If no one gets hired, did the program actually work?
That’s the question I keep coming back to. In workforce development, we spend a lot of time talking about how many people we trained, how many completed a program, how many earned a credential. That matters, but too often, we stop the story there. We have to remember training is not the goal—employment is.
In Birmingham, Ala., the city was awarded $10.8M to train 1,200 people and place 1K of them into healthcare jobs, many of them at UAB Medicine. On paper, that sounds like a win. But once the education providers, employers, and government agencies leading the project got into the work, we hit a real problem. We didn’t have the infrastructure to make it happen. We lacked strong, consistent connections between training providers and employers. When it came time to show actual outcomes, we struggled.
This was not because people weren’t working hard. It was the result of a system not built to carry people all the way through. It took us time—honestly, a couple of years—to work through the issues. Once we did, we found something that worked: We got employers to treat training like it’s part of their hiring process. Because it is.
If done right, the classroom becomes a long interview. Employers get to see how someone shows up, how they learn, how they interact. And students get to see employers up close, their expectations, their culture, and the reality of the role. It’s a “try before you buy” model on both sides. And it’s a better hiring model than a 30-minute interview will ever be.
To get there, though, we had to start by saying the hard part out loud—that many employers say they’re on board but then don’t make it to the finish line. Leaders like me at UAB Medicine have even seen that happen in our own hiring practices. We ask for a class. We help design it. We get what we asked for, but then we move on before the hiring actually happens.
To break this pattern, we designed programs with a clear three-fold structure focused on alignment, job immersion, and structured hiring.
Alignment Before Day One
We made sure the training actually matched real hiring needs and not general workforce trends. The training fit our jobs, expectations, and reality. Clinical leaders and hiring managers reviewed the training content before the program ever launched. They identified skill gaps, shaped the curriculum, and ensured the clinical externship reflected the real environment students would walk into.
If there were gaps, we filled them before the class started. By the time the program launched, hiring managers already had confidence that the program would produce the type of candidate they were actually looking for.
Not Just Training, but a Trial Run
We made sure students and trainees had proper exposure to and familiarity with their specific job space. We brought the employer into the classroom and embedded parts of our onboarding and orientation into the training itself. Students were exposed to UAB Medicine’s culture, our expectations, and the day-to-day reality of the role before they were ever hired.
They got to see if they wanted us. We got to see if we wanted them.
Everyone wins with this kind of trial run; employers and training partners don’t waste resources, and students don’t waste their time preparing for a job they don’t really want.
Hiring Isn’t a Goal, It’s Part of the Program
We didn’t leave hiring up to chance. We took the full list of candidates and made sure each one had a clear path to a real job opportunity. Hiring managers who had already engaged with the class reviewed candidates and ensured interviews happened. Then we tracked it. From the class start date to the job start date, workforce development teams, training providers, hiring managers, and recruiters stayed aligned. All shared updates, removed barriers, and followed each candidate through the process.
Once we built that structure, everything changed. We went from unclear outcomes to real results. We saw 85 to 90% of the class hired into jobs. This achievement did not come from the training alone. It came from staying connected to the process all the way through.
If the goal of workforce training is employment, then we have to measure employment and not just who completed a program. Who actually got hired? Who stayed in the job? Who was promoted within a year or two?
When we start with those questions, we build programs that give employers real ownership. And when employers take ownership, training turns into hiring.
People don’t need more certificates. They need jobs.
Tiffany Bishop is Director of Workforce Development at UAB Medicine, where she leads strategic initiatives to build healthcare talent pipelines through education, employer partnerships, and career pathway programs.