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At the Forefront of Health Care Leadership: Three RWJF Clinical Scholars Alumni Reflect on Their Path to Becoming University Deans

At a time when physician training did not focus far beyond individual patient care, the Clinical Scholars program set out to break new ground in physician leadership. That was in 1972. Today, more than 1100 Clinical Scholar alumni are having an impact in every corner of health and health care. Among these exceptional alumni are three university deans who provide the strategic leadership and insight at some of the top schools for health education in the United States.

William B. ApplegateOne of them, William B. Applegate (UNC CSP ’75-’77) dean of the Wake Forest University School of Medicine, remembers thinking that while business and law school emphasized leadership across disciplines, “the primary emphasis in medical school was on taking care of the individual patients, and not on the larger issues related to health systems and public health.” Applegate was seeking an opportunity that a standard medical training program didn’t offer—a look at the bigger picture and the chance to be a health leader.

Linda RosenstockSo was Linda Rosenstock (Washington CSP ’80-’82) dean of the UCLA School of Public Health, who entered the Clinical Scholars program with a plan to improve the health of the underserved. “Most people in the program would define themselves as change agents, and the environment created by the program really gives you the opportunity to see what that means and understand what it takes,” explains Rosenstock.

The Clinical Scholars program was the first of its kind to integrate training in clinical medicine, public health and health services research. For Applegate, who participated in the second cohort at UNC just three years after the program was founded, the Clinical Scholars program was the only fellowship opportunity where he could receive academic training as well as look at health systems more broadly through health services research. Knowing how to think of health care from a systems-based perspective and how to address problems analytically and quantitatively, combined with the peers and mentors from the program, have helped guide Applegate throughout his career.  “Since the time I was a scholar, there have always been role models, mentors and colleagues, so you are never on your own,” says Applegate.

David  B. NashNearly 10 years after Applegate became a Clinical Scholar, David B. Nash (Penn CSP ’84-’86), founding dean of the Jefferson School of Population Health at Thomas Jefferson University, recalls that physician leadership was still being met with some skepticism, but “the Clinical Scholars program was establishing the credibility of a new leadership class in medicine.” This new leadership class was paving the way for a dramatic shift in health care. “Back then, we needed a protected environment, and we were accepted as part of an elite group of physician leaders,” says Nash.

For Nash, joining this elite group was 12 years in the making. As a high school senior, Nash was struck by the prophetic vision of Samuel P. Martin III, M.D., who founded the Clinical Scholars program at the University of Pennsylvania and was certain that one day health care would need professionally trained physician executives. Nash felt that the only way to become one of these physician leaders was to become a Clinical Scholar at the University of Pennsylvania. Today he is founding dean of the Jefferson School of Population Health, where he has created a program aimed at producing a new type of health leader—one who can tackle the complexities of managing population health and who can create meaningful policies to support those efforts. “There’s no school on how to be a dean, but the closest thing is being a Clinical Scholar,” says Nash.

Rosenstock credits the program as a once-in-a-lifetime opportunity to have “the freedom to tackle big issues and challenge the status quo.” When she entered the program, Rosenstock was determined to focus on underserved populations more broadly, and with the time, faculty and peer support she discovered an underserved population she had never considered: workers. Her experience as a Clinical Scholar launched an academic career in occupational and environmental health that spanned 15 years and led to an appointment as the director of the National Institute for Occupational Safety and Health (NIOSH). Her accomplishments, which included creating a framework for guiding occupational safety and health research, earned her the Presidential Distinguished Executive Rank Award, the highest executive service award in the government.

For these three deans, it is an exciting and truly opportune time to produce leaders who can fill the gaps in our health system and workforce. Applegate, for example, is working with his team to revise the Wake Forest medical school curriculum to emphasize the need for future physicians to assume leadership roles in American health care. Their students benefit from the multidisciplinary training and elite network they bring to their work every day.

The Clinical Scholars network of peers and mentors is vast and powerful, and continues to fuel the momentum that Applegate, Rosenstock and Nash built during the two-year Clinical Scholars program. “My peer group at the University of Washington was first rate, and the national group continues to be a phenomenal group of people that have emboldened me to know what I can accomplish as an academic,” says Rosenstock. Nash says he thinks about his cohort every day. “I call them to get advice around recruiting faculty, connecting at the national level, and influencing policy. And I get my phone calls returned…..e-mails, even faster.”

When Nash heard that one of his Clinical Scholar peers at the University of Pennsylvania, Risa Lavizzo-Mourey, M.D., M.B.A., was selected as the president of the Robert Wood Johnson Foundation, he saw it as “a telegraph to the world that we are picking one of our own because we believe so strongly in what this program is about.”

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