Physician assistant fellowships, also known as residencies, are an opportunity for new graduates or experienced providers looking to switch specialties, to obtain further advanced training in various medical and surgical fields. Trained as generalists, physician assistants can use these focused programs to acquire further clinical and didactic education at an expedited pace over on-the-job training. This article will highlight the application process and benefits.
What are Clinical Fellowships?
After completing physician assistant school and becoming board certified, a graduate can enter the workforce and apply for any position available. Fellowships developed as an alternative path for physician assistant graduates wanting to expand their knowledge base in a structured environment, rather than as a new hire. Post-graduate learning allows more time to refine clinical skills, increase expertise, and become more proficient while building confidence and competence.
There are programs available in mostly all specialties including critical care, trauma, cardiology, cardiothoracic surgery, dermatology, emergency medicine, burn surgery, geriatrics, hospitalist medicine, hematology/oncology, internal/family medicine, obstetrics and gynecology, interventional radiology, orthopedic surgery, otolaryngology, pediatrics, psychiatry, urology, and general surgery.
Clinical Fellowships in California
The APPAP (The Association of Postgraduate Physician Assistant Programs) is a great website to research all available locations and specialties. California has several opportunities as listed below:
University of California, Davis (Advanced Practice Providers Fellowship | UC Davis Health)
- Burn Surgery
- Endocrinology
- Neurosurgery / Neurology
- Oncology
- Orthopaedic Surgery
- Interventional Radiology
- Trauma / Acute Care Surgery
Arrowhead Regional Medical Center (Physician Assistant Fellowship Programs | San Bernardino County Hospital)
- Emergency Medicine
- OB/GYN
- Orthopaedic Surgery
Loma Linda University (Orthopaedics Physician Assistant (PA) Residency – Graduate Medical Education | Loma Linda University Health)
Riverside University Health System (Orthopaedic Physician Assistant | Riverside University Health System)
Shasta Community Health Center (Primary Care Fellowship Program)
University of California, Fresno (UCSF Fresno Emergency Medicine)
University of California, Fresno (UCSF Fresno Orthopaedic Residency)
Kaweah Health Medical Center (Emergency AP Fellowship Kaweah Health Medical Center (vituity.com)
Preparation and Process
Most physician assistant fellowships average 12-18 months in duration and will pay, on average, less than a starting salary at a full time position. Additionally, the weekly hours typically exceed forty hours. It is not for everyone, and it is important to consider your current financial and family situations prior to applying.
However, the pros are indisputable as the education and experience obtained generally put a new graduate in a better position to secure a more desired job in their field of choice, and typically at a higher average wage, following completion of the program. Student loans can be deferred and most programs offer a medical and dental plan with a 401K in addition to the monetary stipend.
To initiate the application process, it is recommended to narrow your search on the APPAP website to a preferred specialty and the desired locations you are willing to relocate. From that list, investigate each program for their deadlines and application requirements. The majority require:
- Being a graduate from an ARC-PA accredited program
- A baccalaureate degree
- NCCPA certification
- State licensure
- DEA licensure
- Three letters of recommendations
- Curriculum Vitae
- Current BLS and ACLS certifications
- And a personal interview
What is Life Like in a Clinical Fellowship Programs?
Postgraduate programs condense a large amount of material into an abbreviated time frame of 12 to 18 months, with some extending 2 years. They are intense and rigorous with a curriculum consisting of lectures, assigned reading, journal clubs, multidisciplinary rounds, simulation procedural and case scenarios, grand rounds, and morbidity and mortality conferences. Typically cohorts are small, ranging from one to slightly over ten trainees, therefore there are limited available spots annually.
For an inpatient fellowship, expect to perform shift work with an average schedule of 10-12 hours per day, three to five times a week with some weekends. Outpatient medicine has more favorable hours, consisting of 8-10 hour days during a regular business week of Monday through Friday. Somewhat mimicking physician residencies and fellowships, the program’s goal is to produce highly qualified physician assistants.
Advantages of Clinical Fellowship Programs
The opportunity to evaluate, participate in care, and perform procedures on an increased number of patients is unmatched when compared to any new physician assistant job. Despite a temporary disruption in work-life balance and maximum earning potential, which are ideal aspects of being a physician assistant, a candidate is ensured to leave with a stronger belief in themselves, a greater sense of autonomy, and a thorough knowledge of their area of study. Additionally, they will have a great resume, a larger network of connections, and improved potential to land their dream position all while negotiating for more money or other benefits.
Frequently Asked Questions
A physician assistant fellowship, also known as residency, is a 12-24 month post graduate structured clinical learning program designed to expand one’s education within a specialty field of practice by providing further lectures and treating more patients in a supervised environment. The result is refined skills, increased expertise, improved proficiency, and ultimately, confidence.
A physician assistant fellowship, similar to the degree, is designed from the medical model. The most notable difference is the length of duration. Aside from the time frame, they are very similar in regards to education and training. Often hospitals will utilize physician assistant fellowships in lieu of medical residents.
The APPAP (The Association of Postgraduate Physician Assistant Programs) is a great website to research all available programs, locations, and specialties.
Each fellowship is slightly different so ensure you read all the requirements and take notice of the deadlines. All will necessitate that you have graduated from an ARC-PA accredited program, are NCCPA certified, and have the appropriate state and DEA licenses. There are limited slots available, therefore higher grades, excellent letters of recommendation, and ultimately a personal interview will determine the final candidates.
Although not inclusive to every state, most specialties are available throughout the country including critical care, trauma, cardiology, cardiothoracic surgery, dermatology, emergency medicine, burn surgery, geriatrics, hospitalist medicine, hematology/oncology, internal/family medicine, obstetrics and gynecology, radiology, orthopedic surgery, otolaryngology, pediatrics, psychiatry, urology, and general surgery.
Most are 12-18 months, with some extending to 2 years.
The pros clearly outweigh the cons, with the greatest benefit being extended education and specialty training. This makes a candidate more marketable to obtain their desired position of medical practice.
Conclusion
As a physician assistant student, you are trained as a generalist but also introduced to several specialty areas of medicine and surgery. The clinical year is only twelve months however, exposing you to at most thirty days of experience per rotation. As you prepare to graduate and ponder your near future, I would highly recommend considering a fellowship, especially if you have decided what area of medicine you would like to practice.
Performing at a high level post graduation is a daunting task, but expected. The guidance of a fellowship can improve self confidence and clinical ability by expanding your education, gaining more training treating patients, and learning the fine details of each specialty,
