The overall goals and objectives of this program are to provide each fellow with:

• The opportunity to work and assume administrative leadership experience while working under the mentorship of department leadership
• An in depth working knowledge of ED operations, process improvement, and administrative leadership
• Further improvement and development of healthcare leadership skills
• Refinement and broadening of residency training skills at one or more of the affiliated hospitals
• Academic training that is consistent with the long-term goals of the candidate
• These program objectives align with the six core competencies for emergency medicine:
• Patient care. The fellows will continue to refine their clinical skills in the care of the full spectrum of emergency department patients at our clinical sites. They will be evaluated by residents and medical directors. They will also receive feedback on performance on quality metrics.
• Medical knowledge. The fellows will continue to acquire knowledge through conference attendance, independent reading and board certification preparation.
• Professionalism. The fellows will gain understanding in the elements of professionalism expected not only of emergency physicians, but physician leaders through the fellowship and associated coursework.
• Systems-based practice. This is essentially one of the foci of the fellowship: learning how to optimize the delivery of emergency care from a departmental and system perspective. This includes any associated advanced degree work.
• Practice-based learning and improvement. The fellow will be included in administrative meetings at all levels and asked for input; feedback will be provided in discussion with leadership teams.
• Interpersonal and communication skills. Again, this is another critical element in the fellowship. The fellow will receive education and feedback on their communication skills. This will be included in any advanced degree work.

• Identify an operational opportunity for improvement
• Design and implement an operational improvement project
• Prepare a financial analysis of an operational project
• Develop leadership, communication and teamwork skills to implement an operational project.
• Identify the leadership skills for success at the local and national level
• Describe techniques for evaluating and optimizing operational efficiency
• Demonstrate conflict resolution techniques
• Submit an abstract for publication or presentation at a regional or national meeting
• Deliver a lecture within the residency program on an administrative or leadership topic

Brown offers a one or two year curriculum that allows each fellow the flexibility and depth of training in clinical, experiential administrative training, and academic training.  The diversity of clinical sites and the associated administrative experience will allow each fellow to develop an in depth experience in each practice environment.  As such, the curriculum includes combining the clinical and administrative experience at several sites.

Fellows pursuing the one year track will complete the first 2 phases of the ACEP Emergency Department Directors Academy. These two national conferences provide foundational training in the essentials of Emergency Department administration. Fellows will also have the opportunity to attend the Emergency Department Innovations conference to acquire additional training in ED operational efficiency.

Fellows will have dedicated training by affiliated experts on topics  including Audit and Compliance, Billing, Coding and Reimbursement issues, Advocacy and Media training, Conflict Resolution, Contract Negotiation, Healthcare Finance, Academic Practice Plan development, Budget Preparation and Review, Human Resource Issues, and Leadership Development.

Fellows will attend monthly meetings at their assigned site including the hospital level Medical Executive Committee and site Clinical Operations meetings, Brown EM level Clinical Operations, Finance and Negotiations, and Brown-wide departmental Faculty meetings, as well as the quarterly network level Brown University Health Emergency Services Council. 

Fellows pursuing the two year track will have the option of enrolling in an approved advanced degree program or certificate program. These include a Brown MPH and/or a 2-year M.B.A. program at Bryant that dovetails with the ED schedule, with classroom work required two evenings per week.