Nurse Practitioner Residencies

[JuiceBoxHero]

I am wondering; are there any current practicing nurse practitioners who have completed a residency/fellowship who would be willing to share about their experience? Thanks in advance!

[Psych-DNP, DNP, APRN]

On 12/28/2021 at 8:30 AM, Amber MSN said:

@Psych-DNP I was hoping to pick your brain about your acceptance into the VA residency program. What did you experience look like before? Are you a veteran? I’d love any information. I’m originally from CA and before spending time applying to all of these residencies and planning to uproot my family to another state, I’d love to weigh my chances! Thanks in advance!

It's very much like a job interview. The candidates with nursing experience stand out most, as well as those who have been working with some sort of marginalized population (LGBTQ+, women's health, working in FQHC in Latinx area). Veterans are given a preference, but they only make up a small percentage of the applicants. 

The biggest thing is wanting to stay with the VA long term. If your goal is to complete the residency and leave it's probably not the right program. The needs of veterans doesn't always translate to what you would be doing in the community.

[esipbisn]

On 2/25/2022 at 5:45 AM, Psych-DNP said:

It's very much like a job interview. The candidates with nursing experience stand out most, as well as those who have been working with some sort of marginalized population (LGBTQ+, women's health, working in FQHC in Latinx area). Veterans are given a preference, but they only make up a small percentage of the applicants. 

The biggest thing is wanting to stay with the VA long term. If your goal is to complete the residency and leave it's probably not the right program. The needs of veterans doesn't always translate to what you would be doing in the community.

Good afternoon @Psych-DNP

I was reading your posts and I was wondering if you knew about the SF VA residency program and if you could tell me more about it, please?

Thank you in advance

[jensfbay, BSN, DNP]

On 11/7/2021 at 6:52 AM, Sun1 said:

on the tail end of my primary care residency program at an FQHC. much harder than NP school, very rigorous, but I wouldn't trade it for no residency. I feel much prepared to handle complex patients. I don't recommend it to residents with young kids though

Thank you and apologies for the late response. this is a community health clinic, primary care residency for FNPs. It's tough because we see patients 3 (if not 4) days a week. We see a lot of patients 

[Mfeimy]

I am considering applying for critical care fellowships at Atrium Health Carolinas Medical Center and Duke University Medical Center in 2025. Does anyone have any insight into the fellowship programs at these facilities? It's been difficult to find information about the programs such as how they are structured and what people's experiences have been who have completed these programs. Thanks!

[considercranium]

Psych-DNP said:

After graduating with my DNP I completed one of the PMHNP Residency programs at the VA (there are several: Boston, Sacramento, Salt Lake City, San Francisco, there are more that I can't remember, and more are being added every year). It was one of the best decisions I could have made to start my career. Each residency is a little different from what I understand and is determined by the site. It provided me with a year of on the job experience that was designed to give me exposure to multiple settings: multiple outpatient psych clinics, inpatient psych, psych emergency (to name a few); multiple patient populations within the VA: Transgender health, addiction programming; almost every setting I was in I was part of a multidisciplinary team of APNs, social workers, psychologists, and physicians; I was able to get a varied experience in prescribing, group psychotherapy, and individual psychotherapy; and there is a requirement for all sites to provide weekly didactic lectures. My VA had a wide range of topics from food/sugar addiction, benzo sparing alcohol withdrawal treatment, LGBTQ+ health, PTSD treatment, minority stress, (again this is just a few of the many topics); there are opportunities to teach with the university we are partnered with (e.g., one day presentations, or being a guest in a seminar on interview building skills). The amount of growth and knowledge I received in that one year alone. I am still learning so much. Every patient encounter is supervised and the the educators I had were adept at teaching learners.

There are also some pretty great perks too, you can get medical and life insurance, 13 days of vacation, 13 sick days, 11 paid holidays. You won't get to participate dental, vision, or the retirement during residency. Three is a significant amount of free training available throughout the year. Did I make significantly less than I would have if I went to work for a psychiatrist in a private practice doing nothing but prescribing adderall and ativan? YES! Did I gain experience that far outweighed that? Also, YES! When I finished the residency and became staff I got a significant raise and access to the full benefits package the VA offers (which is huge!).

There are residencies around the country, I think Mayo, Duke, Rush universities, and some community settings have them. The great thing about being at the VA is that if you graduate in one state you can still apply for a VA residency in any state because you only need one licence in any state. I graduated in Illinois, if I wanted to go to Mayo or Duke I would have to pass my boards, get my licence in IL, then apply for a licence by endorsement before I could start working. Depending on that state's board of nursing that can be a nightmare. Also, you can graduate and be eligible for licensure to start the VA residency. You then have 90 days to pass your boards and get your state license.

This might be an unpopular opinion--residency should be a requirement for NPs. Especially in states where full practice authority is allowed. (But that might be a different post)

I completed the Boise VA adult primary care NP residency because I too strongly believe in postgraduate NP training. The program also enhanced the rigor of my education particularly through exposure to multiple specialty rotations that broadened my clinical foundation and challenged me to grow as a new clinician. That said, my experience was marked by significant concerns that I believe future applicants should be aware of. In my view, there was limited transparency about program weaknesses, inconsistent mentorship, shifting expectations across preceptors, and feedback and learning plans that were often vague or underdeveloped. At times, support felt more performative than substantive, and normal aspects of early clinician development were treated as problematic rather than educational. While I fully support NP residencies and believe they are critically important for safe and competent practice, I would encourage applicants who are applying to Boise to ask very direct questions about structure, feedback, and mentorship of the program to ensure it truly prioritizes resident development and informed consent.