The first NP post-graduate residency program was started in 2007 at the Community Health Center, Inc., of Connecticut by Margaret Flinter. Despite NPs & PAs having an expedited entry into practice without medical residency requirements when juxtaposed to their physician counterparts, and because of the escalating complexity of healthcare, sub-specialization and intent focus on the patient experience (e.g., individualized treatments, quality of care, patient satisfaction), new NP & PA residency/fellowship programs are gradually growing in numbers and presenting as an extended training resource and/or a structured educational pathway for specialization.

NP & PA residencies/fellowships are tailored to new graduates and those with limited experience in their particular specialty. They vary in length depending on program design, but typically are 12 months. Some programs offer monthly stipends while others pay at or near what a new graduate NP or PA would earn at that organization. All residencies/fellowships are highly selective, commonly admitting no more than 1-4 residents/fellows annually, mostly due to limited funding.

Teaching methods include direct clinical experience, procedural and skills training, and formal preceptoring inclusive of feedback, coaching, mentoring, and peer evaluation. Many programs offer didactic, classroom-based lectures and presentations, commonly derived from, coordinated or in partnership with graduate medical education provided to resident/fellow physicians.

Given the diverse nature and lack of standardization of NP & PA post-graduate training, the need for structure and consistency has been apparent over the last several years. As a result, organizations like the American Nurses Credentialing Center (ANCC) and the National Nurse Practitioner Residency & Fellowship Training Consortium (NNPRFTC) have developed an accreditation process, recognizing the need to begin to standardize these programs.

APPex has identified and gathered information regarding all known post-graduate residency/fellowship programs for NPs, PAs, and CRNAs throughout the U.S., in both ambulatory/clinic-based and acute care settings. Programs are searchable by organization, specialty, role, and location (state).

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