THE FELLOWSHIP EXPERIENCE
INTRO TEXT
Orientation: Worth the Price of Admission
“Orientation was invaluable. At the time we didn’t realize how valuable it was to be.
As it turns out, our orientation is the envy of all those who work on the Hill. Clearly [Congressional] staffers believe that such a good introduction to health policy within the Beltway should not be wasted on neophytes.”
— Dan Clouser, 1986-1987 Fellow
The Start of Orientation
From the first conception of the Health Policy Fellowship, a training component was a critical piece of the proposal. What this training program looked like, though — who would lead it, what content it would focus on, and how long it would last — was up for consideration.
The original July 1972 proposal stated, “Fellows will enjoy a planned group educational experience which should systematically explore the interrelationships among the various arms of the Health Enterprise (or Industry) and all those governmental and non-governmental agencies and organizations which significantly influence public policy. It is likely that much can be learned in this area from the experience of the White House Fellows program which has been in existence for more than 5 years.”
A document to the Robert Wood Johnson Foundation Trustees later that year gave more explicit recommendations. It proposed a two-part training program:
“[U]nder the first part the fellows would be enrolled in the Congressional Fellowship Program sponsored by the American Political Science Association, the principal scholarly society in the public affairs disciplines. The Congressional Fellowship Program provides the best practical learning experience now available in the country of how public policy is determined.
The second part of the proposed Foundation fellowship program would be seminars organized by the independent board established by the Foundation, and would take place during the fellows’ Congressional staff assignments. The board would be responsible for the development of a series of seminar sessions on issues in medicine and public policy, which would include participants from organizations such as the Institute of Medicine, the executive branch health agencies, and academic researchers in the public policy field.
Finally, in the March 1973 proposal to establish, the planning committee landed on a training plan that the program still follows today:
“Fellows would be expected to mọve to Washington, D. C. in time for the opening sessions, and to spend a period of six to eight weeks in an orientation program centered on matters of health and health policy organized by a staff based at the Institute of Medicine. This portion might include seminars to familiarize fe1lows with health agencies in government, congressional comnittees responsible for health affairs and the areas covered by each, problems and opportunities in health policy as viewed by the IOM staff and various IOM members, guest experts, HEW staff and congressional staff. Site visits to the various agencies might be scheduled. Insofar as it would be possible and consistent with the development of seminars, the preliminary program should be tailored to each fellow’s individual interests.
Following the IOM-sponsored period, the fellows would join the regular Congressional Fellows Program. They would be incorporated in the program along with fellows from the fields of political science and journalism. The Congressional Fellowship Program begins with a period of introduction to the Federal government and how it functions.”
On September 16, 1974, the first six fellows gathered for their first day of the program’s three month orientation. Little did they know how much they would learn over the next three months and that they were embarking on a program that would gain **************************.
Explore a sampling of orientation schedules over the years
1976
Charles Clark
“Certain rules (which I am sure Dick [Seggel] will agree with) apply to this phase in order to make it most profitable. …
[For example,] never let anybody get to their slides. Unless questions come up fairly quickly in an interview you will get a canned lecture starting something like ‘in 1786 the Public Health Service was founded.’ We usually let them go on somewhere between five and ten minutes and then asked them something like, ‘Who determines your budget?’ and ‘When was the last time you met with Ted Cooper?’
“Most of them were very candid; we were quite careful to keep things off the record so that nobody got into trouble from telling the truth. The best opening question was, ‘How did you get from there to here?’ Then ask them what their major problems were and why they couldn’t be solved. Another good question is to ask them what their three wishes would be.”
“In the first six or eight weeks as we traveled with gun and camera through the jungle of ‘H’ (not heaven, not hell, just health, as in HEW) we found they talked funny in Washington. I knew about BUNS and EKGS but what the devil was OTA and how was that different from OMB. ADAMHA continues to elude me, and deep in my heart I still think that OMB is really a secret bureaucratic mantra.
“Not only do the folks here have their own codes, they also have their own etiquette. Brought up in parochial schools and working in the formal setting of an Eastern ‘elite’ medical center, I had never quite managed the easy informality of the ‘first name’. The Dean of the Medical School remained Doctor, and certainly no intern or resident presumed to call me ‘Maggie’. In Washington, everyone is first named, so much so that I was at times uncertain whether the first name being dropped was a close friend, an acquaintance, or someone met on the pages of the Washington Post. ‘Teddy told me Jimmy is going to back the Kennedy Corman bill.’ Teddy White?? Jimmy Stewart??’ After a while you begin to catch on and find yourself talking about ‘markups’, and ‘exec’ and ‘side by sides’ like a native of this new country. Why just the other day, I told Jake Javits and Pete Williams they should support NHI for mothers and children.
Margaret Heagarty
Charles Clark
“Frequently we rehearsed questions. There was usually one of us who knew more than the others about the subject. We had him background one or more of us. If one of us was embarrassed to ask pointed questions because of our past or potential future relationships with an individual, the others would ask his questions. So, for example, the NIH people were asked the hard questions by our public health dentist and the Chief Dentist of the Commonwealth was asked the hard questions by our pediatrician. We also set up signals to control the sessions. When Margaret took off her glasses, it was time to start asking questions. When anyone pulled his ear, it was time to end the session and we all stopped asking questions.”
“The first phase of the fellowship, besides providing time for orientation to the language, organization and mores of the place also has another and perhaps more important asset. In those first few weeks while we were spending long days together, we had the time to take social histories and to make diagnoses on one another. We found that we enjoyed, liked and could learn from each other. But this discovery required at the minimum the effort of taking time at the end of the day to compare impressions, to hold postmortems on what we had seen and heard. since alcohol was often included, these were the times for giggling, for finding out who was the wine expert, who could sing barbershop harmony and who would invariably invoke St. Anthony when we needed help. From this sharing we began to weave the tapestry of trust and affection called friendship.”
Margaret Heagarty
The Reading List
Every summer before the fellowship officially begins in September, the incoming fellows get a reading list and a stack of books and articles mailed to their homes.
The 1974 reading list included 27 articles, books, and documents. Today it boasts *******.
Explore the reading lists from the first year, the 25th year, and the 50th year.
A Day in the Life
The IOM orientation schedule was hectic, often involving traveling across town. I was surprised to discover that all of the fellows were able to maintain their enthusiasm and interest in the orientation over the entire two months. Furthermore, it provided an opportunity for us to become familiar with Washington’s geography.
— Edward Wimberley, 1989-1990 fellow
About half the meetings were held at the IOM, and half at the offices of the relevant agency. This worked out quite well, as it allowed for efficient use of time (IOM site) and becoming familiar with the city (outside sites). Refreshments and health snacks were provided at the meetings (and lunch when appropriate). This alleviate gastric obstacles to paying attention during the meetings, and made me feel that the IOM staff were very concerned about our welfare.
— Philip Goodman, 1989-1990 fellow
THE TRIPS
NEED TO ADD STUFF ABOUT THE TRIPS
@NAM: Any ideas when the regional trips were added? And when the CDC trip was added?
An Ode to Our Fearless Leaders
“The preparations for the orientation phase must be likened to the preparations by General Eisenhower for D-Day.”
— Charles Clark, 1976-1977 Fellow
“In reviewing the orientation schedule, a quick tally resulted in some useful statistics. Out of the more than seventy-five individuals and organizations we had the opportunity to visit, forty five (60%) proved to be central to the conduct of my fellowship responsibilities. At least 19 (25%) of the total became regular contacts, meaning weekly phone or in person meetings. Mr. Seggel knew what he was doing when he put together the orientation.”
— Marie Michnich, 1985-1986 Fellow
“Dick Seggel’s extensive knowledge of where the skeletons were buried and where the power really lies was most helpful in penetrating any tendency on the part of the speakers to be devious.”
— Michael Till, 1975-1976 Fellow
“It is the IOM’s orientation to the fellowship that distinguishes this program from the other Congressional fellowship programs. It is insufficient to say that we had an opportunity to meet the most influential and knowledgeable of the nation’s health care elite (being tutored in health care economics by Gail Wilensky comes to mind). More to the point is how access to these leaders was achieved. In our case, access was provided by Marion Ein Lewin. It is inconceivable to me how IOM and the Robert Wood Johnson Foundation could have found a more knowledgeable, talented, and “connected” person than Marion. Without doubt, many of those from the association, Congressional committees and staffs, and the like participated in the orientation due to Marion’s influence. Not only did Marion make this portion of the fellowship year happen for us, she proved to be so knowledgeable in her own right that she was able to help us synthesize the vast amounts of information that we had gleaned over two months.”
— Edward Wimberley, 1989-1990 Fellow
Getting Placed
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Personal Connection
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Jurisdiction
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Legislative Focus
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Your Title Goes Here
In the last 50 years, only three offices have hosted more than ten fellows: Senator Jay Rockefeller, Senator Edward Kennedy, and Senator Orrin Hatch. Senator Rockefeller hosted 16 fellows over the course of his 30 years in the U.S. Senate. Senator Hatch hosted 13 fellows and Senator Kennedy hosted 11 fellows.
The Rockefellows: 1990–2013
Senator Edward Rockefeller (D-MA)
The Hatchlings: 1985–2012
The Kennedy Cohort: 1983–2000
