Management and Leadership Pathway

Future leaders in medicine must excel in the clinical arts as well as the complex management settings that now dominate health care. The Management and Leadership Pathway for Residents (MLPR) provides those future leaders with the knowledge and skills essential to bridge clinical practice and management and become effective physician executives. Identifying talented individuals early in their careers and providing management training and focused mentoring in addition to clinical expertise is critical to that development.

The MLPR is a 15- to 18-month rotational experience that allows trainees to work on high-priority initiatives across Duke Health. MLPR trainees study across multiple disciplines, including health-system management and operations; financial management and planning; quality improvement and safety; informatics; technology transfer; global strategy and business development; research enterprise management; clinical service enterprise management; and supply chain management.

To accommodate this expanded training alongside the demands of residency, MLPR trainees typically will add an additional year to residency or re-purpose built-in elective or research time. The 15-18 months of structured management experiences (modules) are intermingled with traditional clinical rotations in three- or six-month blocks. These management modules are project-based, with a clear work product produced by the end of each experience. Residents also engage in regular didactic sessions and structured learning programs.

Benefits of Participation

Through advanced management and training experiences, residents:

  • Receive exposure to the full breadth and depth of an integrated delivery network and learn to articulate issues in health care beyond a given specialty, hospital, or training program;
  • Learn how the clinical, research, and educational enterprises of an academic health system function within a framework of financial, managerial, regulatory, and entrepreneurial forces;
  • Acquire expanded knowledge of the administrative, financial, and organizational issues related to the management of health at individual, system, community, and population levels;
  • Participate in senior-level working groups, meetings, and retreats, representing unprecedented access to the "nerve center" of a world-class academic health system, its three hospitals, numerous clinical centers and institutes, and School of Medicine;
  • Interact with other MLPR trainees and brainstorm about project ideas and other areas of common interest;
  • Collaborate with a growing cohort of other MD-MBAs and physician executives at Duke Medicine; and
  • Receive mentoring by senior leaders at Duke.

By demonstrating excellence during the program, trainees become a part of Duke Health's talent pool and accelerate their course to becoming a physician executive.


The MLPR program allows trainees to (a) complete requirements for clinical practice and ABMS board eligibility and (b) participate in project-driven modules that provide solutions to high-priority issues within their clinical department and across Duke Health. Throughout the combined training program, clinical rotations and management modules are aligned to the extent possible.

Core Curriculum

Health System Management and Operations
One of the keys to successfully managing complex organizations is to understand the ways individual components interact with each other. Focusing on the multifaceted relationships among various parts of Duke Medicine builds greater insight into future needs of the organization and the best approaches to address system-wide needs. This rotation imparts trainees with the know-how to create efficiency on an organizational level by properly aligning multiple elements within the system.

Financial Management and Planning
Physician executives must be able to use the latest quantitative techniques and strategies to measure and improve a health system’s value and performance. This rotation imparts the knowledge, behaviors and confidence to meet the challenges of today’s real-world and real-time health care economy.

Selective Curriculum

Information Technology/Informatics 
Properly developing and deploying information technology and informatics capabilities plays an integral role in the success of major health care organizations. Developing fundamental knowledge about the role of information technology and potential innovations within academic health care provides the basis for future strategic planning. This rotation teaches trainees to use the tools of information technology to advance clinical care and health system management.

Hospital Operations
Inpatient care continues to represent a large part of a health system’s operational and financial foci. The hospital setting is ideal for trainees to learn the symphonic interplay among such diverse entities such as environmental services, food preparation, perioperative services, and others. This rotation will allow residents to participate in the daily activity of one or more of Duke Health’s hospitals.

Global Strategy and Program Development
Academic health care organizations, including Duke Medicine, are expanding their global presence. Future leaders must comprehend the changing global landscape for academic medicine and its potential impact to the organization. This rotation will educate trainees on how to generate synergies among global initiatives to further the mission of Duke Medicine.

Research Enterprise Management
Leaders in academic health care organizations must thoroughly understand the structure and management of research enterprises associated with these organizations. This rotation focuses on developing a deeper comprehension of the interplay between the clinical and research functions of major academic health care organizations such as Duke.

Clinical Service Enterprise Management*
Recognizing opportunities to expand services to meet demand is crucial to the viability of a health care organization. This rotation imparts an understanding of ways to grow and modify services in the midst of changing demographics, competitive reimbursement environments, and fluid institutional priorities. Trainees may choose to focus on a specific service line, such as the Duke Cancer Insitute or Heart Center.

Supply Chain Management
Understanding how supply chain activities, including management and negotiation of contracts for goods and services, logistics and materials distribution, and reduction of non-labor spending, impact the functioning of a health system is vital to a physician executive’s repertoire of skills. This rotation focuses on the acquisition of goods and services, supplier relationships, and cost reduction.


Who should apply?
Applicants should have already begun residency training at Duke to qualify for this program. Therefore, most will apply in December/January of their internship year. Interested trainees should have a record of excellence in his/her training program; a graduate degree in management (e.g. MBA, MHA, etc.) or a minimum of two years management/administrative experience; a sense of maturity with respect to career goals; and a history of taking responsibility and delivering results.