I'm a Surgical NP, and I completed the ACNP track. The only thing you gain by getting an acute care certificate is that you'll complete rotations in ICUs, so when you have patients there, it would be familiar. That's the only thing you'll gain. I'm a CNOR, and AORN endorsed the ACNP as the "official" track for Surgical NP, so that's why I did it. I knew that I never wanted to work with kids, so I was fine with it. What I never expected was that I would fall in love with my ER rotation, but because I didn't do a FNP program, I would never be considered for a spot in the ER. In other words, you can become a Surgical NP as an FNP, and it'll open doors for congenital pedi surgery and any other specialities with a lot of peds, such as high paying ortho (sports medicine). Good Luck to you!