What’s the Difference Between NP Fellowships and Residencies?

Post-graduate learning opportunities for nurse practitioners are increasing in popularity. In general, these programs that help NPs transition to practice are referred to as ‘fellowships’ and ‘residencies’. So, are there any differences between a fellowship and a residency? Why might one program fall into one category over another?

To understand these terms, we must take a look at education and training for physicians as this is the profession that pioneered the residency and fellowship models. After graduation from medical school, physicians are required to complete a residency. During this program, the MD is essentially a student-worker in the field where they’re specializing, for example orthopedics or cardiology. While medical school provides a broad foundation, residency helps physicians hone in on more specialized training in the patient care setting.

Following residency, physicians may opt to complete a fellowship. Fellowships give even more specialized education and experience in a specific field of medicine. For example, an orthopedist may complete a shoulder and elbow fellowship or a foot and ankle fellowship to acquire highly specialized knowledge and skills in these orthopedic subspecialties.

When it comes to nurse practitioners, the structure and requirements of fellowships and residencies are much different than those for physicians. But, one general principle is consistent – fellowships provide more specialized training than residencies. Residencies tend to provide a broader clinical foundation then fellowships. For example, most nurse practitioner residencies are in the primary care setting. Fellowships for NPs are more specialized and may be in cardiology, gastroenterology or urgent care to name a few.

Post-graduate opportunities for nurse practitioners are relatively new so the verbiage surrounding them in many cases isn’t well defined. In fact, some organizations have suggested that all optional post-graduate opportunities for NPs be referred to as fellowships. But for now, if you’re looking for practical post-graduate experience, the breadth of knowledge you can expect to obtain in the program is the main distinction between residencies and fellowships and should give you an idea of what you’re getting into with specific programs.

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2 thoughts on “What’s the Difference Between NP Fellowships and Residencies?”

  1. I was accepted into an organ transplant NP fellowship and will start this July. To give people a little insight: I will be doing 2 month rotations in the fields of heart transplant, lung transplant, liver transplant, and kidney/pancreas transplant. There is weekly didactic sessions as well as a requirement to conduct research. I’m super excited for this opportunity and am planning to write a small paper at the end to give future NP’s and students an idea of what it is like to do a fellowship and my experience!

  2. Jeanne Cameron Gonzalez

    This isn’t a new idea. Thirty years ago many of my professors were MDs. No one knew what we did or where we fell in the dichotomy of care. After the completion of my rotations, I did a many month fellowship with my own own office in the Emergency Department. It’s a great idea for any NP. While we do a great job, frequently, equal to an Md…. The amount to education received by mid levels is decreasing since we we proved ourselves in the 80’s. Is is bettter to have more ore better. I think you know the answer.

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