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Training the Next Generation of Physician–Executives: An Innovative Residency Pathway in Management and Leadership

Ackerly, D. Clay MD, MSc; Sangvai, Devdutta G. MD, MBA; Udayakumar, Krishna MD, MBA; Shah, Bimal R. MD, MBA; Kalman, Noah S.; Cho, Alex H. MD, MBA; Schulman, Kevin A. MD; Fulkerson, William J. Jr MD; Dzau, Victor J. MD

doi: 10.1097/ACM.0b013e318212e51b
Leadership Development

The rapidly changing field of medicine demands that future physician–leaders excel not only in clinical medicine but also in the management of complex health care enterprises. However, many physicians have become leaders “by accident,” and the active cultivation of future leaders is required. Addressing this need will require multiple approaches, targeting trainees at various stages of their careers, such as degree-granting programs, residency and fellowship training, and career and leadership development programs. Here, the authors describe a first-of-its-kind graduate medical education pathway at Duke Medicine, the Management and Leadership Pathway for Residents (MLPR). This program was developed for residents with both a medical degree and management training. Created in 2009, with its first cohort enrolled in the summer of 2010, the MLPR is intended to help catalyze the emergence of a new generation of physician–leaders. The program will provide physicians-in-training with rigorous clinical exposure along with mentorship and rotational opportunities in management to accelerate the development of critical leadership and management skills in all facets of medicine, including care delivery, research, and education. To achieve this, the MLPR includes 15 to 18 months of project-based rotations under the guidance of senior leaders in many disciplines including finance, patient safety, health system operations, strategy, and others. Developing both clinical and management skill sets during graduate medical education holds the promise of engaging future leaders of health care at an early career stage, keeping more MD-MBA graduates within health care, and creating a bench of talented future physician–executives.

Dr. Ackerly is research fellow, Duke Clinical Research Institute at Duke University, Durham, North Carolina, clinical fellow, Harvard Medical School, Boston, Massachusetts, and a resident in internal medicine, Massachusetts General Hospital, Boston, Massachusetts.

Dr. Sangvai is assistant professor in community and family medicine, pediatrics, and psychiatry and behavioral sciences, Duke University, Durham, North Carolina.

Dr. Udayakumar is assistant professor of medicine and global health, Duke University, Durham, North Carolina, and assistant professor, Duke-National University of Singapore Graduate Medical School, Singapore.

Dr. Shah is assistant professor of medicine, Duke University, Durham, North Carolina.

Mr. Kalman is an MD/MBA student, Duke University, Durham, North Carolina.

Dr. Cho is assistant professor of medicine, Duke University, Durham, North Carolina.

Dr. Schulman is professor of medicine, Gregory Mario and Jeremy Mario Professor of Business Administration, and associate director, Duke Clinical Research Institute, Duke University, Durham, North Carolina.

Dr. Fulkerson is professor of medicine, Duke University, and executive vice president, Duke University Health System, Durham, North Carolina.

Dr. Dzau is James B. Duke Professor of Medicine and chancellor for health affairs, Duke University, and president and chief executive officer, Duke University Health System, Durham, North Carolina.

Please see the end of this article for information about the authors.

Correspondence should be addressed to Dr. Dzau, Office of the Chancellor, Box 3701 Medical Center, Duke University, Durham, NC 27710; telephone: (919) 684-2255; e-mail:

First published online March 23, 2011.

© 2011 Association of American Medical Colleges