Physicians spend years mastering the science and art of patient care. What most do not receive during medical school, residency or fellowship is formal training in how healthcare organizations operate, strategic decisions are made and leaders influence quality, safety and patient outcomes across an entire system.

Houston Methodist aims to change that through its new Accreditation Council for Graduate Medical Education (ACGME)-accredited Healthcare Administration, Leadership and Management (HALM) Fellowship, one of only 11 such programs nationwide and the first of its kind in Texas.

"Nationally, relatively few physicians lead hospitals," says Jonathan Rogg, MD, chief quality officer for Houston Methodist Hospital and director of the HALM Fellowship. "You learn to be a good doctor in medical school and residency, but you don't learn much about leadership, and there's no formal pathway to becoming a leader."

That gap in this training led to the creation of HALM as a new subspecialty. Approved by the ACGME in 2023, the fellowship provides a structured, nationally recognized pathway for physicians pursuing leadership careers.

A new specialty in physician leadership

For decades, physicians who moved into executive, administrative or operational roles largely learned on the job. While many became highly effective leaders, healthcare's growing complexity has created demand for more formal preparation.

The HALM fellowship is unique because it is the first ACGME-accredited, board-certifiable, non-clinical specialty for physicians.

"In the same way that physicians can become board certified in cardiology or internal medicine, they can now become board certified in healthcare administration, leadership and management," Dr. Rogg says. "To me, it's less about the certification itself and more about creating a rigorous training pathway for physician leaders."

The fellowship is intended for physicians who have recently completed residency or fellowship training, or who are within the first few years of practice and are interested in leadership roles within healthcare organizations.

Learning leadership by doing

The two-year fellowship combines hands-on learning, executive mentorship and project-based work. Rather than relying primarily on classroom instruction, fellows rotate through leadership roles at Houston Methodist while participating in real-world organizational initiatives.

"Our goal is to provide a program that is very much experiential and project-based because that's what works for physicians and adult learners," says Dr. Rogg.

Fellows will work directly with physician and non-physician leaders across the Houston Methodist system, including hospital CEOs, chief quality officers, chief medical information officers and other executive leaders. Through these rotations, participants gain firsthand exposure to the decisions and challenges that shape healthcare delivery.

"Physicians have unique insights into patient care and healthcare delivery. This fellowship provides them with the knowledge, experience and mentorship to turn those insights into meaningful leadership."

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Jonathan Rogg, MD

The curriculum focuses on competencies that are rarely emphasized in traditional medical training but are essential for leadership, including:

• Quality and patient safety

• Healthcare finance

• Strategic planning

• Operational management

• Change management

• Physician engagement

• Health informatics

• Organizational leadership

"This is a much broader view of what's important for physicians," Dr. Rogg says. "How do you lead other physicians? How do you improve quality? How do you make care more efficient? How do you understand how healthcare is financed and delivered? These are the issues an administrative fellowship allows physicians to explore."

Unique exposure across an integrated health system

One of Houston Methodist's distinguishing advantages is the breadth of leadership experience available across the system.

Unlike programs centered on a single hospital, the HALM fellowship provides exposure to an academic medical center, network hospitals and a physician organization.

"You get the academic hospital experience, the community hospital experience and the physician-organization experience," Dr. Rogg says. "You really get to understand leadership within a complex hospital system, and that's unique even among the programs that currently exist."

The fellowship also builds on Houston Methodist's long-standing success in developing healthcare leaders through its administrative fellowship program. While that program has traditionally focused on nonphysician trainees, the HALM fellowship offers a complementary pathway designed specifically for physicians.

Multiple paths to leadership

The fellowship is not designed to prepare physicians for a single leadership role. Instead, it provides a foundation that supports a wide range of career paths.

Participants may ultimately pursue positions such as:

• Chief Quality Officer

• Chief Medical Information Officer

• Department Chair

• Chief Medical Officer

• Hospital CEO

• Graduate Medical Education Leader

• Strategic Operations Leader

"There are many physician leadership roles in healthcare," Dr. Rogg says. "The fellowship is for physicians who want to take on a broader leadership role while maintaining their connection to patient care."

Fellows continue clinical practice during training, enabling them to stay engaged in medicine while broadening their impact beyond individual patient encounters.

Leadership development beyond the fellowship

As part of their training, fellows will participate in the Houston Methodist Physician Organization Leadership Development Program, offered in partnership with Rice Business Executive Education at Rice University. The program offers additional opportunities to study leadership principles, collaborate with other emerging physician leaders, and learn directly from faculty and healthcare executives.

The fellowship also encourages participation in scholarly work related to quality, safety, well-being and healthcare operations.

Investing in the future of healthcare

Houston Methodist plans to accept up to two fellows annually, forming a small cohort intentionally designed to maximize mentorship, executive access and individualized development.

Recruitment for the inaugural class is already underway, with training set to begin July 1, 2027. Applications are open nationwide, reflecting the program's goal of attracting exceptional physician talent from across the country.

"We certainly hope fellows stay here and become leaders at Houston Methodist," Dr. Rogg says. "But having this type of program is also attractive to physicians, faculty and trainees nationwide."

Ultimately, the fellowship is about more than leadership titles. It is about equipping physicians with the skills to influence quality, improve systems and shape the future of healthcare delivery.

As healthcare systems continue to evolve, Houston Methodist's HALM Fellowship represents an investment in a new generation of physician leaders, professionals who are not only skilled clinicians, but also prepared to guide the organizations that care for patients, physicians and communities alike.

"The goal is to create a formal pathway for training physician leaders," Dr. Rogg says.