Acute Care NPs - To do a residency or not?

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I'm a dually certified ACNP/FNP. My goal is to eventually work in the ER. I have the opportunity to do a residency program at my hospital that covers multiple specialties: ER, ICU, trauma, nephrology, cardiology, orthopedics, neurology, infectious disease, endocrine, heme/onc, and palliative care. 

Pros: it's a full fellowship program with classroom instruction, rounds with teaching physicians in each specialty, exposure to all the departments in the hospital, excellent learning opportunity, chance to gain more confidence in diagnosis, procedures, etc.

Cons: the pay is "meh" compared to the workload, no time off during the program, geared for MDs/DOs (but they do take NPs/PAs), doesn't start until November (a little over 7 months from now).

For those who are current acute care (hospitalist or ER) NPs, do you think doing a fellowship as a new grad is necessary? Or do you feel that going right into the specialty I want (ER) would be a better route? I would love to hear opinions as I like to weigh all the pros and cons before making a big decision. I have until mid-April to make a decision.

Let me hear your opinions ? 

Specializes in Former NP now Internal medicine PGY-3.

I don’t think any of the ones here have done a fellowship here. But I have not fact checked that statement. I don’t think there is a fellowship anywhere near where I am which may be why. Assuming those who have done a fellowship are also highly motivated and likely are more likely to succeed either way with some experience. 

On 8/29/2022 at 4:09 PM, Numenor said:

Just a note, I spent my entire career almost as a CCRN/ICU nurse, did not transfer over to a hospitalist role at all. Being a RN has nothing to do with being a NP, it's all about the education and the thousands and thousands of hours as a provider which prepares you.

At my hospital we practice at the top of our license per our admin and locums docs (99% independent) but I assume most places have decent MD involvement for safety reasons.

Where is it that you work, or what type of facility?  Rural/ community or Teaching center?  Do you place chest tubes? What do you mean by operating at the top of your scope? How does that look for your day-to-day practice?

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