Fellow ship (as in MD kind) good idea?

[Tony1790]

I admit, that I may be the only person that didn't know that NP's can apply to some of the specialized Fellowships, like Emergency Medicine, Psych, GI, etc but then again, I really didn't know that much about how MD's did their training and lo and behold, I mainly work with MD"s now and several fellows in Rheumatology and totally get how doing a fellowship and really getting immersed into the field can be a huge boost to both ones knowledge and confidence inspiring.

So my question is, would taking a paid 12 month fellowship in Emergency Medicine or psych be smart? Pro: 12 months of intense training in one field alongside MD's, with a likely guaranteed job at the end of it, and the Con: most stipends that I saw were in the mid $50k range during your training, but you can moonlight on off days to earn some extra cash, plus you are back in the training mode again, ugh.

Honestly, I think that if I knew about the possibility and could have gotten into one, I would have loved to have the in-depth training that I think was lacking in my FNP program. I am continually humbled at my current position at the difference between what I know and what the fellows know, but I"m new and I'll catch up, but still.

What do you all think?

[Corey Narry, MSN, RN, NP]

NP's are nurses and for that reason, our training programs will never be structured under the guidance of established physician training programs. Post-graduate training programs for NP's have adopted the word "fellowship" to refer to any type of structured educational offering fresh NP grads can avail of in order to sub-specialize or fill-in educational gaps not offered in any of the Consensus Model based tracks (FNP, AGPCNP, AGACNP, WHNP, NNP, PNP-AC, and PNP-PC).

In my opinion, it doesn't make sense to have a fellowship program in General Psych for grads of PMHNP programs because that should already be the focus of PMHNP programs. However, a fellowship program in Psych may sell itself as having a focus on Psychotherapy training for instance which does add a layer of skill and specialization not offered as an intensive to the PMHNP track.

I've also seen Primary Care fellowships for new FNP's and AGPCNP's and again, I feel that Primary Care is already the focus of those programs so I'm not sold on having another year of fellowships for the same skills that the NP training program should have already prepared the new provider for. However, some graduates do feel a need to have additional exposure to the same field in order to gain confidence as providers especially in some job markets where new grad on-the-job training does not exist and new NP's are expected to hit the ground running when they land their first job.

I happen to work for an Academic Medical Center that offers a fellowship program for new AGACNP's in Critical Care and Surgery and I'm designated as one of the Preceptors for the Critical Care portions of the training. It is an additional layer of intensive training that AGACNP's don't all get in their program. Yes, the pay is much lower than the rate for NP's in the medical center, however, the position is not listed under the medical center but rather the School of Nursing which was able to secure funding for the program.

Is it fair? maybe, maybe not. That fellow is a board certified NP and fully credentialed by the medical center to write orders, write notes, and perform procedures under supervision initially just like a new NP would be. Even with full university benefits, that does sound like cheap labor. But then it's also a two-way street because we are offering a service to the fellow and making sure they have structured rotations in various Critical Care and Surgical settings with seasoned NP's and physicians throughout the fellowship year.

We've graduated 4 fellows since we started this program and all 4 have worked for us in various Critical Care and Surgical Specialties where their job applications were given priority over outside applicants. Typically, we get numerous resumes submitted when we have openings and they were considered before anyone else. In the end, I think it's a win win for both fellow and the medical center. Our program is currently applying for accreditation with ANCC which has become the equivalent of ACGME for nurses in terms of post-graduate training programs for nurses.

[djmatte, ADN, MSN, RN, NP]

NP's are nurses and for that reason, our training programs will never be structured under the guidance of established physician training programs. Post-graduate training programs for NP's have adopted the word "fellowship" to refer to any type of structured educational offering fresh NP grads can avail of in order to sub-specialize or fill-in educational gaps not offered in any of the Consensus Model based tracks (FNP, AGPCNP, AGACNP, WHNP, NNP, PNP-AC, and PNP-PC).

In my opinion, it doesn't make sense to have a fellowship program in General Psych for grads of PMHNP programs because that should already be the focus of PMHNP programs. However, a fellowship program in Psych may sell itself as having a focus on Psychotherapy training for instance which does add a layer of skill and specialization not offered as an intensive to the PMHNP track.

I've also seen Primary Care fellowships for new FNP's and AGPCNP's and again, I feel that Primary Care is already the focus of those programs so I'm not sold on having another year of fellowships for the same skills that the NP training program should have already prepared the new provider for. However, some graduates do feel a need to have additional exposure to the same field in order to gain confidence as providers especially in some job markets where new grad on-the-job training does not exist and new NP's are expected to hit the ground running when they land their first job.

I happen to work for an Academic Medical Center that offers a fellowship program for new AGACNP's in Critical Care and Surgery and I'm designated as one of the Preceptors for the Critical Care portions of the training. It is an additional layer of intensive training that AGACNP's don't all get in their program. Yes, the pay is much lower than the rate for NP's in the medical center, however, the position is not listed under the medical center but rather the School of Nursing which was able to secure funding for the program.

Is it fair? maybe, maybe not. That fellow is a board certified NP and fully credentialed by the medical center to write orders, write notes, and perform procedures under supervision initially just like a new NP would be. Even with full university benefits, that does sound like cheap labor. But then it's also a two-way street because we are offering a service to the fellow and making sure they have structured rotations in various Critical Care and Surgical settings with seasoned NP's and physicians throughout the fellowship year.

We've graduated 4 fellows since we started this program and all 4 have worked for us in various Critical Care and Surgical Specialties where their job applications were given priority over outside applicants. Typically, we get numerous resumes submitted when we have openings and they were considered before anyone else. In the end, I think it's a win win for both fellow and the medical center. Our program is currently applying for accreditation with ANCC which has become the equivalent of ACGME for nurses in terms of post-graduate training programs for nurses.

What these programs tend to do is offer a greater degree of training and experience in the chosen path which given the nature of many clinical requirements, I'm sure it's not a bad thing. I view it as a structured ramp up where clinics pay you a bit less for giving you the breadth to really get your footing as a provider. The reality is many schools across the board are failing new nurse practitioners who could benefit from better education and longer clinical rotations. This is a one year opportunity to get well structured experience.

[NHGN]

It's just one guy's opinion, but check out episode 66 of The NP Dude podcast.