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Advance​d Practice Fellowship in Hospital Medicine


​Background

The Advanced Practice Fellowship (APF) is a one-year fellowship program developed to help early-career Nurse Practitioners and Physician Assistants (or those coming back to hospital-based medicine) succeed in the inpatient environment. Recognizing that Advanced Practice Clinician providers are increasingly being utilized in the hospitalist model, our goal is to ensure NPs and PAs have the necessary skills to succeed. Ideal candidates are those interested in becoming a hospitalist or working in a primarily hospital-based specialty. The APF is the first of its kind in the country, having started in 2009, and builds on the successes the University of Colorado Hospital Medicine Group has had in developing its Hospitalist Training Program for Internal Medicine Residents.  

Program Description

The program uses a step-wise approach to developing learners into well-rounded, competent inpatient providers.  It has a strong clinical core but also utilizes frequent didactic sessions and case-based learning.  Fellows will find dedicated MD, NP and PA faculty educators who are always available to assist their learning.  The program utilizes a Multi-phase system:

Phase 1: Boot Camp (2 weeks)

During the first two weeks, the learner will participate in aspects of the University and Hospital Medicine Group orientation including computer training, billing training and specific topic instruction such as how to take a history and perform a physical and the  approach to common clinical conditions.  

Phase 2: Professional Development  (6 weeks)

This phase focuses on the learner by placing the fellow in a team consisting of a physician faculty member, a NP or PA faculty and the fellow.  Beginning with one patient and increasing to as many as 4, the fellow will be responsible for the care of individual patients.  These patients will be presented to the attending physician and patient-based teaching and clinical reasoning instruction will be offered daily. In addition, a topic-based curriculum will be given to the fellows, averaging 2 talks a week for phase 2. 

Phase 3: Clinical Development  (8 weeks)

The focus turns more to clinical medicine with a concentration on the development of clinical competence and efficiency.  The pace picks up as fellows now carry a daily patient load of 4-6 patients, again dependent on the fellow.  The topic-based curriculum continues from phase 2.   

Phase 4: Skills Refinement  (24 weeks)

The focus of the third phase shifts toward more autonomous practice while sampling different care environments.  Learners rotate weekly through 9, 3-week blocks as follows:
  • Week 1: Evenings (3p-12a) - Focus on refining admission skills through caring for a high-acuity panel of patients while developing triage skills.  Dedicated didactic time daily.
  • ​Week 2: Nights (7p-7a) - Focus on further refining triage skills and efficiency through cross coverage and admission of high-acuity medical patients. Dedicated didactic time daily.
  • ​Week 3: Subspecialty (days) - Focus on developing skills in neurology, oncology, stroke, geriatrics, palliative care consultative and comanagement medicine or other specialty of learner’s interest. This is also an opportunity for exposure to potential employers for the coming year.  Dedicated didactic time daily.
Phase 5: Capstone (8 weeks)

The focus of the final 8 weeks is to place the fellow on a service to perform admissions and care for daily patients to as much mimic a real-world position as a hospitalist NP or PA.  This phase is meant to hone the skills gleaned over the prior 10 months and improve the confidence and efficiency of the soon to be graduating fellow.  Average daily census of 7-10 patients.

Optional Subspecialty Training (4 weeks)

This optional rotation can be set up as part of the fellowship as an apprenticeship prior to starting work in a hospital subspecialty.  As graduates of the APF are expected to take jobs in hospitals, this extra rotation can be utilized to apply recently acquired general medical skills to a subspecialty area prior to commencing a job in that field.  For example, an APF interested in a position in the cardiac, neurosurgical or bone marrow transplant field could do an elective month rotation in that area of interest at the University of Colorado Hospital.  Rotations are subject to approval by the APF and Subspecialty Director and are completely optional.  This additional month is not guaranteed to all AP Fellows.

Other Features

The APF program utilizes simulation 2 times during the year to objectively measure the learner’s progress.  We also enroll learners in the Hospitalist Training Program curriculum such that they receive up to 50 hours of learning regarding healthcare finance, hospital business, quality improvement and patient safety.  The fellows will receive instruction on the job market, résumé development and contract review and negotiation.  Finally, fellows attend our monthly Journal Club, Project Conference and Grand Rounds as well as the Rocky Mountain Hospital Medicine Symposium.

Hours

The APF is generally a Monday-Friday program with 10-hour days.  During the third phase the fellows will rotate on the evening and night shifts as noted above.  No vacation will be permitted during the first 16 weeks of the fellowship.  After that, the fellows are allowed to take 4 weeks of vacation in one-week blocks (Mon-Friday). Vacation requests are accepted after the first month of fellowship on a first-come first serve basis.  Time off for major holidays cannot be guaranteed.

Salary and Benefits

We offer a competitive fellowship salary of $65,000 for the year.  AP fellows are full faculty members at the University of Colorado and receive the same benefits package as that offered to other faculty members.  This is a one-year fellowship with an optional subspeciality month (with APF Director approval) with no guarantee of employment beyond the fellowship period. Salary is commensurate with skills and experience. The University of Colorado offers a full benefits package. Information on University benefits programs, including eligibility.

Application

There will be six positions available each year for the following start dates:

  • August 1st
  • October 1st
  • December 1st
  • February 1st
  • April 1st
  • June 1st 

If interested, please apply at www.jobsatcu.com under Job Posting F00976.  If you have additional questions, you may also email Emilie Wagner at emilie.wagner@ucdenver.edu.

Minimum Qualifications

  • Must be an NP or PA
  • Must be Nationally certified and certification exam results must be provided 60 days prior to start date

Desired Qualifications

  • Acute care training or experience in adult inpatient medicine preferred

Special Instructions to Applicants

Applications are accepted electronically through the University Job Site​, refer to job posting F00976. 

The following (5) documents are required in order to be considered: a cover letter, CV/resume, (1) letter of recommendation, three (3) professional references contact information and a one-page personal statement explaining why you would like to be a part of the fellowship. Applications missing any of these documents will not be reviewed.

Do not submit documents (via email) to the job posting contact.

Review of applications will continue until the position is filled.

The University of Colorado is dedicated to ensuring a safe and secure environment for our faculty, staff, students and visitors. To achieve that goal, we conduct background investigations for all prospective employees. Some positions may require a motor vehicle records check.

The University of Colorado is committed to diversity and equality in education and employment.

At this time The Division of General Internal Medicine is unable to support VISA sponsorship.

Application

We are currently hiring for Academic Year 2014 (July 2013 - June 2014).  The job posting is below. If you have additional questions, email Emilie Wagner​

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