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Pathway Director


Anders Chen, MD, MHS
Director, Health Systems Pathway
Internal Medicine Residency Program

The Health Systems Pathway is designed for residents who are interested in a career which incorporates both clinical care and improving systems of health care delivery. The pathway provides residents exposure to different avenues for health systems improvement (e.g., focusing at the micro, meso and macro levels of change*; or applying research, managerial or policy approaches**), professional development mentoring to explore potential areas of focus, and experiential work to develop the skills to be future physician-leaders.

Interested residents must apply in January of their intern year.

Health system levels description



The R2 year allows residents to build a foundation in clinical microsystem quality improvement work. During the immersion block residents lead a high-level, multidisciplinary improvement project at Harborview Medical Center, with support from Harborview’s process improvement team and administrative leadership.

The R3 year is focused on meso and macro levels of change. Residents can choose from three existing arcs developed based on experiences from prior residents, or design other independent electives. The existing arcs are:

  1. Payment and Delivery Evaluation: residents can work with UW's Value and Systems Science Lab on analyzing policy and/or evaluating health systems issues related to health care payment and delivery.
  2. Health Policy: residents can work at the Washington State Health Care Authority, the state agency which administers the state Medicaid, Public Employee Benefits Board, and the School Employees Benefits Board programs, making it the largest purchaser of health care in the state and a major driver in state policy.
  3. Administration and leadership: residents can work with medical directors and quality and safety physician leadership at our various medical centers (both inpatient and outpatient), to gain more insight and experience in leading health care organizations.


Examples of previous independent electives include working with the UW Chief Diversity Officer to address racial disparities in breast cancer screening. Residents can collaborate with Department of Medicine Health Systems leadership to explore independent proposals.

HEALTH SYTEMS In the department of Medicine


The UW Department of Medicine is committed to supporting people and groups interested in improving health care systems. Led by Associate Chair for Health Systems, Joshua Liao, the Department does so by offering a range of programs and resources, including avenues for connecting individuals for collaboration or mentorship; and support for health systems-related design and evaluation, dissemination, and proposals. As Department members, pathway residents have access to these programs and resources. Interested residents are encouraged to visit the Department of Medicine’s Health Systems website and reach out to the team with additional questions at hscollective[at]uw[dot]edu.

Current Residents

Grad Year 2024 Grad Year 2023
Jonathan Avery, MD Max Birger, MD
Jason Castaneda, MD Roxanne, Hicks, MD
Adrian Lena, MD Kim Matsumoto, MD

Pathway Residents: What are they doing now?

As of the 2021-2022 academic year, we have graduated 4 cohorts and 10 total Health Systems Pathway residents. What are they doing now?

  • 5 are pursuing additional training: 1 Chief Resident for Quality and Safety; 1 Inpatient Chief Resident; 1 Geriatrics Fellow; 2 residents in psychiatry (2nd residency after completing internal medicine)
  • Hospitalist and associate medical director of the hospitalist group
  • Hospitalist with FTE from the Washington State Health Care Authority doing policy work
  • Academic primary care physician with FTE for QI and education work
  • Hospitalist
  • Primary care physician and director of public health and medical education for the health center