Healthcare Careerists - Middle is the New Early

A Research Brief By: Ashton O'Malley AO

October 23, 2017

This research brief was created with the purpose of establishing criteria to create an accurate timeline of career progression for healthcare administrators. The criteria aims to correctly identify positions for each professional on a scale from "Early" to "Middle," to "Senior" Career. This research lends itself to the construction of the Health Equity Leadership Pipeline Competency Analysis. This project is intended to establish a pathway between graduate students as emerging professionals and administrators as senior healthcare executives. Along with career progression, additional information is utilized. These include; race, gender, previous positions and undergraduate/graduate institutions. The criteria based around this career timeline in particular is in terms of healthcare leadership, specifically, rather than simply healthcare "administration." All participants have completed some form of an advanced degree and therefore, their early career positions are often labeled "master's entry level" or, more commonly, middle-management.

This review references peer-reviewed publications, personal interviews and public labor statistics which determines the position in the timeline primarily based on years of experience. Secondary factors include the growth of functioning areas and teams the administrator oversees. Moreover, the analysis takes into consideration the leadership competencies that accompany the progressive years of experience. Keywords used in research queries included "career, pathway, timeline, leadership, progression, healthcare and executive." Moreover, keywords and research strategies were changed in order to accommodate the specifications of each segment. This helped to clearly distinguish the years of experience associated with each level of career. Terms such as "manager", "director" and "executive" were used when delving further into the early, mid and senior segments respectively.

In accordance with multiple resources, the timeline for an "early careerist" is, on average, 0-5 years post-graduation. Appropriate keywords for this position type were revealed as; "administrative fellow, resident, manager, supervisor and project manager." The criteria of an early-career professional can vary. One text described an early careerists as having normally "2 years of project management experience". Further alluding to five years being the threshold as an early career professional, the most recent study released by the Bureau of Labor Statistics cites individuals have "less than 5 years". of experience in a related occupation before obtaining a position in the mid-career realm.

In terms of years of experience, the "mid career" portion of the timeline contains the most grey area. Although, some executives argue there was an obvious separation in responsibilities upon entering the mid-career threshold. Matthew Comstock, Chief Operations Officer and Executive Vice President of the University of Michigan Medical School claimed "there was a clear break". in terms of responsibilities when he attained his mid career position. This included a closer working relationship with higher level management and having a significant growth in team size from 5 to 60. These positions keywords were found as "director, clinical manager and senior project manager." Roughly 5-10 years post graduation is what was determined to be the most reasonable criteria relating to these positions. Additional labor statistics suggest these mid-career professionals have "more than 5 years of experience". In an interview with Mr. Eric Williams, Vice President of Transplant Services at Stanford Health Care, he posited that the labels associated with career growth were more subjective rather than standardized. For example, when asked about his own career progression, Mr. Williams said he had "more professional goals" for himself and considers his position mid career. Although many would consider a Vice President to be an executive role.

The title of executive often exists in the senior level. Evidence suggests many different fields of operation set different requirements for what is considered a senior position. Furthermore, research posits there is a clear distinction in requirements for senior managers and the c-suite level. For now, the term "executive" is going to summarize the following titles used in the prompt; Executive Vice President, Executive Director, Senior Vice President, President and C-Suite. The Bureau of Labor Statistics 2016 report supports this by showcasing that healthcare executives spent "5 years or more" in a somewhat related position before the promotion to the higher level. Moreover, other researchers attempted to summarize the overall "climb" of the career ladder for health administrators. For instance, in regards to non-clinical executives, "the time required to work up through the rank-and-file to 'CEO-qualified' is typically 15 years". These authors take into account all previous positions, including those attained in the early years. The evidence points towards a timeline of 7+ years post "mid career" to attain senior level career status.

In summation, the health administration career timeline can be quantified to a scale, based on years of experience. After acquiring a graduate degree, the early segment falls between 0 to 5 years, while anywhere from 5-10 years of experience will include mid-careerists and finally, senior level positions can be attained 7 years or more afterwards.

 **Ashton O'Malley is a Research Assistant in the Health Equity Leadership Pipeline Collaborative at the University of Michigan's School of Public Health. For more updates about the ongoing research, events, and news from the collaborative, follow us on Facebook, Twitter and Instagram!**