Q & A | Nurse Practitioner Fellowship / Residency

Having recently completed a nurse practitioner fellowship (aka residency) myself and documenting my journey, I've received many questions including:

• What are nurse practitioner fellowships/residencies?
• How did I find the nurse practitioner fellowship/residency I went through?
• What I thought about the nurse practitioner fellowship/residency?
• Would I do the nurse practitioner fellowship/residency again or just find a job to start out with?

So I've decided to share my take and answers to these questions! 

What are nurse practitioner fellowships/residencies?

Nurse practitioner fellowship (aka residency) is basically additional training after being board certified and state licensed to help the new provider transition into the role. For any nurses out there, think of it like a nurse residency program...except it's one for the NPs. Fellowship/residency for nurse practitioners is a newer concept and hasn't been around for too long, so you may find yourself explaining what an "NP fellow" or "APP fellow" is. Some are accredited (and likely to be more rigorous, I would think) and some are not. Either way, the idea behind it is to provide structured support and training for the new provider. The fellowship/residency is available in various specialties and primary care, and there are more in the east coast compared to the west coast (at least for now).

How did I find the nurse practitioner fellowship/residency I went through?

Honestly, I heard about the nurse practitioner fellowship/residency program that I went through because I happened to go to NP school there. As far as applying and getting selected, I didn't have any connections or know anyone who went through the program. I just applied and gave myself a chance at it. 

I did compile a list of nurse practitioner fellowships and residencies that I found via Google search to a spreadsheet and categorized it by state, specialty, application requirements, and application deadlines. It helped keep things organized; and as I narrowed down top choices/specialties, it made the application process a lot smoother since I had all the information I needed in front of me.

What I thought about the nurse practitioner fellowship/residency?

I thought the nurse practitioner fellowship I completed was pretty good, despite being only the second person to go through it for my department. I felt that all of my colleagues, attendings, and residents were supportive of me and my learning and taught me a lot about their subspecialty and/or the nurse practitioner role. There was always someone I could touch base with or run my plan over with. It was nice too being able to take the time to learn and to build up the amount of patients I was able to see on my own. 

We had monthly meetings focused on an advanced practice provider (aka nurse practitioner and physician assistant) topic and a quick debriefing of how the month was going for us. There were a total of 5 fellows including myself in my fellow cohort, but we all were in different specialties except for 2 of them. 

What I wish we had more of was didactics in our specialty fields. I know this would have been tough to figure out since we all are pursuing different specialties, and in that sense, have different learning needs... but I think that would have helped with the knowledge gap between school and practice, and make the transition in the specialty all the more smooth. I really had to take the initiative myself to learn during my down time and to do resource gathering, so I really think it's like the saying goes:  "you get as much out of it as you put in."

Would I do the nurse practitioner fellowship/residency again or just find a job to start out with?

There are times now in hindsight where I wonder the same thing. In a way, the learning process was tough, but I learned so much in neurosurgery and had so much support in my transition to the provider role. Having trained in a specialty right out of school has been helpful when applying for neurosurgery jobs because, well, that's what I've been trained in now. The additional training seems to have caught many recruiter's eyes, but the deal breaker is that I am not acute-care certified, although I now have inpatient work experience, and I am also not certified to first assist (APPs didn't really need it at the place I had trained). Both of these really depend on the hospital policy, hospital type (academic vs community), and work setting. Per policy where I trained, nurse practitioners for this specialty did not need to have the acute care certification nor the ability to first assist at the time. 

There seems to only be small spurts of job openings for my specialty and location. I'm not sure how much of this has to do with COVID and decrease in surgical cases, but it may be something to keep in mind when applying for a fellowship or residency, especially if it's in a specialty. 

So far, as I've job hunted, it's been difficult applying to other specialties or even primary care. When I have been extended an interview for another specialty or for primary care, I've always been asked "why not neurosurgery?" Of course, I tell them I'm interested in something else and translate the skills I have gained from fellowship and neurosurgery to the one I'm interviewing for. For the most part, I haven't made it past the interview stage for this. 

This past year, I have had colleagues and classmates who found their first job this past year and ended up being furloughed or laid off due to COVID. In that aspect, I am thankful that I at least was able to keep my job and continue learning in the fellowship. 

I guess what I'm trying to say is that the fellowship was worth it for me when everything is taken into account. It gave me the training, support, and time I needed to transition to the provider role and stand out when applying to jobs in the specialty. Then again, being a family nurse practitioner with this training under my belt, I'm in a gray zone where recruiters seemingly want me to have these additional certifications and duties...unless I work in a solely outpatient capacity, which I haven't found too many openings for yet in my job search post-fellowship. 

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If you're thinking of applying or looking into nurse practitioner fellowships/residencies yourself, feel free to ask me anything in the comments below or send me a message!

Nicole G.

@nextwithnicole // @nursenicoleg