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NP Fellowship experience

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by NPfellow123 NPfellow123 (New Member) New Member Nurse

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Hi Everyone, 

I am writing a post I wish I could have found online a year ago when I was trying to decide how to start my career as a new nurse practitioner. I am in a fairly prestigious NP Fellowship program in NYC and I do not recommend it. Be very cautious with your expectations and who you talk to if you are looking into programs like these. Ask to speak with fellows or former fellows who are not the people the company first recommends. Ask very specific questions such as, what kinds of concerns have current fellows expressed, and how many of the fellows have expressed any concern about the program. If there is something that is important to you to get out of doing a fellowship or residency, don't be scared to ask about it in great detail in the interview and if you get an offer. Ask them and pursue getting a clear answer. Ask how many fellows have gotten to do the procedures you care about doing or how often fellows see patients in specific populations if that motivates you (peds, newborns, obstetrics) and ask for very specific percentages. Ask about who the preceptors are and how often fellows are not precepted in person by someone who has experience working for the organization when they are supposed to be precepted. Ask about what any "independent" clinic time means, for example, ask if it means that fellows will be completely on their own from day 1 of practice during independent clinic with no clinician available for even on site EMR assistance or training. Beware of vague answers. This program has not done a lot of the basic stuff it promised us, and has done a lot of additional things that have been terrible. A lot, if not most, of the people here this year are very unhappy. Perhaps the most general advice that I can make based on my group of fellows is, if you have a job offer that appeals to you even somewhat and you are weighing it against a fellowship opportunity, I encourage you to take the job offer. Don't make sacrifices to do a fellowship that you hope/believe will be a great opportunity unless you have really good insight into the program, like a friend who went through it and gave you the real scoop. Fellowships and residencies are great ideas and we need them badly but there aren't a lot of resources to support them, and at least in my company it is basically a disaster. I wish I had asked a lot more specific questions beforehand. Ask to get in writing the things that the fellowship will do that are important to you (even basic things like precepted hours, the ratio of preceptor to fellows- (it's not going to be 1:1), and the definition of precepting- it should not be done by phone "as needed"). I would also get the maximum patient numbers in writing if the program is increasing patient numbers over time. 

I've never posted on this website before, but I always read it before making big career decisions. Sometimes I found helpful info and sometimes I didn't find much. I hope this can be helpful to someone else like me. 

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juan de la cruz has 27 years experience as a MSN, RN, NP and works as a Adult Critical Care Nurse Practitioner.

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Would you be able to specify what type of NP you are (FNP, AGACNP, etc) and what this fellowship program was for (i.e., Family Practice)?

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14 Likes; 2 Followers; 2,943 Visitors; 91 Posts

Great post! Thanks for sharing your experience and helping those who may need it.

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8 Likes; 93 Visitors; 7 Posts

I also suggest some skepticism about any specific population/specialty days outside of clinic or outside of the residency/fellowship's institution or clinics. Ask if fellows are credentialed at other sites or if those experiences are limited to shadowing. Ask whether fellows will have access to and/or chart in the other sites' EMRs. On the other hand make sure you know what patients you will be responsible for following up on in terms of labs, prescriptions, and signing charts. I would suggest getting in writing whether days that are intended to be for learning could potentially include responsibilities that will follow you outside of that experience/day and could add up to a significant additional workload. This is not inherently bad, and certainly likelier to have a learning benefit than exclusively shadowing experiences, but it is not something you want added on to some fellows' plates in a disproportionate way or a way that was not disclosed from the start of the program. And ask about administrative time for fellows and within the organization generally. 

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JuiceBoxHero has 7 years experience and works as a Staff RN.

54 Visitors; 7 Posts

Thank you for taking the time to share this. It's appreciated! 

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Dodongo has 7 years experience as a APRN, NP.

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Can you provide more details about how this residency is structured?  Is this a true NP residency, or actually an orientation that they call a residency (I've seen a few of these).  One has time carved out for lectures every week and off rotation with other specialties/service lines, etc.  One is just an extended orientation where you work in your role for a specified period of time.

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Neuro Guy NP has 7 years experience as a DNP, PhD, APRN and works as a Neurocritical Care NP.

16 Likes; 6,706 Visitors; 183 Posts

I wouldn't actively discourage fellowships as most I know are quite good. One program doesn't reflect badly on the experience in its totality. I know mine was tremendously helpful, especially in this niche specialty. 

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8 Likes; 93 Visitors; 7 Posts

9 hours ago, Neuro Guy NP said:

I wouldn't actively discourage fellowships as most I know are quite good. One program doesn't reflect badly on the experience in its totality. I know mine was tremendously helpful, especially in this niche specialty. 

I agree that it is a really worthwhile thing to do and that some are extremely rewarding. I am writing specifically about the one I am doing. It can be difficult to know whether the program will be what it promises to be. Some are great from what I've heard from people doing them. But I've also heard about plenty that are not and am sorry to have learned how possible finding yourself in a bad program the hard way. 

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8 Likes; 93 Visitors; 7 Posts

22 hours ago, Dodongo said:

Can you provide more details about how this residency is structured?  Is this a true NP residency, or actually an orientation that they call a residency (I've seen a few of these).  One has time carved out for lectures every week and off rotation with other specialties/service lines, etc.  One is just an extended orientation where you work in your role for a specified period of time.

It's not an orientation. It has lectures and specialty time. 

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