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 The rotational experience that allows trainees to work on high-priority initiatives across the Duke University Health System and the School of Medicine. MLP residents study multiple disciplines, including service delivery; financial management and planning; quality improvement and safety; information technology; global health care; population health; business development; and school and department operations.

To accommodate the above, MLP residents will add a PGY-4 year to a three-year residency program, or re-purpose built-in elective or research time within longer programs. The 15-18 months of structured management experiences (modules) can be intermingled with traditional clinical rotations in six-month blocks. These management modules will be project-based, with a clear work product that can be produced in three to six months. Residents will also engage in regular didactic sessions and structured learning programs.

Current Management & Leadership Pathway Residents

Benefits of Participation

Through advanced management and training experiences, residents:

  • Gain exposure to the full breadth and depth of a world-class academic health system;

  • Learn to articulate issues in health care beyond a given specialty, hospital or training program;

  • 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 MLP-R trainees and brainstorm about project ideas and other areas of common interest;

  • Collaborate with a growing cohort of physician-executives at Duke Health;

  • Access career growth opportunities across Duke Health; 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 MLP-R program allows trainees to (a) complete requirements for clinical practice and ABMS board eligibility (and where applicable, specialty board certification), and (b) participate in project-driven modules that provide solutions to high priority issues within their clinical department and Duke Health. Throughout the combined training program, clinical rotations and management modules will be 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

  • Health IT, Analytics, and Data Science
  • Patient Quality Improvement and Safety
  • Global Strategy, Innovation, and Business Development
  • Clinical Service Enterprise Management
  • Department Management and Operations
  • Public Affairs and Government Relations
  • Supply Chain Management

Learn more on the Duke GME website and view the MLP-R handbook and course catalog.


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.