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Nurse practitioner residency and fellowship programs are post-graduate jobs that are specially designed to offer additional training in a specialty or sub-specialty area of advanced practice nursing. They ease the transition to regular APRN positions or offer additional specialty expertise to hone your skills in particular focus areas.
Advance practice nursing is a tough job and it takes intensive study to get ready for it. You had to earn a master of science in nursing or even a doctor of nursing practice to qualify for licensure and board certification, but honestly that was just the start.
There’s just so much real-world knowledge needed in this job that it can be overwhelming to make the jump from academics to real-world practice. And there’s even more of a gap between general practice and the kind of advanced specialty work that goes into becoming an oncology nurse practitioner, for example, or working in other similarly specialized roles.
Filling those gaps are what advance practice residency and fellowship positions are designed for.
What is The Difference Between Fellowship and Residency Programs?
Nurse Practitioner Residency Programs and Transition to Practice
Advanced Practice Nursing Residency and Fellowships by Specialization and State for 2021
Pediatric Nurse Practitioner Residency and Fellowship Programs
Cardiology Nurse Practitioner Fellowship Programs
Family Nurse Practitioner Residency and Fellowship Programs
Acute Care Nurse Practitioner Fellowship Programs
Surgical and Critical Care Nurse Practitioner Fellowship Programs
Women’s Health Nurse Practitioner Fellowship Programs
Psychiatric/Mental Health Nurse Practitioner Residency and Fellowship Programs
Palliative Care and Oncology Nurse Practitioner Fellowship Programs
Orthopedics Nurse Practitioner Fellowship Programs
Neurology Nurse Practitioners Fellowship and Residency Programs
Other Nurse Practitioner Specialty Fellowship and Residency Programs
In a world where nurse practitioners are increasingly being called on to cover for physician shortages, residencies and fellowships are becoming more and more important to fill in the skills gap between the two professions. The typical physician comes out the other side of medical training with more than 15,000 hours of clinical experience. A typical NP may only have one-tenth of that when they are dropped into their first job.
Residencies and fellowships are real jobs with real pay and benefits for Advanced Practice Registered Nurses (APRN), but they only last about a year.
During that year, though, you get the kind of real-world, hands-on training that builds both your confidence and your expertise in your chose APRN specialty.
Even assuming the best nursing education in the world, those hours matter in developing clinical expertise. Fellowships and residencies help fill that gap for nurse practitioners and for the healthcare community.
What is The Difference Between Fellowship and Residency Programs?
It’s easier to understand these terms if you understand where they come from. Being familiar with the medical model of training, the people who developed APRN training consciously or sub-consciously borrowed terminology from the world of physician education.
There, doctors are all required to complete residencies immediately after their graduation from medical school, almost always in their field of specialization. A fellowship is an optional follow-on to residency, one that offers even deeper specialization in their field of practice. For example, a doctor might do their residency in internal medicine. Then, optionally, they could take on a fellowship in hematology, specializing in blood-borne diseases and treatments. Both residencies and fellowships are training positions, not permanent postings.
In nursing, the same general pattern applies.
A residency is a short-term educational position in a nursing specialty area, such as primary care or family practice… A fellowship is also a temporary position, but one drilling down into more specialized topics like oncology or emergency medicine.
Unlike doctors, these placements are not critical to licensing for APRNs. The terms and training also might not be as consistent because of this. Also, unlike doctors, it’s not necessary to complete a residency before applying for fellowships. While you need more experience to get into the average fellowship, that experience doesn’t necessarily have to come through a residency program.
What this all means is that it’s important to look at your options for both residencies and fellowships for nurse practitioners. Both could be in play to give you the combination of general practice area, patient population and specialty-specific training you might be interested in.
What Type of Post-Graduate Program Should You Consider as a Nurse Practitioner?
The landmark Institute of Medicine report “The Future of Nursing: Leading Change, Advancing Health” recommended both residencies and fellowships to increase the professionalism of nurse practitioners and shore up some problems in the profession. In particular, nursing residencies were seen as a way to give new graduates more clinical experience in a specialty area while under supervision and to increase retention rates among new NPs.
Residencies are a great fit for any recent graduate with an MSN or DNP.
Fellowships are there to build your expertise in a specific sub-specialty of practice. They’re often a better fit for NPs who have a couple years experience under their belt. It’s typically at that point in your career that you start figuring out exactly what it is you need to learn more about. Fellowships are where you get that knowledge.
In other cases, fellowships can be more aimed at research than practice. This still offers a high level of training in the sub-specialty, but the focus will be on developing theoretical knowledge rather than honing hands-on direct patient care skills.
You will also find fellowships here that are not exclusive to nurse practitioners. Depending on the specialty in question, a fellowship might be open to doctors, nurses, and even non-clinicians.
Nurse Practitioner Residency Programs and Transition to Practice
A master of science in nursing is a path to advanced practice licensure, but any NP will tell you that when you graduate, you still have a long way to go before you’re fully prepared for anything the job might throw at you.
Residency programs provide an easier transition between academia and the stress and pressure of real-world advanced practice nursing.
A residency program offers you a paying job for a certain amount of time. You are expected to perform the work of an APRN, but you are also expected to learn better how to do that work. Residencies are closely supervised by expert practitioners to guide you through the transition into full independent practice.
Nursing theory is extraordinarily important in defining the APRN role. All the training and classroom education you receive in an MSN program is a core feature. Advanced practice nurses take on levels of care that approach doctors in some respects, but they aren’t the same job. You don’t just learn the mechanics of how to care for patients at an advanced level, but also the conceptual differences that make nursing care the holistic practice that it is.
Translating that theory into day-to-day practice takes work, though. And it’s work that gets easier when expert supervisors from residency programs can walk you through it.
Preceptorships and Mentorships Offer Individualized Supervision to Residents and Fellows
You might be wondering how exactly it is that you get all this advanced training we keep talking about. A residency or fellowship isn’t like a college class, after all. It’s on-the-job training.
A lot of the magic of that training comes through mentors and preceptors.
A preceptor is a senior nurse practitioner that is assigned to new fellows or residents for a period of time, maybe even the entire period of residency. They are the model to follow for observing and picking up key job skills, ward policies and practices, and techniques. They explain processes, act as an available resource to answer questions, and introduce you to other staff and help you settle in professionally.
A mentor is often a less formal advisor, a senior colleague who you develop a personal and professional relationship with and who you can turn to for advice in a wide range of subjects. Sometimes mentors are assigned, but usually they come from relationships that just emerge on the job. They might stick with you for an entire fellowship or residency, or you could end up keeping them on speed dial through your entire career.
The combination of those roles represents many of the real advantages of the residency and fellowship process. Ultimately, it’s that human connection that provides the critical piece to assimilating knowledge. It’s through those relationships that knowledge is transferred in the course of these programs.
How Difficult Is it to Find an Opening in a Nurse Practitioner Residency or Fellowship Program?
Because residencies and fellowships aren’t widespread in the nursing world, it can be a challenge to land a spot in one.
According to the National Center for Education Statistics (NCES), somewhere between 30,000 and 40,000 people graduated with master’s degrees or doctorates in nursing specialties in 2018. Not all of those graduates are bound for advanced practice nursing, but probably the majority are.
In contrast, you can see that there are fewer than 200 residency and fellowship programs available for post-graduate study. If you pare it down by your specialty interests, it’s far fewer. And many of these programs admit only a handful of residents or fellows each year.
Putting the numbers together, you can see that you’re looking at some stiff competition if you want to get your foot in the door at one of these advanced training programs.
What Are the Requirements to Get Into a Residency or Fellowship For Nurse Practitioners?
With the stiff competition for these slots, you might be surprised to find that the entry requirements are not too bad. Like medical residencies and fellowships, there is usually a fixed term, which means you have one shot per year to get your application in, often by early spring for a fall start date.
Between the two, residencies are easier to qualify for. They are aimed at recent graduates. In fact, you might need to apply within a year or 18 months of graduating from your MSN or DNP program. You do usually need to have a state license already, and sometimes third-party certification in the correct specialty area.
Fellowships are more demanding. You’ll need multiple letters of recommendation, a CV showing some commitment to specialty practice in the field and several years of experience, and you’ll usually need an essay or personal statement of your goals. And you’ll definitely need national board certification in your specialty areas.
Is There a Post-Employment Requirement for Nursing Residency or Fellowship Programs?
Nursing residencies are a kind of apprenticeship, and so there is often a commitment that comes with them that you remain employed with the organization for a year or so after your residency is complete.
Fellowships do not typically have any ongoing requirements to stay onboard. In fact, their goal is to get you out the door to spread that knowledge, and free up the spot to get another healthcare professional the training and experience they need.
Advanced Practice Nursing Residency and Fellowships By Specialization and State for 2021
Below you’ll find the most current list of available residency and specialty programs for APRNs in the United States for 2021. The programs are grouped together by specialty, and then listed by state. In many cases, you’ll find that states may only have one program in a given specialty, and sometimes none at all. To find the right fit, you’ll have to shop around.
It pays to check with other resources to find residency and fellowship openings. In some cases, you’ll find them listed on regular job boards, such as the American Association of Nurse Practitioners Job Center, along with other types of NP positions.
Pediatric Nurse Practitioner Residency and Fellowship Programs
- California
- Shasta Community Health Center – Nurse Practitioner Post-Graduate Fellowship Program Pediatric Rotation)
- Connecticut
- Community Health Centers – Nurse Practitioner Residency Training Program
- Massachusetts
- Boston Children’s Hospital/Harvard – Pediatric Health Services Research Fellowship Program
- Boston Children’s Hospital – Pediatric Advanced Care Nurse Practitioner Fellowship
- New Jersey
- Children’s Specialized Hospital – Developmental and Behavioral Pediatrics Fellowship
- North Carolina
- Carolinas Health Care System – Pediatric Hospitalist Fellowship for Advanced Practice Providers
- Pennsylvania
- Penn State Health – Advanced Practice Fellowship in Neonatal Intensive Care
- South Carolina
- Lexington Medical Center – APRN Fellowship Program Pediatric Specialty Rotation
- Texas
- Texas Children’s Hospital – Hematology-Oncology and Hematopoietic Stem Cell Transplantation Training and Fellowship
- Washington
- Seattle Children’s Hospital – APP Fellowship in Pediatric Acute Care
Cardiology Nurse Practitioner Fellowship Programs
- Arizona
- Mayo Clinic – Cardiology Nurse Practitioner Fellowship
- North Carolina
- Carolinas Health Care System—Adult Cardiology Fellowship for Advanced Clinical Providers
- Ohio
- The Ohio State University Wexner Medical Center – Advanced Practice Provider Fellowship in Cardiovascular Medicine and Surgery
- South Carolina
- Lexington Medical Center – APRN Fellowship Program Cardiology Specialty Rotation
Family Nurse Practitioner Residency and Fellowship Programs
- California
- Santa Rosa Community Health Centers – Family Nurse Practitioner Residency
- Connecticut
- Community Health Centers – Nurse Practitioner Residency Training Program
- Indiana
- Healthlinc Community Health Center – Family Nurse Practitioner Residency Program
- Massachusetts
- Family Health Center of Worcester – Family Nurse Practitioner Residency
- Maine
- Portland Community Health Center – Family Nurse Practitioner Residency Program
- New Hampshire
- Lamprey Health – Family Nurse Practitioner Fellowship
- North Carolina
- Atrium Health – Advanced Practice Provider Fellowship in Family Medicine
- Washington
- Yakima Valley Farm Workers Clinic – Family Nurse Practitioner Residency
- Tennessee
- Vanderbilt School of Nursing – Genetics Fellowship for Family Nurse Practitioners
- Washington
- International Community Health Services – Family Nurse Practitioner Residency Program
Acute Care Nurse Practitioner Fellowship Programs
- California
- Shasta Community Health Center – Nurse Practitioner Post-Graduate Fellowship Program Urgent Care Rotation)
- Colorado
- University of Colorado Anschutz Medical Campus – Advanced Practice Fellowship in Hospital Medicine
- Connecticut
- Community Health Centers – Nurse Practitioner Residency Training Program
- Washington DC
- George Washington University School of Medicine – Nurse Practitioner Fellowship in Emergency Medicine
- Georgia
- Emory Woodruff Health Sciences Center – Critical Care Nurse Practitioner Residency Program
- South Carolina
- Lexington Medical Center – APRN Fellowship Program Urgent Care Specialty Rotation
- Illinois
- North Shore University Health System – Nurse Practitioner Fellowship in Emergency Medicine
- Minnesota
- Mayo Clinic – Nurse Practitioner Emergency Medicine Fellowship
- New York
- University of Rochester Medical Center – APP Fellowship Program in Emergency Medicine
- New York Presbyterian – Emergency Medicine Nurse Practitioner Fellowship
- North Carolina
- Carolinas Health Care System—Emergency Medicine Fellowship for Nurse Practitioners
- Carolinas Health Care System—Acute Care Nurse Practitioner Fellowship
- Pennsylvania
- Penn State Health – Advanced Practice Fellowship in Emergency Medicine
- Luke’s University Health Network – Critical Care and Emergency Medicine Advanced Practitioner Fellowship
- Rhode Island
- Brown Alpert Medical School – Emergency Medicine Physician Extender Development Program
- South Carolina
- Lexington Medical Center – APRN Fellowship Program Urgent Care Specialty Rotation
- Utah
- Intermountain Medical Center—Trauma and Critical Care Postgraduate Fellowship for Advanced Practice Clinicians
- Virginia
- Carillion Clinic—Urgent Care and Rural Medicine Fellowship for Nurse Practitioners
Surgical and Critical Care Nurse Practitioner Fellowship Programs
- California
- University of California San Francisco – Surgical and Critical Care Nurse Practitioner Fellowship
- Colorado
- University of Colorado Health – Advanced Practice Provider Surgical Fellowship
- Maryland
- University of Maryland Medical Center – Nurse Practitioner Critical Care Fellowship Program
- New York
- Columbia University Department of Medicine – Critical Care Nurse Practitioner Program
- North Carolina
- Carolinas Health Care System—Surgical Critical Care Fellowship for Nurse Practitioners
- Ohio
- The Ohio State University Wexner Medical Center – Advanced Practice Provider Fellowship in Cardiovascular Medicine and Surgery
- The Ohio State University Wexner Medical Center – Advanced Practice Provider Fellowship in Critical Care
- Pennsylvania
- University of Pittsburgh – Critical Care Advanced Practice Provider Residency
Women’s Health Nurse Practitioner Fellowship Programs
- California
- Shasta Community Health Center – Nurse Practitioner Post-Graduate Fellowship Program Women’s Health Rotation)
- South Carolina
- Lexington Medical Center – APRN Fellowship Program Gynecology Specialty Rotation
Psychiatric/Mental Health Nurse Practitioner Residency and Fellowship Programs
- California
- Shasta Community Health Center – Nurse Practitioner Post-Graduate Fellowship Program Psychiatry Rotation)
- San Francisco VA Health Care System – Psychiatric Mental Health Nurse Practitioner Residency Program
- Connecticut
- Community Health Centers – Nurse Practitioner Residency Training Program
- North Carolina
- Duke University School of Nursing – Psychiatric Mental Health Nurse Practitioner Post-Graduate Residency Program
- Utah
- University of Utah College of Nursing—Veterans Affairs Medical Center Psychiatric Mental Health Nurse Practitioner Residency Program
Palliative Care and Oncology Nurse Practitioner Fellowship Programs
- Florida
- University of Miami Health System – Oncology Nurse Practitioner Fellowship
- Massachusetts
- Harvard Medical School Center for Palliative Care – Adult & Pediatric Palliative Care Fellowships
- Massachusetts General Hospital – Palliative Care Nurse Practitioner Fellowship
- New York
- Memorial Sloan Kettering Cancer Center – Advanced Practice Provider Fellowship in Hospice and Palliative Care
- James J. Peters VA Medical Center – Interdisciplinary Fellowship in Palliative Care
- North Carolina
- Carolinas Health Care System—Palliative Care Medicine Fellowship for Nurse Practitioners
- Ohio
- The Ohio State University Wexner Medical Center – Advanced Practice Provider Fellowship in Oncology
- Texas
- MD Anderson Cancer Center—Post Graduate Fellowship in Oncology Nursing
Orthopedics Nurse Practitioner Fellowship Programs
- Ohio
- The Ohio State University Department of Medicine – Advanced Practice Provider Orthopedic Fellowship
- The Ohio State University Wexner Medical Center – Advanced Practice Provider Fellowship in Orthopedics
- South Carolina
- Lexington Medical Center – APRN Fellowship Program Orthopedics Specialty Rotation
- Virginia
- Carillion Clinic—Orthopaedic Surgery Fellowship for Nurse Practitioners
Neurology Nurse Practitioners Fellowship and Residency Programs
- North Carolina
- Duke University School of Medicine – Advanced Practice Providers Residency Program in Neurology
- New Jersey
- Capital Health – Neuroscience Nurse Practitioner Fellowship
Other Nurse Practitioner Specialty Fellowship and Residency Programs
- Arizona
- University of Arizona Center for Integrative Medicine – Fellowship in Integrative Medicine
- Colorado
- Colorado Center for Nursing Excellence – Rural and Underserved APRN Fellowship
- Illinois
- American Association of Nurse Anesthetists—Advanced Pain Management Fellowship Program for Certified Registered Nurse Anesthetists
- Iowa
- University of Iowa Health Care – Nurse Residency Program
- Maryland
- Johns Hopkins Medicine – Gastroenterology and Hepatology Nurse Practitioner Fellowship Program
- Massachusetts
- Lahey Hospital and Medical Center – Dermatology Nurse Practitioner Fellowship
- Minnesota
- Mayo Clinic – Nurse Practitioner Clinical Education Collaboration
- Mississippi
- North Mississippi Medical Institute – Advanced Practice Clinician Fellowship
- North Carolina
- Duke University School of Nursing – Nurse Practitioner Residency in Primary Care for Veterans
- Carolinas Health Care System—Advanced Practitioner Fellowship in Urology
- Carolinas Health Care System—Geriatric Nurse Practitioner Fellowship
- Ohio
- The Ohio State University Wexner Medical Center – Advanced Practice Provider Fellowship in Ambulatory Medicine
- Pennsylvania
- Penn State Health – Advanced Practice Fellowship in Dermatology
- Texas
- Houston Methodist – Nursing Residency Program
- Virginia
- AASLD—Nurse Practitioner Clinical Hepatology Fellowship
- Washington
- Swedish Health Network—APC Gastroenterology Fellowship
- Various
- Indian Health Service – Nurse Residency Program