Building Public Health Fellowships and Pathways to Employment in California

June 15, 2026 | Mayela Arana

The California Academic Health Department (CAHD) project, supported by The California Endowment and led by the Public Health Institute’s Center for Health Leadership & Impact (CHLI), brought together local health departments, schools, and programs of public health to develop a streamlined workforce pathway system for recent public health graduates. The program matched qualified candidates with participating health departments for CAHD summer internships, six-month part-time fellowships, and 12-month full-time residency positions. The project covered a portion of the stipends provided to each CAHD participant.

By reducing financial barriers for both students and health department host sites, CAHD helped students gain meaningful applied experience and supported their transition into public health careers after graduation. This public health workforce initiative ensured health departments could recruit emerging professionals who were prepared, supported, and ready to contribute to their communities.

Partnering to Enhance Student Pathways

Given the size and diversity of California, strengthening its public health workforce requires intentional focus on regions experiencing the greatest strain. CAHD launched a coordinated effort to recruit and retain public health professionals with deep ties in the Inland Empire and Central Valley, two regions designated as health professional shortage areas. A key goal was to encourage individuals who grew up in these regions to build their careers close to home, while also engaging students who had moved away but maintained roots in the area.

The initiative aimed to build strong bridges across academic and practice settings to recruit recent public health graduates for CAHD internships, fellowships, and residencies. CAHD partners engaged health department staff who oversaw workforce development alongside faculty and deans at universities who support students’ early academic and practicum training experiences. Career‑centered staff, professor referrals, and student organizations — including identity‑based groups and student associations — played a critical role in reaching students. This approach ensured that outreach extended beyond the classroom and into the networks where students find mentorship and community.

Successes and Impact

The CAHD fellowship program delivered meaningful results for both students and local health departments, demonstrating the value of coordinated, community-rooted workforce development. CAHD placed 20 recent graduates across six local health departments between 2023 and 2025, with nearly every participant hired by their host site — a strong signal of the model's effectiveness. By covering a portion of fellows' salaries during the placement period, CAHD gave health departments a critical financial on-ramp, making it easier to bring in emerging professionals and transition them into permanent roles. Host site supervisors valued the mentorship dimension of the program and noted that it opened doors for students who may not have previously recognized the breadth of careers available in public health.

For students, the experience was transformative, and the data reflected it: 100% of participants said they would recommend the program to others. Applied learning opportunities allowed fellows to put their skills into practice in ways that aligned closely with local needs, while wrap-around professional development support from CAHD helped strengthen both technical and interpersonal skills. CAHD also created informal virtual networking spaces, such as peer coffee chats, so fellows could build professional connections with one another throughout the experience. Students frequently noted that having "a foot in the door" made all the difference in securing long-term employment, and the program intentionally fostered this by connecting students with local roots to careers close to home.

Building Trust Through Partnership and Collaboration

A key strength of the initiative was its ability to build trust and shared commitment among academic partners, students, and local health departments. The CAHD team drew on their networks of former health officers and long history in workforce development, while also relying on a third‑party intermediary to support both academic and health department partners. Having staff with strong student‑facing experience — including an alum of a similar pathway program — helped deepen outreach and engagement.

Adaptability played a major role in strengthening this project. When early structural challenges emerged — including misaligned funding expectations, variation in contracting processes, and hiring systems too rigid to bring on fellows quickly — the team treated these as opportunities to build a stronger model. By reviewing comparable programs and consistently communicating with funders, CHLI redesigned the fellowship into an annual cohort and identified more flexible placement pathways. A pivotal solution was partnering with Reach Out, a third-party affiliate that could directly hire fellows and place them within local health departments, effectively removing administrative barriers that had slowed progress.

This strong foundation continues to inform the work ahead. The flexible and collaborative model ensured that the program successfully placed fellows where they were needed most. The program incorporated continuous quality improvement through external evaluation, including a Kaiser Permanente-led assessment of participant and host site experiences. The team also leveraged proven tools and strategies from other initiatives, focusing on building on existing partnerships rather than starting from scratch. Although grant funding for CAHD placements has expired, CHLI continues to leverage this model for ongoing workforce development initiatives, most recently through PHIG-funded activities.

Advice for Establishing and Improving AHD Partnerships

Learning from the success of the CAHD initiative, recommendations for developing or expanding AHD partnerships include:

• Understand local needs. Align internship and practicum opportunities with the skills students are gaining and the roles health departments need to fill.
• Coordinate at a regional or statewide level. Centralized staffing and infrastructure ensure consistency, reduce burden on individual institutions, and create a more cohesive pathway system.
• Engage beyond traditional academic partners. Student affairs and career services teams often have the closest connection to students and can strengthen recruitment pipelines.
• Secure longer‑term funding. Multi‑year investment provides stability, supports deeper partnership building, and makes participation easier for both universities and health departments.
• Use an intermediary when needed. Third‑party hiring partners can help navigate contracting barriers and streamline placements across jurisdictions.
• Build for the future. Leverage existing tools and resources, gather ongoing feedback, and maintain program visibility through hubs or shared platforms to strengthen partnerships and support continued growth.

Learn more about AHD partnerships or explore other workforce development resources from the Public Health Foundation. If your health agency wants more information about planning support, please submit a Public Health Infrastructure Grant technical assistance request through PHIVE or contact performanceimprovement@astho.org.

Special thanks to Morgan Major and Kathleen Amos from the Public Health Foundation and Karya Lustig, Amy Max, and Tamnnet Kidanu from the California Academic Health Department initiative of the Public Health Institute’s Center for Health Leadership & Impact for their contributions to this blog post.

Reviewed by Lindsey Myers, MPH, Vice President, Public Health Workforce & Infrastructure.