin fellowships or healthcare administration fellowships in 2024:

1. Embrace Multiple Mentors
2. Be a Sponge Focus on learning from every department you rotate through. Ask questions relentlessly, because the fellowship is your chance to see how the entire system operates and gain insights into the healthcare continuum.
3. Get on the Floor Shadowing experiences are invaluable. Whether it's observing a surgery, understanding how the cafeteria operates, or standing alongside nurses during shift changes, these experiences help you see the human side of healthcare operations and patient care services.
4. Stay Organized During the Application Process Use spreadsheets to keep track of deadlines, application requirements, interviews, and follow-ups. Personalize each application and connection; sincerity can stand out in a sea of applicants for top administrative fellowship programs.
5. Build Deep Relationships Yes, projects and rotations are crucial. But Madeline stresses that building relationships with people across the organization—especially senior leaders—pays long-term dividends and enhances your understanding of physician relations and the overall healthcare management landscape.

Conclusion

Madeline Cremin's story underscores the transformative power of an administrative fellowship, not just for acquiring technical skills, but also for shaping one's broader approach to leadership, relationship-building, and cultural adaptability in healthcare administration. From her initial administrative internship at MU Health Care to her year-long fellowship at Nicklaus Children's Hospital, she gleaned lessons in process improvement, data-driven decision-making, and patient-centered care—all under the guidance of experienced healthcare executives.

Today, as a Program Manager of Clinical Operations at Mayo Clinic, Madeline continues to apply those lessons, crediting her fellowship with accelerating her professional growth in ways she never imagined. Her journey serves as a testament to the depth and breadth of opportunity that a well-structured hospital administrative fellowship can provide.

For aspiring health administrators, her path offers a clear message:

• Seek out diverse experiences in operations, strategy, and quality.
• Immerse yourself in new cultures and departments.
• Invest in relationships, because mentors often become champions who open unforeseen doors.

Above all, Madeline's trajectory illustrates how a healthcare administration fellowship can be the perfect launchpad for those aiming to make an impact in the ever-evolving world of healthcare leadership, preparing them for roles that require a deep understanding of strategic planning, business planning, and the overall healthcare management landscape.