The Current State of Advanced Practice Provider Fellowships in Hospital Medicine: A Survey of Program Directors
BACKGROUND: Postgraduate training for advanced practice providers (APPs) is a growing field in hospital medicine. As hospital programs continue to benefit from highly trained physician assistants (PAs) and nurse practitioners (NPs), fellowship programs have become more prevalent. However, little is known about the number of active programs or how they prepare trainees.
OBJECTIVES: To describe the existing APP fellowships in hospital medicine, with a focus on program characteristics, rationale, curricula, and learner assessment. METHODS: An electronic survey was distributed by e-mail to hospital medicine program directors in May 2018. The survey consisted of 25 multiple choice and short answer questions. Descriptive statistics were calculated utilizing Stata 13 for data analysis.
RESULTS: Of the 11 fellowships identified, 10 (91%) of directors responded to the survey. Eighty percent of programs accept both NPs and PAs and 80% are between 12 and 13 months long. All programs cite “training and retaining” as the main driver for their creation and 90% were founded in institutions with existing physician residencies. Ninety percent of program curricula are informed by Society of Hospital Medicine resources. Despite these similarities, there was wide variation in both curricular content and APP fellow assessment.
CONCLUSION: APP fellowships in hospital medicine are quickly growing as a means to train and retain nonphysician hospitalists. While most programs accept similar types of applicants and share a common rationale for program development, there is little standardization in terms of curriculum or assessment. Further research may be valuable to characterize the best practices to guide the future of these fellowships.
© 2019 Society of Hospital Medicine
CONCLUSION
APP fellowships in hospital medicine have experienced marked growth since the first program was described in 2010. The majority of programs are 12 months long, operate in existing teaching centers, and are intended to further enhance the training and retention of newly graduated PAs and NPs. Despite their similarities, fellowships have striking variability in their methods of teaching and assessing their learners. Best practices have yet to be identified, and further study is required to determine how to standardize curricula across the board.
Acknowledgments
Disclosures
The authors report no conflicts of interest.
Funding
This project was supported by the Johns Hopkins School of Medicine Biostatistics, Epidemiology and Data Management (BEAD) Core. Dr. Wright is the Anne Gaines and G. Thomas Miller Professor of Medicine, which is supported through the Johns Hopkins’ Center for Innovative Medicine.
