Getting fitted for scrubs during junior year at my high school is a rite of passage. For two years, I’d watched upperclassmen walk the halls of DeBakey High School for Health Professions in their clinical uniforms while I wore the standard khaki pants and polo shirt combo of an underclassman.

But in 2018, it was finally my turn to feel the shift – the fabric was stiff and new, and the fit slightly awkward, but none of that mattered because I was initiated into a field I’d spent so much of my young life peering at from the outside.

Junior and senior year curricula emphasized rotations in subspecialties we could see ourselves practicing in. I was fortunate to rotate in the trauma unit at Memorial Hermann Hospital in the Texas Medical Center

I stood in the middle of the controlled chaos, a place where a high school student could either be in the way or genuinely helpful. 

A motorcyclist was flown in after a highway crash, and I worked at his bedside gathering supplies. At first, I moved with hesitation and then, with purpose, alongside doctors and nurses who barely seemed to notice my age. They called me “the med student.”

But I knew what it is like to be on the other side of the curtain. A year earlier, I’d had an emergency surgery, and I remember my parents, both physicians, trying to mask worried looks and failing. My mom kept adjusting my blanket; my dad nervously checked his watch.

Part 1: Baylor administrative fellow reflects on educational journey, starting at BCM Academy at Ryan

Before graduating high school, I felt the thrill of being part of the clinical team, as well as the vulnerability of being the one in the hospital bed. I was beginning to understand that some of the most important work in healthcare happens in the middle of it all.

Healthcare helper 

Three weeks after losing my grandfather to COVID-19, I moved into an apartment in Bryan-College Station to start my freshman year at Texas A&M University. College classes were entirely remote: no orientation, no dorm life, no late-night study sessions in the library.

Within weeks, I started as a pharmacy technician who helped manage the highest-volume pharmacy in the area. The pace was relentless with hundreds of prescriptions a day, constant insurance denials, patients calling in their frustrations because medications weren’t ready or were suddenly unaffordable.

A couple years later, as an administrative intern at a bariatric clinic, I found myself in a different kind of “middle” between patients and a system that is supposed to support them. On calls, I heard about transportation issues, technology barriers and confusion about pre‑ and post‑operative instructions.

I realized the oft-broken system needed structural change and to improve it, I had to understand the business model behind healthcare. The message I heard – implicitly and explicitly – was that I had to choose between being a physician or a business professional.

Administering health

After earning my bachelor’s degree, I immersed myself into learning operations, finance, strategy and organizational behavior at the Mays Business School at Texas A&M University. My understanding of the landscape expanded rapidly through studying value-based care models, analyzing how different organizations balance fiscal responsibility with care quality and exploring case studies of health systems that succeeded and those that failed.

When I graduated with a Master’s of Science in Business, I accepted a healthcare administrative fellowship at Baylor College of Medicine. Before my first day, I met with Dr. Paul Klotman, former president, CEO and executive dean of Baylor, full of gratitude and nerves.

Just outside the president’s office, a large, framed photo caught my eye – the inaugural graduating class of Baylor College of Medicine Academy at Ryan. Seeing that photo as a new administrative fellow was grounding; it reminded me that Baylor had seen and supported me as a learner at every stage. 

Throughout this fellowship year, I have rotated through nearly every corner of Baylor’s clinical, research and education missions. I have collaborated with finance teams on budgeting and revenue‑cycle analysis; supported strategic planning for ambulatory redesign and hospital operations; developed a three‑year growth plan for the allergy section in the largest clinical department; analyzed patient access barriers in neurology; engineered reporting dashboards to monitor hospitalist productivity; and coordinated operational readiness for a cardiology practice relocation, among other initiatives. 

Early in the year, I was observing the ALS multidisciplinary clinic when a caregiver approached me about a malfunctioning wheelchair scale. In this clinic, accurate weight is critical for monitoring disease progression and guiding treatment decisions. As a new fellow, I was once again in the middle of a clinic – neither clinician nor purely back‑office, but someone who could listen, translate and act.

That conversation led not only to repairing the scale but also to partnering with the clinic director to use grant funding to expand mobility‑aid offerings, such as Hoyer slings. What began as a facilities issue became an opportunity to improve both workflow and patient experience.

Onward, upward

I have a deep desire to bridge healthcare as a business and a service industry, balancing clinical expertise and patient care with innovative delivery and strategic development. This desire has fueled my decision to apply to medical school with the goal of returning to that intersection.

From BCM Academy at Ryan to DeBakey High School, from CVS to TAMU to Baylor College of Medicine, every step has brought me closer to understanding healthcare from multiple angles, and I’ve learned that the best leaders are not the ones who choose a side; they are the ones who refuse to.

Standing in front of that BCM Academy at Ryan class photo, I see the girl I was – hopeful, determined, eager to contribute, and I see the leader I’m aspiring to become: Not afraid of being “too much” of one or the other or choosing between physician or business professional but committed to thriving in the middle where patients, teams, and systems meet.

Story by Mariam Kundi, administrative fellow in the Office of the President at Baylor College of Medicine. Kundi holds a bachelor’s degree in kinesiology and a master’s degree in business, both from Texas A&M University. She was part of the inaugural class at Baylor College of Medicine Academy at Ryan in Houston’s Third Ward. 

Baylor College of Medicine’s Administrative Fellowship Program cultivates new talent in healthcare management through observation, exchange and hands-on experience.