Perspective: A framework for career paths in health systems improvement

Abstract

The difference between the U.S. health care system's potential and the outcomes it delivers is vast and well documented. Fortunately, many medical trainees recognize this challenge and aspire to careers that will enable them to help close this gap by improving the systems of care around them. However, the career paths in health systems improvement are not well defined, and interested trainees are frequently left without clear direction. The circuitous and often serendipitous routes that many current leaders in health systems improvement--including medical researchers, health system managers, and policy experts--have navigated to reach their positions of influence do not provide consistent road maps for the trainees who wish to follow in their footsteps.The authors of this Perspective propose a framework to guide career development in health systems improvement. The framework is designed to help medical trainees and their mentors critically analyze various career options in three core focus areas (research, policy, management) and the intersections where those areas overlap (policy advising, implementation science, policy translation).The authors provide examples of the types of work done in each focus area and each intersection to help trainees make explicit decisions concerning skill development and to select opportunities that best fit their interests and strengths. In all, the authors intend the framework to support the development of a generation of physician leaders equipped to drive the improvement that the U.S. heath care system requires.