Administration Fellowship

Emergency Medicine Administration Fellowship Program

The administration and management of an emergency department (ED) is a complex process that requires unique knowledge and skills that are often unattainable in an Emergency Medicine (EM) residency training program. Learning effective ED administration principles and techniques often takes years of trial, error, and on the job training. The fellowship outlined herein is designed to facilitate the rapid assimilation of critical ED management skills by combining an intensive academic curriculum with hands-on involvement in ED and hospital administration.

In addition to the exposure to and experience with EM management and leadership, the fellowship incorporates engagement with the North Shore-LIJ Medical Group. The medical group is a large, high quality, multi-specialty group providing services in a wide array of inpatient and outpatient settings at diverse venues. The North Shore-LIJ Health System (NSLIJ HS) operates 15 hospitals and hundreds of outpatient practices in partnership with more than 2,000 physicians.

NSLIJ HS has also partnered with Hofstra University, the largest private university on Long Island, to develop several key programs and relationships. In 2011, the Hofstra North Shore-LIJ School of Medicine accepted its first class of medical students, and the two groups have also forged a relationship with the Frank G. Zarb School of Business. Fellows will therefore have the opportunity to work and learn with faculty and administrative leaders from both the School of Medicine and the School of Business.

Fellowship Program Goals

  • To educate and equip the next generation of Emergency Medicine Physicians with the clinical, business and operational skills required to become successful leaders in Emergency Medicine and other areas of healthcare.
  • To prepare EM specialists for leadership positions in other areas of healthcare outside of the specialty of EM.

Fellowship Requirements

The fellowship requires a two-year commitment to complete the curriculum and educational objectives. A longer period of time may be necessary to finish advanced degree program options (MBA in Quality Management or Healthcare Administration).

Clinical Requirements

  • The fellow will work clinically in the NSUH/LIJ EDs for 16-18 hours per week.

Academic Requirements

  • The fellow is required to attend the following conferences
    • ACEP ED Directors Academy
    • NY ACEP ED Directors Forum
    • ACEP National Scientific Assembly
    • ACEP Reimbursement and Coding
  • In addition, the fellow is required to:
    • Assist in the implementation of the NSLIJ EM Grand Rounds programs (EM, Pediatric, Ultrasound, Toxicology, etc.)
    • Contribute to resident education by attending EM resident conferences on a weekly basis
    • Actively participate in the education of rotating medical students
    • Participate in any medical staff, nursing or ancillary staff education projects that present during the course of the year
    • Assist in any RRC/ACGME related matters
    • Understand faculty development planning
    • Understand EM Residency Program Development, as well as Fellowship Program Development and Administration
    • Complete the Institute for Healthcare Improvement (IHI) web-based instructional modules on quality improvement (www.improvementskills.org)
    • Engage in ACEP sections of interest 


Curriculum Highlights

Corporate Management

  • Contracts
  • Billing and coding
  • Denials
  • Reimbursement
    • Compliance
    • Diagnostic interpretations
    • Documentation guidelines
    • Mid-level providers
    • Observation services
    • Teaching physicians
    • Outpatient prospective payment system
  • Group organization and structure
  • Physician recruitment, interview skills
  • Physician management and scheduling
  • Physician evaluation
    • Productivity measurements
    • Compensation/bonus strategies
  • Budgets
  • Bankruptcy
  • Review Emergency Physician salary surveys
  • The dynamics of organizational change
  • Democratic groups
  • Managed care
  • Leadership skills
  • Marketing, fundraising, PR
  • Effective communication skills
    • Patients and families
    • Hospital administration
    • Nursing
    • Hospital department heads
    • Medical staff
    • Laboratory services
    • EMS

ED Management

  • Risk management
  • Quality assurance and patient safety
    • Decreasing systems-based errors
    • Understand issues regarding National Patient Safety mandates and initiatives
  • Performance improvement
  • Hospital efficiencies, efficiency in the ED
  • Patient throughput/ LOS
    • Theories, metrics and application
    • Front-end strategies to improve door-to-provider time
    • Back-end strategies to improve disposition, admission, bed search and turnover
    • Middle strategies to improve lab and imaging study turnover, consultant and PMD involvement and discharge/admission process
  • Customer service and patient satisfaction
  • Managing medical staff
  • Complaint management
  • ED marketing
  • EMS agencies: education and management
  • Guidelines for credentialing and delineation of clinical privileges in EM
  • Medical Legal: EMTALA, ethics, expert witness, prudent layperson, standard of care review
  • Triage
  • ED Director responsibilities
  • ED medical record elements
  • Ensuring adequate on-call backup in the ED
  • Observation services
  • OSHA
    • Medical staff structure
    • Urgent care centers
    • Physician remediation, retraining and behavior modification (ACEP resources)
    • Resource utilization in the ED
    • Service management
    • Telemedicine in EM
    • The future of EM
    • The nature of ED services
    • The role of EM in occupational and environmental medicine
    • The role of metrics in managing clinical operations
    • The science of service quality
    • EM boarding and crowding
    • On-call specialty shortage
    • Medicare


  • Pursue leadership role at a state or national level (ACEP, NY ACEP, SAEM)
  • Review ACEP policy statements
  • Understand current legislation and government bills/proposals that will affect or relate to the practice of EM


Other Administrative Duties

  • Monthly ED Faculty meetings
  • Weekly ED Management meetings
  • Medical Staff Affairs meetings
  • Disaster Committee
  • Trauma Committee
  • Stroke Committee
  • PICG Committee
  • NSLIJ Medical Group Committees (Finance, etc.)
  • Graduate Medical Education Committee


Advanced Degree

The Fellow may enroll in a MBA program in Quality Management or Healthcare Administration at Hofstra University.


The fellow will receive an annual salary of $100,000. Moonlighting opportunities will also be made available at various sites throughout the NSLIJ HS, schedule permitting.

Applying for the Emergency Medicine Administration Fellowship

To apply to the Emergency Medicine Administration Fellowship program, eligible applicants may submit a cover letter, updated curriculum vitae, three letters of recommendation, and letter of intent to the Emergency Medicine Administration Fellowship Director, Christopher C. Raio, MD, MBA, FACEP:

Christopher C. Raio, MD, MBA, FACEP
Director, Emergency Medicine Administration Fellowship
Department of Emergency Medicine
300 Community Drive
Manhasset, NY 11030