September 10, 2025 • 29 mins
On this episode of the MGMA Business Solutions Podcast, host Daniel Williams speaks with Rob Fershtman, Senior Director of Corporate Partnerships at U.S. Career Institute. With more than a decade of experience helping healthcare organizations strengthen their pipelines for Certified Medical Assistants and other essential roles, Fershtman shares strategies for addressing staffing shortages, creating flexible education pathways and building long-term retention in medical practices.
Key Takeaways:
- [05:41] - Identifying workforce gaps: How rural healthcare organizations are struggling to recruit talent and why early-stage career roles, like medical assistants, are critical to closing the gap.
- [08:14] - What US Career Institute offers: An overview of the accredited programs and degrees, with a focus on entry-level healthcare pathways and medical assistant training.
- [10:40] - Real-life success stories: How individuals from diverse backgrounds (oil riggers, hairstylists) transitioned into healthcare careers and thrived with support from their employers.
- [12:15] - Didactic + clinical training model: Why combining online coursework with hands-on clinical instruction creates the most effective outcomes for medical assistant preparation.
- [17:20] - Open-book learning and retention: How cognitive load theory and open-book quizzes improve knowledge retention and prepare students for certification exams.
- [25:20] - Partner-driven customization: How organizations can tailor the learning sequence and clinical checklists to align with their unique needs and workflows.
- [28:08] - MGMA CMA program partnership: How practices can access U.S. Career Institute programs directly through MGMA to build and sustain their CMA pipelines.
Resources:
- Visit the U.S. Career Institute website
- MGMA Clinical Medical Assistant Certification, Powered by U.S. Career Institute - Learn More
- Connect with Rob Fershtman on LinkedIn
- MGMA Membership - Learn More and Register
- 2025 MGMA Leaders Conference: Sept 28-Oct 1 in Orlando, FL - Register Here
Additional Resources:
Email us at dwilliams@mgma.com if you would like to appear on an episode. If you have a question about your practice that you would like us to answer, send an email to advisor@mgma.com. Don't forget to subscribe to our network wherever you get your podcasts.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Daniel Williams (00:02):
Well, hi, everyone. I'm Daniel Williams,
senior editor at MGMA, host ofthe MGMA Podcast Network. We're
back today with another MGMAbusiness Solutions podcast.
We've got one of our, businesspartners here today being
represented by Rob Fershtman. Heis senior director of corporate
(00:24):
partnerships at US CareerInstitute.
And tell you a little bit moreabout Rob. He spent more than a
decade working with healthcareorganizations to help them build
strong pipelines for certifiedmedical assistants and other
essential roles. Rob and I gotto catch up about a week or so
ago and connect on a couple ofthings. It was fun getting to
(00:47):
meet him there, and I hope thaty'all get a great opportunity
here to talk to Rob as well orlisten to Rob and hear what he
has to share. So, Rob, welcometo the show.
Rob Fershtman (00:57):
Thank you, Daniel. I really appreciate you
joining me and and having me onyour show.
Daniel Williams (01:02):
Yeah. Now you and I and James, our producer,
were talking about your backdroptoday. It was so unique and
interesting looking. What whatare you sitting in front of
there?
Rob Fershtman (01:14):
So believe it or not, I'm sitting in front of a,
a shiplap wood wall. The roomI'm in is, is what, what we call
at home, my three season room,previously a deck. And so I
always wanted a room that we canenjoy three of the four seasons
in and, true to form. We, webuilt this thing right when it
was a COVID project, you know,architect design, that kind of
(01:37):
thing.
Daniel Williams (01:38):
It's beautiful. I have to ask, what's the what's
the fourth season? What's theone that doesn't make it in the
three season room?
Rob Fershtman (01:46):
So you're you're speaking even though even though
US Career Institute is from FortCollins, Colorado, I am from the
Detroit Metro Area. And sowinter would be the fourth
season. We can be in here. Ihave a fireplace over here. We
can be in here, up the it'sabout January Christmas, January
time.
But after that, it's, notbearable.
Daniel Williams (02:09):
Okay. Okay. So love hearing that. And and I
also love talking to people thattook up new hobbies, new
passions during that pandemictime. They didn't let it, stop
their curiosity and theirpassions.
I've I've talked to so manypeople on here that learned
guitar from YouTube over thepandemic, and you did a
(02:30):
woodworking project. So that'sreally cool.
Rob Fershtman (02:32):
Yeah. Actually, to go down the rabbit hole a
little bit, I've always wantedone of these three season rooms.
It's it's very sizable. It's we,we had a pretty large deck on
our own. And, and so I've alwayswanted one of these and I was, I
was able to do the destructionportion.
I can break just about anything.Right? But we were, we required
(02:53):
actual contractors to, to buildit correctly.
Daniel Williams (02:56):
Okay. When you're not designing three
season rooms, Rob, what do youdo? Tell us a little bit about
yourself, your background inhealthcare and, in the kind of
work that you're doing rightnow.
Rob Fershtman (03:09):
Very good. I appreciate that. So, I got
started in corporate education,about ten years ago. And I,
prior to that, I was in largecorporate banking for a company
you would know as RBS UnitedStates for opening of Scotland,
US, and, had some big success inthat area and, hated every
(03:35):
second of it actually, despitethe success. And a friend of
mine said, you know, given whatyou do and what your wife does,
you would probably be reallygood at corporate education.
And so I got into it and, veryearly on, my wife and I, about
fourteen years ago, we started achild developmental psychology
practice. My wife is apsychologist. Yeah. And I am, I
(03:59):
scale education and I scalebusiness and, and that kind of
thing. And so I became the,financier and biller and coder
for my wife's startup psychologypractice, fast forward fourteen
years, life shifts.
And, as things started to evolveprior to COVID, there were some,
(04:23):
healthcare systems that hadthese unique needs, mostly in
rural areas that they couldn'tget enough talent. And so from a
big wide picture, you know, someis a nerd like me, that's a
finance guy that reads the wallstreet journal. I'm keenly aware
of the age demographic shiftthat had been going on starting
(04:45):
with the front end of the babyboomers. Right? So ten years
ago, the front end of the babyboomers started retiring off and
you could see the chasm that washappening.
And it really started impactinghealthcare, not so much on the
provider end, but in the frontend with the patient facing
(05:07):
people and the people thatoperate behind the scenes, what,
what I'll phrase is the earlystage career. And so people that
were getting out of theworkforce, there were starting
to be these gaps and the ruralcommunities were having a really
hard time figuring that out. Iand I met a lady who was in
(05:28):
charge of HR, a very large NorthDakota, South Dakota, Minnesota
based health system. She had anidea and she, her idea was
instead of recruiting fromschools and hoping people come
to us, can we build theseourselves using online education
and, and clinical training? And,that was prior to the pandemic.
(05:54):
And then fast forward, thepandemic happened and this
explosion happened. And so, itwas really interesting to see
this problem is pervasive,right? And it's not just a
function of the day. It's afunction of, a workforce that's
changing out in an educationsystem that has put up barriers
(06:18):
to entry and now they haveneeds. And so, it started before
the pandemic and has just grownand grown and grown and grown
since.
Daniel Williams (06:29):
That is incredible. So just give us the
elevator pitch then for somebodywho's never heard of US Career
Institute. What is it then? Whatcould someone hope to what's a
course? What's you know, anagenda there, a career pathway
someone could followeducationally and learn there?
Rob Fershtman (06:49):
Very good. I, so US Career Institute is the
operating name of WesternDistance Learning, one of the
original distance learningeducators in the country. We're
an accredited school from FortCollins, Colorado. And so our
accreditation goes across TheUnited States and we have,
we're, we're accredited by theDEAC, but we have different
(07:12):
things that help us cross the,the state borders like NC SARA.
And so what we're known for ishealthcare.
Okay. And so it's the earlystage healthcare. It's where
people start. And so, we have avariety of things. We also
offer, associates in appliedscience degrees.
We even have a high school thatgoes across The United States.
(07:36):
And so depending on wheresomebody wants to start, but
what we're really known for,what really should be impactful
for the MGMA folks is, is thatyou can have people that are
starting in your organization ata relatively entry level and
help them grow and develop thesepeople in exchange for a length
(07:56):
of tenure. And, and what we'veseen is, especially medical
assistant. I joke around, Ithink I said this to you a week
ago. Yeah.
If we were like a one hitwonder, if we were Rockwell, we
would be known for medicalassistant from Maine to Hawaii.
Mhmm. In fact, as we're talking,one of our partners in Hawaii,
(08:17):
it's like, oh wait, we've gotour, we got somebody else we
have to enroll right now for ourlatest cohort. We got one more
that was just like a late addon. Can you help us out?
And so, what's interesting iswhen you're building this talent
and, and getting the retentionthat you would expect, the
correct people will choose tostay. You're you're cultivating
(08:38):
somebody either that has amodicum of experience and a lot
of interest or a lot of interestand little experience. Mhmm. And
we've seen the gamut. We'veseen, we have seen, oil riggers
that are big burly guys, six,four, say to us, no, I know I'm
(08:59):
supposed to be in healthcare,even though I make a lot of
money.
I don't wanna do this. I amsupposed to be in healthcare and
a healthcare, organization gavehim a shot. He, they love him.
Right. And now I think he'sgoing to PA school actually
years later.
Yeah. We have, people that werehairstylists that in COVID could
(09:21):
no longer cut hair and didn'tknow how they were gonna feed
their kids in, urgent care in,in Massachusetts said,
Daniel Williams (09:27):
you know, you would be pretty good
Rob Fershtman (09:28):
at our front desk. And indeed she was, and
they're, oh,
Daniel Williams (09:31):
you would
Rob Fershtman (09:31):
be a pretty good MA. Now I believe she runs three
urgent cares. Right. And so it'sreally, I I'd like to say it's a
testament to us, but it's reallya testament to our partners. And
that's how we approach this.
Right. We are educators. Unliketraditional educators, our
(09:53):
partners' interests andmethodology is taken to an
account to help develop theirtalent. Right? What their
organization needs, how theirorganization goes about it.
We're providing the content thatgets somebody through a national
certification check. But howthey treat the employees and how
(10:15):
they develop that person on dayzero makes all the difference in
the world. Okay.
Daniel Williams (10:20):
It may differ course load to course load, but
is the learning that they'retaking in, is it more
theoretical? Like I'munderstanding concepts? Or are
they actually learning, like,they could walk back into the
practice later that afternoonand they've actually learned a
(10:40):
tool that they could apply tothe practice that day and do it?
How does that balance out? Whereis y'all's focus there?
Rob Fershtman (10:48):
So it's really up to our partners.
Daniel Williams (10:50):
Okay.
Rob Fershtman (10:50):
And, and we run the gamut. Okay. We have, I
would tell you the mosteffective versions, sound
something like the didacticlearning that we're doing is
relatively concurrent with theclinical skills that the partner
is teaching. And so, we havepartners that have taken a
(11:12):
medical assistant course andmade it a very short form, an
eight week crash course. Andthree of the days they're
learning on our didactic.
Okay. Sequence. Right. Butthey've shuffled our sequence so
that they can come and learn theclinical skills associated to
their job. And, and in a medicalassistant role, it's very, it's
(11:33):
very utility, right?
So, a medical assistant in apediatric office will do
something quite different than amedical assistant in a cardio
cath lab. Right. So they, theylearn the core, lesson out of
sequence to what theorganization wants. And then
they send that person to, tomeet with a clinical instructor
two days a week. That seems tobe, at least in my mind, the
(11:58):
most effective and gets the, thefastest, longest term results.
If that makes sense. They'rebuilding a person from scratch.
Daniel Williams (12:08):
Yeah, it does because it seems like, you know,
you'll hear people say, well,I'm a visual learner. People
learn in different ways, but ifyou're learning the practical
tools that you actually apply,it seems like that would, for
many people, would be moreeasily retained. The retention
would be stronger there ratherthan, again, nothing against
(12:29):
theoretical concepts. Those canbe important in strategic type
thinking, but, sometimes they'remore difficult to apply at your
job day one, that sort of thing.
Rob Fershtman (12:42):
Absolutely. Right. It, it, it's more
immersive is the word that Iwould use. Right. So they're
learning these concepts andthey're hearing the, the
language, the medicalterminology and the, the anatomy
in real time from doctors andnurse practitioners and PAs.
And they're talking back andforth and their, their light
bulbs are going off. Oh, I justlearned that. Right? I mean, I
(13:04):
mean, I hear it all the time.
Daniel Williams (13:05):
Right.
Rob Fershtman (13:06):
You know, we just learned that and I just heard
this whole thing happen. Right.And it really, it cements it for
the student.
Daniel Williams (13:13):
Okay. When did you know that medical assistants
were your groove, so to speak?How did you know did you
identify them? Did the marketidentify it for you? What
happened there?
Rob Fershtman (13:25):
So actually, it's funny that we're talking about
that. We do more than medicalsystems. Of course. So there's a
few things that that wespecialize in. Initially, it's
market oriented.
Truly what happens is that,clinics, ambulatory clinic
clinics, urgent cares,outpatient clinics, they have
(13:46):
this need and it's hard toaddress. And there's just not
enough folks coming out For awhile prior to meeting that one
person from the South Dakota, itwas pharmacy techs were that
were having this challenge andthen it switched. And so we see
a combination of, different wesee sterile processing
(14:10):
technicians, surgicaltechnicians, medical assistants,
but the medical assistants farand wide across the country, are
the ones that draw the mostattention and have the strongest
need, irrespective of oforganization size. We are as apt
to see a a small provider with apractice or two offices as we
(14:36):
are a giant organization. And sowe have we have them all pretty
much equally, but they have thesame need.
How they go about training them?Entirely different.
Daniel Williams (14:48):
Okay. So let's think about, in real terms,
let's paint a picture for ouraudience. They may be going, I'm
interested in this. I want tosend some of my team there. What
does it look like?
If you're a student, are yousigning into a Zoom room? Where
is the learning taking place,and how big is the classroom, so
(15:12):
to speak, this virtualclassroom?
Rob Fershtman (15:14):
Very so you are an army of one, and you're gonna
log in Okay. To, to an onlineportal that has our content
already premade in
Daniel Williams (15:25):
there. Mhmm.
Rob Fershtman (15:28):
US career Institute being almost 45 years
old has content writers that, Imean, I can say this without
hesitation because our resultspainted out. They're brilliant.
And, and what they've created isa very lightweight user friendly
way to read, gather video, butretain, didactic knowledge using
(15:51):
real brain mechanics known ascognitive load theory. How much
can a brain absorb?
Daniel Williams (15:56):
Okay.
Rob Fershtman (15:56):
Like an average brain can absorb X in amount of
time. And so it's broken intochunks and, and it has a variety
of learning mechanisms. Somefolks learn by reading. I am, I
was raised in the seventies andeighties, so I am a copious
notetaker. Uh-huh.
Because we had a facilitator.
Daniel Williams (16:15):
Right.
Rob Fershtman (16:15):
If that works for you, you can elect a voice. I
wanna hear a British female'svoice dictate to me and I'll
write down. Yeah. All the keywords. And if I write it down, I
remember it.
Some people have a blend ofthat. Some people need a video
feed. And so we have all thesemechanisms built into the, to
the learning system to helppeople absorb this model. And
(16:39):
then there's this component thatpeople find shocking because
again, raised in the seventiesand eighties. Right.
Our learning is entirely openbook. So when you go to take a
quiz, we actually want you tolook up the answer.
Daniel Williams (16:55):
Okay.
Rob Fershtman (16:56):
And in real brain mechanic terms, you can do this
with any question in the world.I I've said this to you a week
ago. You can ask any question.How far is my front door to the
dead center of the sun? And yourbrain will either tell you, I
know for certain it's X amountof miles away.
Absolutely. And it'll try toconvince you that you're right.
(17:16):
It's right. Or better yet yourbrain will go, uh-oh, I better
look that one up. Right?
And so when you have your quizopen in our learning management
system, we're hoping that yourbrain goes, uh-oh, better look
that one up. Our quizzes aren'ttimed, right? You can take days.
Want you to acquire theknowledge and it isn't until the
(17:36):
course is done and you'regetting ready to prep for the,
the clinical medical exam, thenational exam that we ask you to
close the book to see how muchknowledge you've retained. Okay.
And so it's all meant to inspireand keep you moving forward. And
here's the magic part about it.Everybody's different. Mhmm.
(17:59):
Right?
And so, the designers and thecurriculum writers have really
taken into account a widevariety of approaches and ways
folks work. Does that kind oflong answer your question?
Daniel Williams (18:13):
Yeah, it does. Yeah, absolutely. Absolutely.
Yeah. I think that reallyhelped.
I have a couple of questions inabout that. I wanna follow-up
first with the open book policy.I'm assuming, assuming here,
that y'all did research to seethat this is a valid way to do
it. This is actually helpful inretention. Tell us about this
(18:34):
because this is a unique conceptfor me.
I've not a novel concept. I hadnot heard that before. I wish I
had gone to your institute whenI was in k through 12 and had an
open book the whole time insteadof having to memorize all these
tables. So, help us understandwhat did you find in your
research that says having thisopen book initially is
(18:56):
incredibly beneficial here.
Rob Fershtman (19:00):
So with quite literally thousands and
thousands of students everyyear, the curriculum team
evaluates what is working andwhat is not working. And, they
are always adjusting things. Andso, it helps to think of us as
an organization that as you comethrough, we have data on
(19:22):
everything. What, for when youlog in to how long it takes to
go through a step. And so whenthey are planning and writing
this concept, right.
And developing this, theystarted with cognitive load
theory. How much can somebodyretain within a certain period?
Okay. And there's a, there's aformula for this.
Daniel Williams (19:39):
Okay.
Rob Fershtman (19:40):
And then there's a, there's a scientific concept
known as the Ebbinghausforgetting curves, which in
simplest terms means how longdoes it take for my brain to
forget something when it leaksout my ears? Right? So what
they've discovered was throughrepetitions that are built in
and open book, they're dev-they're, they're lengthening the
(20:03):
time that it takes to forgetsomething. They're lengthening
the Ebbinghaus forgetting termsand they're shortening the time
to learn it. And here's thesecret rhythm.
Right? And so what I I'm gonnagive a tip to the people that
are listening. We have probablyas many organizations that are
(20:23):
large that train people in eightor ten weeks and then have them
sit for the exam and they'redone at twelve or fourteen
weeks. As we do somebody thattakes six months or a year, the
efficacy rates are exactly thesame.
Daniel Williams (20:36):
Yeah.
Rob Fershtman (20:36):
They pass at the exact same rate. It's the rhythm
that you're giving these peopleto come through. And so that
rhythm comes into play from whenthey're learning on our system
to when they're preparing forthe exam, to when they sit for
the exam. What is interestingis, and we have this from time
to time when folks fall out ofrhythm, right? And so when do
(21:00):
they forget?
So here's your, your, your longanswer. How How long does it
take somebody to forget? Aboutthree weeks.
Daniel Williams (21:07):
Okay.
Rob Fershtman (21:08):
About three weeks before you start really
forgetting meaningful contact,content. Right? And so we're
watching for that. And there'stimes as the partner of these
organizations where we have tosay, Nope, you gotta go back.
You gotta go back.
Sorry. Right. And, and, andnaturally we'll get some
pushback. Oh, I was out sick fortwo weeks. I get it.
(21:31):
You gotta go back. Yeah. Like,we can actually see. You have to
go back. Right?
Daniel Williams (21:36):
Yeah. You've brought up a couple of times.
You're a kid of the seventiesand eighties. So with you
talking and talking about rhythmand the way people learn, it
reminded me of an episode of ourera of happy days. There was an
episode where Potsie, one ofRichie's friends, was having
(21:58):
trouble memorizing things.
And so they had that band, thatthey played in. And so Potsie
learned if he sang it, he couldmemorize things. I just wanted
to throw that out there. Ify'all learned you were talking
rhythm, I'm thinking singing andmemorizing things through song.
Is there any merit to that, orwas happy days and Gary Marshall
(22:20):
just way out there by doingthat?
Rob Fershtman (22:23):
No. Manomics are anomics are in a known brain
mechanic way to, to, to get youto memorize things. And in fact,
wife, the psychologist, right? Iget a lot of singing these
things and putting things to arhyme might be the single best
(22:43):
way if you're an audiblelearner. Okay.
If you learn by hearing, if youlearn by speaking and hearing,
right, it might be the singlebest way to do it. There's a
reason why religiousorganizations, churches, and and
such have a choir so you canremember things. Right? It it's
time tested. Wow.
Daniel Williams (23:02):
That is so cool. I love learning things
from you and from seventiessitcoms too.
Rob Fershtman (23:08):
So Yeah. No. I I remember happy days quite well.
I will never be as cool as theFonz. So
Daniel Williams (23:21):
you brought up something earlier that I think
would be very important to ourlisteners here, and I want to
make sure I understand thisbefore we sign off. In some
cases, you're partnering withthe practice to help develop the
curriculum. I want to make sureI understood that. What role is
the organization playing, inhelping either design or show
(23:47):
you what their people need tolearn? I I just wanna help, have
that explained again so weabsolutely are clued in on
what's happening there.
Rob Fershtman (23:55):
Absolutely. So, so when an organization partners
with us, before we launch, weask them to take a look at our
content. Okay. We're notactually adding content or
changing content. Okay.
We have a, we have a hugelibrary that we can add out. But
when you're talking aboutmedical assistant, all the
content that is there, isdesigned to help somebody sit
(24:19):
for the CCMA, the certifiedclinical medical assistant exam,
and pass it on the first try.The order that they take it in,
except for medical terminology,is unlocked. And so we want the
organization to tell us, whenyou train people, what can you
do when you're training peoplewith the clinical skills to move
(24:41):
them in faster or better? Someorganizations say, no, no
problem.
Just use your own sequence. Buta lot of organizations actually
take our content. There's 27lessons in there. And they say,
instead of going one, two,three, four, five, they say,
let's go one, seven, 315, 24pause. Then we're gonna bring
(25:01):
them in for a clinical thing.
Can you help us do a checklistfor the clinical skills that
they should have learned in thatsequence? And the answer is yes,
we don't charge more for that.You're a partner. Right? Right.
And then we will, we'll bringthem back and then they'll go
22, eight, nine. Right? And soit's really unique to that
organization. And what we havefound is the organizations that
(25:25):
choose to do that. And even fromcohort to cohort, or even
student to student, they get theresults that they're looking
for.
Right? They have, they havesequenced in somebody that by
the time they get through theexam, this person is actually
ready for their job almost infull. Right? And here's the, the
amazing part about this. Even ina short window, like a twelve
(25:46):
week or fourteen week thing, notonly are they training them for
this role, but the, the folksthat they're gonna be working
with, these utility players aregetting to know them.
Right? And they're givingfeedback back to the, to the HR
team or the training team. Wehave an, we have a few
organizations that bring peoplein off the street and give them
(26:09):
a thirty day wait period. Andthen they bring them into our
program and providers have a sayin this. And so very much a
partnership, very much a lefthand and a right hand doing
this.
I can, I can say this, I don'tthink two organizations do it
the same way?
Daniel Williams (26:26):
Before we sign off, Rob, I want to give you an
opportunity. Do you have anyupcoming events that might be
free to the public or resourcesor anything you might want to
point our listeners to who wouldwant to know more about US
Career Institute or buildingthat CMA pipeline?
Rob Fershtman (26:43):
You know what? We are, we are part of the MGMA CMA
program. Yeah. And so right onthe MGMA site, you can go right
there. And click on certifiedmedical assistant and learn
about it and reach us rightthrough there.
And, and really what I will sayis when you contact us through
the MGMA, Hey, have a vision,make a plan, right? We adapt
(27:07):
around you. You don't have toadapt around us. We'll do our
best to, to assist. Yeah.
Right? And, and when I, when Ithink about this, the MGMA, if I
may, you have such a widevariety of organizations and
providers. It really, when theyreach out to us, this is
(27:29):
definitely not a, our, ourcontent is the same, but how we
go about it is really about thatmember. Okay. Right.
And, and that level of success.So when people reach us through
the MGMA, right. Yeah. Thinkbig. Yeah.
Right. That's all I Yeah. Could
Daniel Williams (27:47):
Rob Furstman, it has been a blast getting to
meet you again and learn moreabout you and your organization
today. Thank you so much.
Rob Fershtman (27:55):
Thank you, Daniel. I appreciate it. Yeah.
So we look forward to continuingthat dialogue with y'all.
Daniel Williams (28:00):
Absolutely. So everybody, what I'm going to do
is in the episode show notes,I'm going to put a direct link
to what Rob was referencing thatyou'll be able to find that on
the MGMA website. I'll also putit in an upcoming article that
we're going to create based onthis conversation here. So I
just wanted to say thanks againto Rob and to US Career
(28:22):
Institute for partnering withMGMA. I think this partnership,
it is so needed.
Think all of you, hopefully,you're nodding your heads at
home or wherever you are aboutyour CMA programs and needing
that pipeline there more nowthan ever. So I did want to give
you that link to theirorganization. It's
(28:43):
uscareerinstitute, all one word,USCareerInstitute.edu. And so
for now, I just wanna say thankyou all for being MGMA podcast
listeners.
Well, hi, everyone. I'm Daniel Williams,
senior editor at MGMA, host ofthe MGMA Podcast Network. We're
back today with another MGMAbusiness Solutions podcast.
We've got one of our, businesspartners here today being
represented by Rob Fershtman. Heis senior director of corporate
(00:24):
partnerships at US CareerInstitute.
And tell you a little bit moreabout Rob. He spent more than a
decade working with healthcareorganizations to help them build
strong pipelines for certifiedmedical assistants and other
essential roles. Rob and I gotto catch up about a week or so
ago and connect on a couple ofthings. It was fun getting to
(00:47):
meet him there, and I hope thaty'all get a great opportunity
here to talk to Rob as well orlisten to Rob and hear what he
has to share. So, Rob, welcometo the show.
Rob Fershtman (00:57):
Thank you, Daniel. I really appreciate you
joining me and and having me onyour show.
Daniel Williams (01:02):
Yeah. Now you and I and James, our producer,
were talking about your backdroptoday. It was so unique and
interesting looking. What whatare you sitting in front of
there?
Rob Fershtman (01:14):
So believe it or not, I'm sitting in front of a,
a shiplap wood wall. The roomI'm in is, is what, what we call
at home, my three season room,previously a deck. And so I
always wanted a room that we canenjoy three of the four seasons
in and, true to form. We, webuilt this thing right when it
was a COVID project, you know,architect design, that kind of
(01:37):
thing.
Daniel Williams (01:38):
It's beautiful. I have to ask, what's the what's
the fourth season? What's theone that doesn't make it in the
three season room?
Rob Fershtman (01:46):
So you're you're speaking even though even though
US Career Institute is from FortCollins, Colorado, I am from the
Detroit Metro Area. And sowinter would be the fourth
season. We can be in here. Ihave a fireplace over here. We
can be in here, up the it'sabout January Christmas, January
time.
But after that, it's, notbearable.
Daniel Williams (02:09):
Okay. Okay. So love hearing that. And and I
also love talking to people thattook up new hobbies, new
passions during that pandemictime. They didn't let it, stop
their curiosity and theirpassions.
I've I've talked to so manypeople on here that learned
guitar from YouTube over thepandemic, and you did a
(02:30):
woodworking project. So that'sreally cool.
Rob Fershtman (02:32):
Yeah. Actually, to go down the rabbit hole a
little bit, I've always wantedone of these three season rooms.
It's it's very sizable. It's we,we had a pretty large deck on
our own. And, and so I've alwayswanted one of these and I was, I
was able to do the destructionportion.
I can break just about anything.Right? But we were, we required
(02:53):
actual contractors to, to buildit correctly.
Daniel Williams (02:56):
Okay. When you're not designing three
season rooms, Rob, what do youdo? Tell us a little bit about
yourself, your background inhealthcare and, in the kind of
work that you're doing rightnow.
Rob Fershtman (03:09):
Very good. I appreciate that. So, I got
started in corporate education,about ten years ago. And I,
prior to that, I was in largecorporate banking for a company
you would know as RBS UnitedStates for opening of Scotland,
US, and, had some big success inthat area and, hated every
(03:35):
second of it actually, despitethe success. And a friend of
mine said, you know, given whatyou do and what your wife does,
you would probably be reallygood at corporate education.
And so I got into it and, veryearly on, my wife and I, about
fourteen years ago, we started achild developmental psychology
practice. My wife is apsychologist. Yeah. And I am, I
(03:59):
scale education and I scalebusiness and, and that kind of
thing. And so I became the,financier and biller and coder
for my wife's startup psychologypractice, fast forward fourteen
years, life shifts.
And, as things started to evolveprior to COVID, there were some,
(04:23):
healthcare systems that hadthese unique needs, mostly in
rural areas that they couldn'tget enough talent. And so from a
big wide picture, you know, someis a nerd like me, that's a
finance guy that reads the wallstreet journal. I'm keenly aware
of the age demographic shiftthat had been going on starting
(04:45):
with the front end of the babyboomers. Right? So ten years
ago, the front end of the babyboomers started retiring off and
you could see the chasm that washappening.
And it really started impactinghealthcare, not so much on the
provider end, but in the frontend with the patient facing
(05:07):
people and the people thatoperate behind the scenes, what,
what I'll phrase is the earlystage career. And so people that
were getting out of theworkforce, there were starting
to be these gaps and the ruralcommunities were having a really
hard time figuring that out. Iand I met a lady who was in
(05:28):
charge of HR, a very large NorthDakota, South Dakota, Minnesota
based health system. She had anidea and she, her idea was
instead of recruiting fromschools and hoping people come
to us, can we build theseourselves using online education
and, and clinical training? And,that was prior to the pandemic.
(05:54):
And then fast forward, thepandemic happened and this
explosion happened. And so, itwas really interesting to see
this problem is pervasive,right? And it's not just a
function of the day. It's afunction of, a workforce that's
changing out in an educationsystem that has put up barriers
(06:18):
to entry and now they haveneeds. And so, it started before
the pandemic and has just grownand grown and grown and grown
since.
Daniel Williams (06:29):
That is incredible. So just give us the
elevator pitch then for somebodywho's never heard of US Career
Institute. What is it then? Whatcould someone hope to what's a
course? What's you know, anagenda there, a career pathway
someone could followeducationally and learn there?
Rob Fershtman (06:49):
Very good. I, so US Career Institute is the
operating name of WesternDistance Learning, one of the
original distance learningeducators in the country. We're
an accredited school from FortCollins, Colorado. And so our
accreditation goes across TheUnited States and we have,
we're, we're accredited by theDEAC, but we have different
(07:12):
things that help us cross the,the state borders like NC SARA.
And so what we're known for ishealthcare.
Okay. And so it's the earlystage healthcare. It's where
people start. And so, we have avariety of things. We also
offer, associates in appliedscience degrees.
We even have a high school thatgoes across The United States.
(07:36):
And so depending on wheresomebody wants to start, but
what we're really known for,what really should be impactful
for the MGMA folks is, is thatyou can have people that are
starting in your organization ata relatively entry level and
help them grow and develop thesepeople in exchange for a length
(07:56):
of tenure. And, and what we'veseen is, especially medical
assistant. I joke around, Ithink I said this to you a week
ago. Yeah.
If we were like a one hitwonder, if we were Rockwell, we
would be known for medicalassistant from Maine to Hawaii.
Mhmm. In fact, as we're talking,one of our partners in Hawaii,
(08:17):
it's like, oh wait, we've gotour, we got somebody else we
have to enroll right now for ourlatest cohort. We got one more
that was just like a late addon. Can you help us out?
And so, what's interesting iswhen you're building this talent
and, and getting the retentionthat you would expect, the
correct people will choose tostay. You're you're cultivating
(08:38):
somebody either that has amodicum of experience and a lot
of interest or a lot of interestand little experience. Mhmm. And
we've seen the gamut. We'veseen, we have seen, oil riggers
that are big burly guys, six,four, say to us, no, I know I'm
(08:59):
supposed to be in healthcare,even though I make a lot of
money.
I don't wanna do this. I amsupposed to be in healthcare and
a healthcare, organization gavehim a shot. He, they love him.
Right. And now I think he'sgoing to PA school actually
years later.
Yeah. We have, people that werehairstylists that in COVID could
(09:21):
no longer cut hair and didn'tknow how they were gonna feed
their kids in, urgent care in,in Massachusetts said,
Daniel Williams (09:27):
you know, you would be pretty good
Rob Fershtman (09:28):
at our front desk. And indeed she was, and
they're, oh,
Daniel Williams (09:31):
you would
Rob Fershtman (09:31):
be a pretty good MA. Now I believe she runs three
urgent cares. Right. And so it'sreally, I I'd like to say it's a
testament to us, but it's reallya testament to our partners. And
that's how we approach this.
Right. We are educators. Unliketraditional educators, our
(09:53):
partners' interests andmethodology is taken to an
account to help develop theirtalent. Right? What their
organization needs, how theirorganization goes about it.
We're providing the content thatgets somebody through a national
certification check. But howthey treat the employees and how
(10:15):
they develop that person on dayzero makes all the difference in
the world. Okay.
Daniel Williams (10:20):
It may differ course load to course load, but
is the learning that they'retaking in, is it more
theoretical? Like I'munderstanding concepts? Or are
they actually learning, like,they could walk back into the
practice later that afternoonand they've actually learned a
(10:40):
tool that they could apply tothe practice that day and do it?
How does that balance out? Whereis y'all's focus there?
Rob Fershtman (10:48):
So it's really up to our partners.
Daniel Williams (10:50):
Okay.
Rob Fershtman (10:50):
And, and we run the gamut. Okay. We have, I
would tell you the mosteffective versions, sound
something like the didacticlearning that we're doing is
relatively concurrent with theclinical skills that the partner
is teaching. And so, we havepartners that have taken a
(11:12):
medical assistant course andmade it a very short form, an
eight week crash course. Andthree of the days they're
learning on our didactic.
Okay. Sequence. Right. Butthey've shuffled our sequence so
that they can come and learn theclinical skills associated to
their job. And, and in a medicalassistant role, it's very, it's
(11:33):
very utility, right?
So, a medical assistant in apediatric office will do
something quite different than amedical assistant in a cardio
cath lab. Right. So they, theylearn the core, lesson out of
sequence to what theorganization wants. And then
they send that person to, tomeet with a clinical instructor
two days a week. That seems tobe, at least in my mind, the
(11:58):
most effective and gets the, thefastest, longest term results.
If that makes sense. They'rebuilding a person from scratch.
Daniel Williams (12:08):
Yeah, it does because it seems like, you know,
you'll hear people say, well,I'm a visual learner. People
learn in different ways, but ifyou're learning the practical
tools that you actually apply,it seems like that would, for
many people, would be moreeasily retained. The retention
would be stronger there ratherthan, again, nothing against
(12:29):
theoretical concepts. Those canbe important in strategic type
thinking, but, sometimes they'remore difficult to apply at your
job day one, that sort of thing.
Rob Fershtman (12:42):
Absolutely. Right. It, it, it's more
immersive is the word that Iwould use. Right. So they're
learning these concepts andthey're hearing the, the
language, the medicalterminology and the, the anatomy
in real time from doctors andnurse practitioners and PAs.
And they're talking back andforth and their, their light
bulbs are going off. Oh, I justlearned that. Right? I mean, I
(13:04):
mean, I hear it all the time.
Daniel Williams (13:05):
Right.
Rob Fershtman (13:06):
You know, we just learned that and I just heard
this whole thing happen. Right.And it really, it cements it for
the student.
Daniel Williams (13:13):
Okay. When did you know that medical assistants
were your groove, so to speak?How did you know did you
identify them? Did the marketidentify it for you? What
happened there?
Rob Fershtman (13:25):
So actually, it's funny that we're talking about
that. We do more than medicalsystems. Of course. So there's a
few things that that wespecialize in. Initially, it's
market oriented.
Truly what happens is that,clinics, ambulatory clinic
clinics, urgent cares,outpatient clinics, they have
(13:46):
this need and it's hard toaddress. And there's just not
enough folks coming out For awhile prior to meeting that one
person from the South Dakota, itwas pharmacy techs were that
were having this challenge andthen it switched. And so we see
a combination of, different wesee sterile processing
(14:10):
technicians, surgicaltechnicians, medical assistants,
but the medical assistants farand wide across the country, are
the ones that draw the mostattention and have the strongest
need, irrespective of oforganization size. We are as apt
to see a a small provider with apractice or two offices as we
(14:36):
are a giant organization. And sowe have we have them all pretty
much equally, but they have thesame need.
How they go about training them?Entirely different.
Daniel Williams (14:48):
Okay. So let's think about, in real terms,
let's paint a picture for ouraudience. They may be going, I'm
interested in this. I want tosend some of my team there. What
does it look like?
If you're a student, are yousigning into a Zoom room? Where
is the learning taking place,and how big is the classroom, so
(15:12):
to speak, this virtualclassroom?
Rob Fershtman (15:14):
Very so you are an army of one, and you're gonna
log in Okay. To, to an onlineportal that has our content
already premade in
Daniel Williams (15:25):
there. Mhmm.
Rob Fershtman (15:28):
US career Institute being almost 45 years
old has content writers that, Imean, I can say this without
hesitation because our resultspainted out. They're brilliant.
And, and what they've created isa very lightweight user friendly
way to read, gather video, butretain, didactic knowledge using
(15:51):
real brain mechanics known ascognitive load theory. How much
can a brain absorb?
Daniel Williams (15:56):
Okay.
Rob Fershtman (15:56):
Like an average brain can absorb X in amount of
time. And so it's broken intochunks and, and it has a variety
of learning mechanisms. Somefolks learn by reading. I am, I
was raised in the seventies andeighties, so I am a copious
notetaker. Uh-huh.
Because we had a facilitator.
Daniel Williams (16:15):
Right.
Rob Fershtman (16:15):
If that works for you, you can elect a voice. I
wanna hear a British female'svoice dictate to me and I'll
write down. Yeah. All the keywords. And if I write it down, I
remember it.
Some people have a blend ofthat. Some people need a video
feed. And so we have all thesemechanisms built into the, to
the learning system to helppeople absorb this model. And
(16:39):
then there's this component thatpeople find shocking because
again, raised in the seventiesand eighties. Right.
Our learning is entirely openbook. So when you go to take a
quiz, we actually want you tolook up the answer.
Daniel Williams (16:55):
Okay.
Rob Fershtman (16:56):
And in real brain mechanic terms, you can do this
with any question in the world.I I've said this to you a week
ago. You can ask any question.How far is my front door to the
dead center of the sun? And yourbrain will either tell you, I
know for certain it's X amountof miles away.
Absolutely. And it'll try toconvince you that you're right.
(17:16):
It's right. Or better yet yourbrain will go, uh-oh, I better
look that one up. Right?
And so when you have your quizopen in our learning management
system, we're hoping that yourbrain goes, uh-oh, better look
that one up. Our quizzes aren'ttimed, right? You can take days.
Want you to acquire theknowledge and it isn't until the
(17:36):
course is done and you'regetting ready to prep for the,
the clinical medical exam, thenational exam that we ask you to
close the book to see how muchknowledge you've retained. Okay.
And so it's all meant to inspireand keep you moving forward. And
here's the magic part about it.Everybody's different. Mhmm.
(17:59):
Right?
And so, the designers and thecurriculum writers have really
taken into account a widevariety of approaches and ways
folks work. Does that kind oflong answer your question?
Daniel Williams (18:13):
Yeah, it does. Yeah, absolutely. Absolutely.
Yeah. I think that reallyhelped.
I have a couple of questions inabout that. I wanna follow-up
first with the open book policy.I'm assuming, assuming here,
that y'all did research to seethat this is a valid way to do
it. This is actually helpful inretention. Tell us about this
(18:34):
because this is a unique conceptfor me.
I've not a novel concept. I hadnot heard that before. I wish I
had gone to your institute whenI was in k through 12 and had an
open book the whole time insteadof having to memorize all these
tables. So, help us understandwhat did you find in your
research that says having thisopen book initially is
(18:56):
incredibly beneficial here.
Rob Fershtman (19:00):
So with quite literally thousands and
thousands of students everyyear, the curriculum team
evaluates what is working andwhat is not working. And, they
are always adjusting things. Andso, it helps to think of us as
an organization that as you comethrough, we have data on
(19:22):
everything. What, for when youlog in to how long it takes to
go through a step. And so whenthey are planning and writing
this concept, right.
And developing this, theystarted with cognitive load
theory. How much can somebodyretain within a certain period?
Okay. And there's a, there's aformula for this.
Daniel Williams (19:39):
Okay.
Rob Fershtman (19:40):
And then there's a, there's a scientific concept
known as the Ebbinghausforgetting curves, which in
simplest terms means how longdoes it take for my brain to
forget something when it leaksout my ears? Right? So what
they've discovered was throughrepetitions that are built in
and open book, they're dev-they're, they're lengthening the
(20:03):
time that it takes to forgetsomething. They're lengthening
the Ebbinghaus forgetting termsand they're shortening the time
to learn it. And here's thesecret rhythm.
Right? And so what I I'm gonnagive a tip to the people that
are listening. We have probablyas many organizations that are
(20:23):
large that train people in eightor ten weeks and then have them
sit for the exam and they'redone at twelve or fourteen
weeks. As we do somebody thattakes six months or a year, the
efficacy rates are exactly thesame.
Daniel Williams (20:36):
Yeah.
Rob Fershtman (20:36):
They pass at the exact same rate. It's the rhythm
that you're giving these peopleto come through. And so that
rhythm comes into play from whenthey're learning on our system
to when they're preparing forthe exam, to when they sit for
the exam. What is interestingis, and we have this from time
to time when folks fall out ofrhythm, right? And so when do
(21:00):
they forget?
So here's your, your, your longanswer. How How long does it
take somebody to forget? Aboutthree weeks.
Daniel Williams (21:07):
Okay.
Rob Fershtman (21:08):
About three weeks before you start really
forgetting meaningful contact,content. Right? And so we're
watching for that. And there'stimes as the partner of these
organizations where we have tosay, Nope, you gotta go back.
You gotta go back.
Sorry. Right. And, and, andnaturally we'll get some
pushback. Oh, I was out sick fortwo weeks. I get it.
(21:31):
You gotta go back. Yeah. Like,we can actually see. You have to
go back. Right?
Daniel Williams (21:36):
Yeah. You've brought up a couple of times.
You're a kid of the seventiesand eighties. So with you
talking and talking about rhythmand the way people learn, it
reminded me of an episode of ourera of happy days. There was an
episode where Potsie, one ofRichie's friends, was having
(21:58):
trouble memorizing things.
And so they had that band, thatthey played in. And so Potsie
learned if he sang it, he couldmemorize things. I just wanted
to throw that out there. Ify'all learned you were talking
rhythm, I'm thinking singing andmemorizing things through song.
Is there any merit to that, orwas happy days and Gary Marshall
(22:20):
just way out there by doingthat?
Rob Fershtman (22:23):
No. Manomics are anomics are in a known brain
mechanic way to, to, to get youto memorize things. And in fact,
wife, the psychologist, right? Iget a lot of singing these
things and putting things to arhyme might be the single best
(22:43):
way if you're an audiblelearner. Okay.
If you learn by hearing, if youlearn by speaking and hearing,
right, it might be the singlebest way to do it. There's a
reason why religiousorganizations, churches, and and
such have a choir so you canremember things. Right? It it's
time tested. Wow.
Daniel Williams (23:02):
That is so cool. I love learning things
from you and from seventiessitcoms too.
Rob Fershtman (23:08):
So Yeah. No. I I remember happy days quite well.
I will never be as cool as theFonz. So
Daniel Williams (23:21):
you brought up something earlier that I think
would be very important to ourlisteners here, and I want to
make sure I understand thisbefore we sign off. In some
cases, you're partnering withthe practice to help develop the
curriculum. I want to make sureI understood that. What role is
the organization playing, inhelping either design or show
(23:47):
you what their people need tolearn? I I just wanna help, have
that explained again so weabsolutely are clued in on
what's happening there.
Rob Fershtman (23:55):
Absolutely. So, so when an organization partners
with us, before we launch, weask them to take a look at our
content. Okay. We're notactually adding content or
changing content. Okay.
We have a, we have a hugelibrary that we can add out. But
when you're talking aboutmedical assistant, all the
content that is there, isdesigned to help somebody sit
(24:19):
for the CCMA, the certifiedclinical medical assistant exam,
and pass it on the first try.The order that they take it in,
except for medical terminology,is unlocked. And so we want the
organization to tell us, whenyou train people, what can you
do when you're training peoplewith the clinical skills to move
(24:41):
them in faster or better? Someorganizations say, no, no
problem.
Just use your own sequence. Buta lot of organizations actually
take our content. There's 27lessons in there. And they say,
instead of going one, two,three, four, five, they say,
let's go one, seven, 315, 24pause. Then we're gonna bring
(25:01):
them in for a clinical thing.
Can you help us do a checklistfor the clinical skills that
they should have learned in thatsequence? And the answer is yes,
we don't charge more for that.You're a partner. Right? Right.
And then we will, we'll bringthem back and then they'll go
22, eight, nine. Right? And soit's really unique to that
organization. And what we havefound is the organizations that
(25:25):
choose to do that. And even fromcohort to cohort, or even
student to student, they get theresults that they're looking
for.
Right? They have, they havesequenced in somebody that by
the time they get through theexam, this person is actually
ready for their job almost infull. Right? And here's the, the
amazing part about this. Even ina short window, like a twelve
(25:46):
week or fourteen week thing, notonly are they training them for
this role, but the, the folksthat they're gonna be working
with, these utility players aregetting to know them.
Right? And they're givingfeedback back to the, to the HR
team or the training team. Wehave an, we have a few
organizations that bring peoplein off the street and give them
(26:09):
a thirty day wait period. Andthen they bring them into our
program and providers have a sayin this. And so very much a
partnership, very much a lefthand and a right hand doing
this.
I can, I can say this, I don'tthink two organizations do it
the same way?
Daniel Williams (26:26):
Before we sign off, Rob, I want to give you an
opportunity. Do you have anyupcoming events that might be
free to the public or resourcesor anything you might want to
point our listeners to who wouldwant to know more about US
Career Institute or buildingthat CMA pipeline?
Rob Fershtman (26:43):
You know what? We are, we are part of the MGMA CMA
program. Yeah. And so right onthe MGMA site, you can go right
there. And click on certifiedmedical assistant and learn
about it and reach us rightthrough there.
And, and really what I will sayis when you contact us through
the MGMA, Hey, have a vision,make a plan, right? We adapt
(27:07):
around you. You don't have toadapt around us. We'll do our
best to, to assist. Yeah.
Right? And, and when I, when Ithink about this, the MGMA, if I
may, you have such a widevariety of organizations and
providers. It really, when theyreach out to us, this is
(27:29):
definitely not a, our, ourcontent is the same, but how we
go about it is really about thatmember. Okay. Right.
And, and that level of success.So when people reach us through
the MGMA, right. Yeah. Thinkbig. Yeah.
Right. That's all I Yeah. Could
Daniel Williams (27:47):
Rob Furstman, it has been a blast getting to
meet you again and learn moreabout you and your organization
today. Thank you so much.
Rob Fershtman (27:55):
Thank you, Daniel. I appreciate it. Yeah.
So we look forward to continuingthat dialogue with y'all.
Daniel Williams (28:00):
Absolutely. So everybody, what I'm going to do
is in the episode show notes,I'm going to put a direct link
to what Rob was referencing thatyou'll be able to find that on
the MGMA website. I'll also putit in an upcoming article that
we're going to create based onthis conversation here. So I
just wanted to say thanks againto Rob and to US Career
(28:22):
Institute for partnering withMGMA. I think this partnership,
it is so needed.
Think all of you, hopefully,you're nodding your heads at
home or wherever you are aboutyour CMA programs and needing
that pipeline there more nowthan ever. So I did want to give
you that link to theirorganization. It's
(28:43):
uscareerinstitute, all one word,USCareerInstitute.edu. And so
for now, I just wanna say thankyou all for being MGMA podcast
listeners.
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