Today’s healthcare workforce is thinner, more mobile, and under constant pressure. That means organizations can’t afford leadership gaps. Building a strong bench from the ground up creates continuity, protects institutional knowledge, and reduces overreliance on costly external hires—while signaling to early-career talent that you intend to invest in them.

When you ask Emerson Health why they invest in internships and a one-year fellowship—especially when budgets are tight—the answer comes back to strategy and values: grow the people who will carry your mission. In a recent Healthcare Plus Podcast conversation with Quint Studer, Emerson’s Christine Schuster, Craig Nesta, and Michael Tracy walk through a pipeline that starts with paid internships, moves into a fellowship with real responsibility, and increasingly ends with alumni leading service lines across the enterprise.

A few insights from the podcast:

Keep funding the pipeline (even in lean years). Emerson treats talent development as a long game. Their stance is simple: if you want great care for patients, you need great people—and you can’t shrink your way to a strong bench.

“You’re not going to be able to cut your way to success,” says Schuster. “But if you grow people that share your organization’s values, that put the patient at the center, you will have the horsepower to step up and meet the challenges, financial, clinical, whatever the world brings your way.”

Great internships aren’t about shadowing and coffee-runs. They’re about deep learning and mentoring. Emerson places about between 10 and 12 interns every summer from mid-May through mid-August at the graduate and under. Interns are embedded in real practices and supported by a layered mentoring structure: a direct manager, peer “buddies” who’ve been through the program, and senior leaders who stay close. Relationships with academic programs and regional partners (including Mass General/Brigham) expand the learning surface and strengthen the pipeline.

Make fellowships hands-on. At Emerson, administrative fellows step into operations early, learn standards and accountability, and practice the conversations leadership requires. As Nesta recalls, those early repetitions mattered. He credits leaders who were present and practical so by the time a larger assignment showed up, the muscles were already built.

Be clear on what “good” looks like. (This should be reflected in your culture.)  Hiring and advancement focus on a few simple traits. “Number one, we want somebody who is flexible,” says Nesta. “Number two, that’s a team player. And number three, that expresses initiative.”

In generally, teams need people who are teachable, steady under pressure, and generous with others. Those expectations are reinforced in daily work: clear goals, visible coaching, and leaders who model the behaviors they ask from their teams.

Follow the best practices. Emerson’s approach yields proven takeaways for other health systems. For example:

• Fund the future on purpose. Don’t raid development lines to solve short-term gaps.
• Make internships real. Place learners in operating units with managers who teach and peers who guide.
• Practice the conversations. Role-play tough moments; debrief often.
• Hire for fit and fundamentals. Flexible, team-first people scale best.

Emerson’s approach works because it’s disciplined, repeatable, and anchored in values. In a competitive market, the system relies on tight partnerships and an internal pipeline to stay nimble. The result is a workforce that understands the community, aligns to standards, and can move quickly as needs change

As you’ll learn in the podcast, Tracy’s own story shows the arc: intern, to fellow, to multi-service-line leader. Asked what the experience meant to him—having the support of a senior leadership team and the ability to learn from everyone in the organization—he’s concise: “Yeah, it meant everything.”

He goes on to add: “If I could give a little bit of advice to future fellows or interns, I would say, approach your decision on where to go based on the folks that are leading within that organization. Ensure that there are people that you feel are going to be there to support you. You’re going to make mistakes. You’re going to learn. But to have leaders who will be there to ensure that you’re learning in a collaborative environment is so critical.”

Build Your Own Bench: How Emerson Health Turns Interns and Fellows into Leaders shares more insights on investing in people and building a strong leadership pipeline. Click here to listen!  

Craig Nesta, JD, MBA, MS, Vice President, Emerson Practice Associates; Administrative Fellowship Director

Craig Nesta oversees Emerson Health’s physician practice enterprise and directs the system’s Administrative Fellowship Program, leading national recruitment, placement, and mentoring. He brings 25+ years in healthcare administration, with prior faculty roles at Boston University School of Public Health and Stonehill College. A longtime accreditation leader, he served the Commission on Accreditation of Healthcare Management Education—including as chair of the Accreditation Council—and is a past board member of AUPHA. Craig is a fellow of ACHE, HFMA, and MGMA.

Christine Schuster, RN, MBA, President and Chief Executive Officer, Emerson Health
Christine (Chris) Schuster has served as Emerson Health’s president and CEO for two decades, following CEO roles at Quincy Medical Center and Athol Memorial Hospital and earlier service as COO for Tenet’s Saint Vincent Healthcare (Extended Care Division). She serves on multiple regional health and business boards and advisory groups and has been recognized by Boston Magazine among the “Most Influential Bostonians,” along with honors from the Boston Chamber, Massachusetts Health Council, and ACHE. Chris holds an MBA (with honors) from the University of Chicago Booth School of Business and a BS in Nursing from Boston University.

Michael (Mike) Tracy, Administrative Director, Emerson Health
Mike Tracy leads multi-service-line operations at Emerson Health. A Boston College graduate with an MHA from Virginia Commonwealth University, he began at Emerson as a summer intern, returned for a yearlong Administrative Fellowship, and advanced through roles including Practice Manager and Senior Practice Manager to his current post. An active member of HFMA’s MA/RI Chapter, Mike serves on the chapter’s board and has chaired the New to Healthcare Leadership Conference planning committee.