<p>hello everyone this is Cole from the American Journal of healthc care strategy and I am joined by a special guest Meredith Meredith please introduce yourself hi Cole thank you so much for having me my name is Merida Steinfeld I work at Nicholas Children's Health System down in Miami Florida as an administrative fellow [Music] and I have a background in public health so I got my master public health degree from tus University School of Medicine about a year ago and congratulations on getting that degree I know I believe your concentration was in biostatistics and epidemiology right yes I was really interested in biostatistics coming out of undergrad I got my bachelor's in sociology with a minor in biology and and had a little bit of a background in biostatistics from Hobart and William Smith colleges I graduated in 2020 in the height of the P pandemic I knew that I was interested in pursuing a graduate degree but I didn't really know um where it would take me I ended up finding tough's program with the concentration in biostatistics and ended up going there and the rest is history back at Hobart and William Smith you were also a evolutionary biology researcher right yes so the summer after my first year I was interested in and staying on campus and doing research I knew that I wanted to pursue a Premed track so I actually went through all of the prxs for medical school through undergrad I knew that I wanted to work in healthcare but I wasn't exactly sure what that path would look like for me I knew that I wanted to do research from the very start in undergrad so I took an intro to biology course during my first year of college I had a great relationship with my professor and ended up staying on campus that summer and doing a research study on esclipus Soraka otherwise known as the common milk weed it was a great summer I love my time in the The evolutionary bioinformatics lab so when I see people who've done evolutionary biology research I just love to have a brief chat about it because it's really an interesting experience they kind of just throw you right into it it's an awesome place to get some of that kind of experience working with professionals so that's awesome what made you get that mph instead of going into med school what did that transition look like for you yeah so I actually I grew up outside of Boston probably an hour away and so I was very familiar with the city I used to beg for my parents to take me to Boston on the weekends on my birthday that's all I wanted to do but ironically moved away for college and then when I was doing my online course work in the the mph program at toughs I wasn't in Boston so I ended up moving after undergrad to Rochester New York which is around 45 minutes away from Hobart and William Smith colleges and then I stayed there when I was doing my mph my online mph and that was one of the reasons why I was so interested in the program to begin with because it meant that I didn't have to move during the pandemic and the future was uncertain so I I just wanted to make sure that I didn't have to move to a new city and that I could stay where I was and so it was very convenient and it was also great because it allowed me to engage with people from all over the world um in my classes I did all the prxs for medical school throughout College around the summer going into my junior year I started becoming very passionate about social justice I had taken a few sociology courses and actually you know going into college I was a biochem major so I was really immersed in all the Sciences but I was a minor in sociology at the time I had never really heard of Sociology I didn't know what it was but I started taking more classes and becoming more passionate about social justice my freshman and sophomore year and then the summer going into my junior year I decided to switch so I became a sociology major with a biology minor and my senior year I ended up doing an honors study on masculinities and and social Justice and sexual violence prevention on college campuses and so I think part of it was being so passionate about social justice and wanting to continue to pursue some of the topics that I had learned about and been introduced to as a sociology major and also knowing that I wanted to continue on in healthc care and I didn't know exactly what that path would look like for me but I knew that I was interested in biostatistics and it was also the the second part of this is it was the height of the pandemic so I actually didn't have a graduation ceremony at the end of college I was part of the class that went to spring break and then got a letter you know at the end of spring break saying don't come back and and stay home and so I didn't really know what the future held at that time I knew what I didn't want to do was move across the country and go to medical school and start off in a new city when I didn't even know when the pandemic would end or or if it would end and what the future really held so I knew that I wanted to take a bit of a break I spent the summer deciding what the next steps would be and then I happened upon um tough's online M program um and it was my path forward so I I um saw that they had a biotics and epidemiology concentration it seemed like it would be the perfect marriage of sociology and social justice and healthc care I found that program and I never looked back what's great about that online program though right is that a lot of times when people think of online programs it's like you're going to be like isolated and you know but you were doing lots of things with toughs at the same time right you had three or four positions that you had kind of worked with the quality improvement side research assistance so how was that integration did you feel like you were part of the tough's community so that was actually one of the things I was most nervous about going into an online program however being part of that graduating class I graduated during the pandemic I had a little bit of an intro into what it would be like to learn online because from spring break forward until graduation and undergrad I was taking all of my classes online so that made me a lot more comfortable knowing I know how to use zoom I know how to use teams and you know no matter what I'll be successful taking classes online I think if the pandemic hadn't happened and I hadn't sort of gotten that intro into you know Zoom world and learning online I may not have felt as comfortable but once I started at toughs I made lots of friends I was able to establish relationships with all of my professors a lot of our classes actually started 15 minutes early so the zoom room would open up before class and I would say that was really how I started forming those relationships because I'm one of those people that likes to join early and start a conversation and learn about the people that I'm learning with and and the faculty and so I would always join 15 minutes early and stay 15 minutes late and it was those conversations that I had before and after class that really helped me start to form those meaningful relationships and opened up other opportunities outside of the the classroom so I was able to form those relationships and anytime I was taking a class that I had to a particular interest in the topics and wanted to gain hands-on experience in I would make that known to the professor and ask for opportunities to do extra assignments or get extra experience in the topics I was really able to work for the American Public Health Association work at ch's Medical Center become a teaching assistant and a research assistant it was really by just having conversations and expressing interest because the faculty at tus are all professionals outside for the most part professionals outside of being a professor so many of them work at organizations like T Medical Center the CDC the FDA all sorts of great organizations across the country and around the world and so you know they have a lot of resources and it's a a great opportunity to gain experience outside of the classroom so good advice as well for the faculty of other organizations on how to Foster that Community with an online program is is creating that opportunity before and after I really like that so you're really integrated in this program you did of course excellent you graduated with the perfect you know GPA there and so you've done really well in the Public Health Arena and then of course you're member of the American Public Health Association I'm a big fan of them as well and so you know then this Fellowship path presents itself you didn't end up going on to be an epidemiologist or to get a PhD like a lot of our mph colleagues do but you took this administrative Fellowship route how did that come up I kind of want to understand how you actually got introduced to that idea at what stage of your mph program then what made you choose that route this is another kind of funny story but I grew up thinking I was going to go to medical school I went into college Premed and I just expected life would be this you know clear path but it ended up being you know kind of twisty attorney and this is another example of that so I go into tus into my mph program thinking that I'm going to be an epidemiologist or biostatistician and then the first term of my mph program I take an elective course and it's sort of a crash course in an MBA that's how it's marketed so you learn basic negotiation skills financial accounting and I actually fell in love with the curriculum and it was kind of jarring to me because I was worried that I was in the wrong program I remember vividly having a conversation after class one of those 15 minute you know after class conversations with my professor and saying I really love the work that I'm doing I find myself at the end of the day when I shouldn't be doing any work when it's just my time to unwind doing your cases I'm enjoying the work so much and it's just exciting to me and am I in the wrong program should I you know I was in the first term with my mph program should I be in an MBA program and he said you're doing fine stay where you are if you're still interested in this material at the end of your program or in a year or so then reach out to me because at the time this was Professor Mark hos he was the executive director of medicine at T Medical Center and so at tus you have a practicum experience at the very end and so it's usually an an applied learning experience is what Al stands for and all students have to complete their Al and it's a term you know one semester long practicum opportunity and then present your findings and the project that you did um and he said if you're serious about this material and you would like to gain hands-on experience reach out to me when you're ready and we'll see if there's any project opportunities available so I'm one of those people that doesn't forget things and when I'm really interested in something I'll write it down and I'll just remember and so a year goes by and I'm still thinking about this MBA crash course class and excited to reach out to him so I emailed him I said I've gotten these experiences during my mph program I was research assistant and I worked with the men's health caucus at the APA and I've maintained my GPA and I would really love to work for you and he reached back out and he said I have a quality improvement project that's starting up soon if you're interested let me know and we can work together and so I ended up doing my Al with him and then at the end of the Al I said what now I'm finishing my M soon I am done with this Al and want to continue working on these topics I'm still interested in finance but like I said the mph program that was an elective course in in my first term so I didn't have much experience in finance or strategy and so how do I continue to gain experience in those areas and Professor hos was the one who said if you're if you continue to be serious about these topics and want to gain more experience there's something called an administrative fellowship program and you should really look into it there very competitive but if you are still interested then apply to a few and see if you get one and then pursue that path because this will expose you not only to finance and to strategy but you'll continue to gain experience in um quality improvement I knew that I was interested in that and I also was still interested in you know Community engagement and public health and epidemiology um and um data analytics so I felt like it was the perfect opportunity to continue to explore lots of different topics and not you know avoid pigeon hoing myself in one of them because I knew that I wasn't ready to really make the commitment yet to one of those fields actually very inspiring I'm sure we're probably going to use some of that answer for our shorts on Instagram as well because very inspiring let's go back for a minute though why you know it's funny because I'm sure maybe you did this I know we did during my biology major we made fun of the business majors right because the courses are like com we always said they were comically easy and I'm sure the business majors made fun of us later of course I became a business major in undergrad as well and so what did you like about that you know those business courses what particularly did were you doing that you said wow this is really cool I think for me it was being able to work with numbers in a different way possibly I mean I was used to working with numbers and and data analytics for biostatistics so all mys courses I learned how to code and to work in STA and that was really interesting to me but I think that working with numbers in a different way was kind of exciting and also being able to do cases and apply some of the things that I was learning to real world scenario so we used a lot of Harvard Business Review case studies and I think that was really exciting and I think part of me has always want wanted to work in healthcare administration and not necessarily known the words to use healthcare administ because that was never something that I had been exposed to so I didn't really know that healthcare administration was a thing the first Glimpse that I had into Healthcare admin you know case studies where I have to open an urgent care center in a mall and doing the analysis on is this going to be profitable you know it gave me some insight into the topics that I would be learning about if I were working in as an admin fellow and and Healthcare admin and so I think maybe part of me knew that was my path and that you know it was just really exciting to me but I also love negotiating and we had a few exercises where I got to do negotiations and just apply the things that I was learning about and I think that was always really exciting for me I think you gave a good answer for sure you know I love our mph research colleagues so much I think they're incredible people and one of the issues I know that some of them struggle with is okay you have this way of solving a problem but it's kind of in a vacuum sometimes where finances don't always play into it and so some of the most powerful people I've seen are are the people who have that mph background but also have that business background and then they're able to translate these hugely impactful social projects into something that could actually be profitable or at least have supporting revenue and I've seen that a few times at our institution so I think it's an incredibly powerful combination where you're able to translate things into that Financial backing one of the big questions I have for you is why did you choose the fellowship program that you did down in Florida especially as a northeasterner like myself what was that like and please tell us about the program that you chose yeah so I as I said before I'm at Nicholas children's system in Miami I had always wanted to live somewhere a bit warmer so I'll just be very upfront and transparent I was always interested in living in this part of the country but I started out really by looking at the different types of programs and the different models that were offered um because not all fellowships are equal I think that there are a lot of things that you need to consider if you're interested in one so there are some fellowship programs that are rotation based and some that are Project based and I knew that I wanted a bit of wol so I wanted to and they're also semi-structured rotations and then very rigid structured um rotations where you'll start and you'll be in finance for two months and then strategy for two months quality for two months and every fellow you know does sort of the same thing and goes through that cycle I knew that I wanted a little bit more flexibility from my fellowship program and and Nicholas really allows the fellow to sort of make their own path and tailor it to their own interest so that was the first sort of thing that stood out to me about Nicholas children's that made me interested in the program I also knew that Nicholas had one fellow at the time at we're actually growing our program so this July will be joined by two administrative fellows it'll be our first multi fellow cohort so super excited about that but when I was looking at administrative Fellowship programs I knew that I wanted to be a part of a program that gave me a lot of great exposure to Executive leadership and at Nicholas children's the fellow is really treated as part of the executive leadership team so we work in the SE Suite we report directly to the CEO Matt love and we gain a lot of exposure we sit in all the board meetings we go to Executive leadership team meetings and we gain a lot of insight into the way that leaders work and and the way that their minds work and how they make certain decisions I think that was also something that stood out to me because I ended up going through the first phone call interview and then the second round interview was with leaders you know director level leaders VPS fellows and then the third round was in person and I actually interviewed with the CEO with the president of the hospital Perry andne Reed and the chief of staff Dr mccaffery and so I think that interviewing in person and seeing the level of investment that the executive leadership team had and or had made in the fellowship program was something that stood out to me as well and then also being a Pediatric Health System so the culture is really different at Nicholas children's and it it sounds kind of cheesy but it's the truth so you know I interviewed in person at a few different hospitals and Health Systems Nicholas children's was the only one that I interviewed in person that was a children's health system and I really felt the difference so it's not a super corporate environment even though I'm working in the SE Suite I'm still surrounded by people who want to work with children and better you know the patients and the family's lives and the things that we do on our campus are just different it attracts a different um type of person I think and personalities and so you know we are Healthcare administrators but at the end of the day we just do things a bit differently and and you feel that so people come to work very happy and like you you get off the elevator and you're surrounded by people on a Monday morning and everyone's smiling and excited to go to work you know it's the only hospital that I can walk around in and I see clowns like walking by me and dogs running around it's just a a nice feel that they really like the environment more than they even expected to I think that being at Nicholas children's and and having experienced it I don't know that I could actually go into the adult world I think it' probably be easy to do the reverse and to work at an adult health system and then go into pets but I don't know that I could do the reverse at this point because it's such a nice environment to work in even though I might be staring at a a computer screen doing you know an analysis all day at the end of the day I know that I'm making the lives of of children better and even though my work might not be directly related to Patient Care Downstream I am having that impact um and it's something that every large meeting we have at Nicholas children's we start our meetings with a mission moment and so we start with a video of a patient and their story and it ties it back to the care that we're providing and so I think that also is very fulfilling to see the the impact that I'm having um as a fellow even though I might not be working with patients in my day-to-day it sounds like an incredible place to work congratulations on finding such an an amazing place I want to ask how many programs did you apply to initially that's a great question so I think probably around a dozen I don't have the exact number off the top of my that seems like a good average yeah I would say probably around a dozen I knew that the administrative Fellowship track back was extremely competitive and you know I've always been a type A personality worked hard and pushed myself but I knew that everyone else that was applying was the same way and so I knew that I needed to give myself options and it kind of felt like a good number I've met fellows who have applied to two to one and they got it and it worked well for them but I honestly I treated it like it sounds silly but I treated it a bit like the college application in a way I know that there are some people that apply to one college and they get in it's it works out but I used navus the sort of like common app for administrative Fellowship applications and did it that way and it made it very simple and streamlined and it worked out I'm really happy that it worked out I think that that's excellent it seems like you're extremely happy there so that's wonderful and how long is that is it a one year or twoyear Fellowship another good question it's a 12-month Fellowship uh program which is kind of flexible at at the same time so if you decide to transition into a full-time role early then that is an option but it's designed to be a 12mon program and I started in June I believe my end date is around June I I started June 26 and and that's around the end date sorry our next fellows are starting in the beginning of July oh nice so you well this is the big question is then what are you doing next where are you going to be in July I will be at Nicholas children's heal system I've really enjoyed my program I've made a lot of very meaningful relationships with all of our leaders I've really immersed myself in every aspect of our health system and I think if you know me you'll hear me saying this a lot at at Nicholas children's the most important part of the administrative fellowship program is the relationships that you build in my opinion so I've done lots of projects and going into it I thought that would be the most valuable aspect of it would be the experience I would gain but at the end of the day it really is the relationships that I've built and so you know I could take that elsewhere and maintain those relationships but I think it would be a lot more difficult and I really don't want to leave that behind so I'll be staying at Nicholas children's and you know excited to see what these next few years bring because that's one of the first people you met right at the beginning I I'm excited to continue on with those same relationships that I've built throughout my fellowship program to continue working with the same people and learning from them because I'm I'm at the start of my career I'm fresh out of graduate school I think that it's important to continue maintaining those relationships and learning from people who have so much great experience to offer and to learn from so kind of an extracurricular question for you for all of the people who are probably going to be so interested in coming to the Miami area for their Fellowship what is Miami area like we know that it's been increasing in the cost of living there as lots of people have been moving development Urban Development has been going really well in Miami for the administrative fellows is this a city where you have to have a roommate where you have your own apartment where you rent your own house is it an urban area what does that really look like for the fellows I think that really depends on on the individual I did move down here with a partner so I was able to split rent which was really nice I have friends that live with roommates and friends that live alone and I think that there are affordable places if you're just willing to hunt for them and to put in the time so I live relatively close to the hospital which is really nice especially because of Miami traffics Nicholas Children's Hospital is located in in the Coral Gables area it's actually a pretty residential area which is another reason I I forgot to mention this when I was answering why Nicholas children's but another aspect that I really love D about the hospital when I visited I had really never been to Miami before when I came down from my in-person interview I still remember I pulled up in an Uber right into the hospital and I remember thinking where is this hospital at first because we were pulling into the neighborhood and it's surrounded by residential homes and it's in the middle of a little neighborhood and it's very well hidden honestly so I was pulling up I saw we were only a few minutes away and I still didn't see the hospital after my interviews I walked out of the hospital and I walked around the neighborhood and it was very nice just to know that there were sidewalks and it was very walkable so often on my lunch I'll just walk around the neighborhood and it's just a really nice area and place to live so I'm lucky that I don't live too far and it is a very nice area I think I a lot of people think of Miami as very City lots of urban Sky Rises and nightlife and hustle and bustle like a mini New York City which there are areas that are like that Bickle is a really popular area for people to live and people do refer to it as a mini New York City but then we have Coral Gables which is closer to the hospital which is more residential lots of outdoor shopping outlets and restaurants and then you know Coconut Grove which is pretty close by as well so I would say those are probably the most popular areas for people to live close to Nicholas children's we have more residential and if you want to get in on the action and go into Brickle and be a part of the city lifestyle then that's an option too but I would say as someone who's lived here for around a year it pays to live close to the hospital because the traffic is real and so you know I can get up in the morning and be at the hospital within a half an hour from waking up and getting ready to being in at my desk and I know some people who are in the car for an hour and a half so you know absolutely well it sounds like an awesome place to live big difference of course from the Northeast Corridor for sure from what it sounds like so that's wonderful I'm so happy you found such a nice place and I hope that a lot of our future fellows are going to see this and consider applying so I really do appreciate you coming on and and talking with us and hopefully we can stay in touch thanks so much cole for having me it was a pleasure</p>