Value of Post-grad Fellowship

[Avenger1]

Is there value in doing a post-grad fellowship or residency? Let me expound, I see obvious benefit as far as knowledge expansion and skill enhancement. But I have just started reading about more of these begin available for NP's and PA's yet have not spoken to anyone who has completed one.

For example the Carilion Clinic in Virginia offers an Emergency Medicine fellowship for NP's https://www.carilionclinic.org/emergency-department/fellowship

Would completion make the post-grad a much more desirable candidate? Would there be a salary increase? Certainly scope of practice or role in the care team would be the same regardless. There are 20 some other's in multiple specialties that I read about. Some very specialized such as Hepatology.

Thoughts?

[traumaRUs, MSN, APRN]

Wow - sounds like a great program. Since you would be an employee of the hospital already, I wonder if they hire you to a position afterwards?

[Dranger]

I am definitely looking into fellowships when I finish.

[Jules A, MSN]

With what is imo the superficial education and minimal clinical hours we presently receive before prescribing I think residencies or fellowships should be mandatory and would likely result in a much higher quality of care.

I'm weary of the less than impressive 20yo references, many nothing more than questionnaires sent to docs who employ NPs, indicating our outcomes are on par with physicians. I suspect that as the numbers of new NPs enter the field, especially since few require nursing experience and some of the schools seem less than stellar we are going to see a downturn in both our care and reputations.

[Corey Narry, MSN, RN, NP]

We started an in-patient ACNP fellowship last year (multi-institution and combination of ICU, surgical specialties, and trauma). Because the one open position per year was developed through university funding, the pay wasn't competitive which turned many highly recommended new grads from our ACNP program away. However, the fellow position was filled by an excellent new grad NP who is now finishing up the fellowship year.

There are advantages from the fellow's standpoint: the fellow has the required NP certifications and is fully credentialed as a provider in the institutions rotated to. After a year of rotating through the various in-patient services during fellowship, this person was offered employment by many of those services and got to pick the best permanent position and felt well-prepared to hit the ground running.

[traumaRUs, MSN, APRN]

I have to say Jules, I agree. I received 6 months formal orientation which included clinical as well as didactic with our MDs.

That said, 9 months into my employment and only 3 months off orientation, I made a horrific mistake which even 9+ years later, I have a very difficult time reconciling myself to it. My practice was extremely supportive of me, but it still resulted in many years of added stress.

And the root cause of my incident was I was led down a path by a nurse and physician that I never should have gone down.

I think there should be more education/opportunity/fellowship info about getting a phone report, the questions to ask, when/if to just nope, I'm doing this. In other words, when to know your limitations.

[Jules A, MSN]

That said, 9 months into my employment and only 3 months off orientation, I made a horrific mistake which even 9+ years later, I have a very difficult time reconciling myself to it. My practice was extremely supportive of me, but it still resulted in many years of added stress.

Thank you for sharing this pearl. It is is lousy but it happens, been there/done that. I still shudder to think of what "could have happened" and will always be thankful for my team's support.

In my experience the best we can hope for is that we recognize our errors, reflect on how not to ever repeat them and have a healthy amount of respect for the gravity of responsibilities we have been entrusted with. Sadly I'm not sure this is the always the case for some providers of all disciplines.

[PG2018]

I lime the idea of one year residencies for NPs. I think all NPs should receive a more broad, general education more akin to PAs , and we can subspecialize in electives and residency. I make too much money presently to quit and pursue scholastics, but I'd consider added training later perhaps.

[PG2018]

In fact, I don't lime it. I like it.

[Jules A, MSN]

In fact, I don't lime it. I like it.

Awww man, now I have to unlike it. If you don't "lime the idea of one year residencies for NPs" I can no longer support your post, lol.

[racarlton85]

I wouldn't waste your time with Carilion clinic ER fellowship. They have a PA program right down the road and are very biased towards them. They only take three providers if you can get an interview, and by interview I mean 8 twenty minute interrogations.

[racarlton85]

But I do think a post grad fellowship would give some great experience. I just started 6 months ago in urgent care and now have an interview for an ER position.