Deland Fellowship in Health Care and Society Candidate Application Contact Information Name ___________________________________________________________________________ (Last) (First) (Middle) Address_________________________________________________________________________ City______________________ State____________________ Zip Code_____________________ Telephone___________________________ E-Mail_______________________________________ Required Materials Curriculum Vitae or Resume’ Graduate Program Transcript References Please list below three to four individuals who are willing to provide feedback on your candidacy including: A current or past supervisor (as applicable) Professor or academic advisor (1 or 2 individuals) *We reserve the option to contact these references at various points during the recruiting process. Name Position/Organization Relationship Telephone ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ Candidate’s Statement The Deland Fellowship in Health Care and Society at the Brigham and Women’s Hospital seeks to train outstanding leaders in healthcare. Professionals embarking on a career in healthcare administration will benefit from the Deland Fellowship which combines clinical exposure with financial and management training, thereby providing a distinctive and unique learning opportunity in health care delivery. Answer the following questions in a separate document and attach them to the application. (Please include your name in the upper-right hand corner of all pages.) 1. Identify two areas or issues within healthcare administration that are of particular interest to you. a. What past experience or course of study has fostered these interests? b. How does each area or issue integrate into your near-term professional goals? (one-half to one page, single-spaced) 2. What two or three experiences or opportunities are most critical to your development as a future leader in healthcare? What aspects of the Deland Fellowship program will help you meet these goals? (up to one-half page, single-spaced) 3. Hospital administrators face a variety of challenges in their daily work including balancing the needs of multiple stakeholder groups, working under aggressive timelines, communicating effectively to a diverse audience, and maximizing the effectiveness of the teams that they work with. Please share an experience in which you had a leadership role and were required to deal with some or all of the above challenges. What steps did you take to respond to the situation? What was the outcome of the effort? What, if anything, would you have done differently if given the chance? (up to one page, single-spaced) Please submit a completed application and supporting materials via e-mail to bwhdeland@partners.org