What to Expect from a Physician Assistant Fellowship or Residency Program

Choosing to complete a physician assistant/ physician associate (PA) residency or fellowship program is a weighty step for many PAs seeking to start their careers. While residencies and/ or fellowships (we'll use the term fellowship from here on out, as it is more common) are not mandatory nor standard for PAs, they are growing in popularity, especially among new graduates and those looking to switch specialties.

Few if any PA programs provide didactic or clinical instruction in every specialty, and starting a PA role in a position where the clinical medicine is foreign can be overwhelming. Additionally, adequate onboarding is often more of an exception than a rule at many health institutions. A fellowship program offers structured, hands-on training beyond the standard PA education, preparing graduates for more advanced roles in healthcare. Understanding what to expect from a PA fellowship can help you make informed decisions about your career path and maximize the benefits of this intensive training.

Understanding PA Fellowship Programs

PA fellowship programs are postgraduate training opportunities designed to enhance clinical skills in specific medical specialties in surgery, emergency medicine, and/ or primary care. Unlike the average instruction at a PA program, which covers a broad range of medical knowledge, fellowship programs focus on intensive, specialty-specific training.

Fellowship programs typically last from 12 to 24 months and combine clinical rotations, didactic learning, and mentorship. PA fellows work closely with attending physicians, advanced practice providers, and other healthcare professionals, gaining experience in complex patient care scenarios and procedural training.

Key features of PA fellowship programs include:

• Specialized clinical training: Focus on a particular medical specialty or population.

• Supervised patient care: Hands-on experience under expert guidance.

• Didactic sessions: Lectures, case discussions, and skills workshops.

• Professional development: Opportunities to improve communication, leadership, decision-making skills, and networking.

  
  

Participating in a fellowship program can significantly boost your confidence and competence, making you a more competitive candidate for specialized PA roles.

PA fellowship training can include procedural and surgical skills training (Mayo Clinic Medical & Surgical Gynecology PA Fellowship)

How Fellowship Programs Enhance Your Career

Fellowship programs provide a unique environment to refine your clinical skills and expand your medical knowledge. They are especially valuable for PAs who want to transition into specialties that require more in-depth training than what is robustly offered in a PA program.

Benefits of completing a fellowship program include:

1. Increased clinical competence: Exposure to complex cases and procedures with structured guidance.

2. Higher employability: Employers often prefer candidates with experience, especially in unique specialties.

3. Networking opportunities: Connections with specialists and healthcare leaders.

4. Potential for higher salary: Specialized skills can lead to better compensation.

5. Confidence in patient care: Ability to handle challenging medical situations independently.

   
   

For example, a PA completing a surgical fellowship will gain hands-on experience in preoperative and postoperative care, surgical assisting, and managing surgical complications. Considering surgical PA roles are varied in their practice environments, this experience is invaluable when applying for surgical PA positions.

Fellowship programs also often include training in leadership and healthcare systems, preparing PAs to take on roles that involve supervising other healthcare staff or managing clinical operations. As the world of management expands, the role of PAs in management is imperative to equitable workplace environments for APPs. Leadership starts early, and time dedicated to leadership training is valuable for any practice environment in a future medical career.

Surgical instruments used in PA fellowship training

How to Choose the Right PA Fellowship Program

It's worth noting that PA fellowship programs are not at all synonymous with residencies or fellowships for medical doctors (MDs or DOs). The requirements, standards, hours, pay, and expectations are all distinctly unique for PA fellowships, medical residences, and medical fellowships. While residencies and fellowships for MDs and DOs are standardized by the ACGME, PA fellowships are not held to the same scrutiny or set of standards. While this allows PA fellowships to autonomously consider their objectives and mission, it does also imply some risk in accepting a fellowship position, as the fellowship program may not always provide the experience they advertise. Selecting the right fellowship program is crucial for your professional goals and growth. Consider the following factors when evaluating programs:

• Specialty focus: Choose a program that aligns with your career goals, whether it’s emergency medicine, surgery, internal medicine, or another field.

• Program length and structure: Some programs last one year, others two. Look for a curriculum that balances clinical exposure with didactic learning.

• Accreditation and reputation: Research the program’s accreditation status and reputation within the medical community.

• Mentorship opportunities: Strong mentorship can enhance your learning experience and professional development.

• Location and resources: Consider the hospital or clinic setting, available technology, and patient population.

• Compensation and benefits: Most programs offer stipends or salaries, and programs may vary on what benefits they provide.

  
  

It’s also helpful to connect with current or former PA fellows to get firsthand insights into the program’s strengths and challenges.

For those interested in exploring available options, our PA residencies and fellowships page offers a comprehensive directory of opportunities across various specialties and locations.

Optimizing Your PA Fellowship Experience

To get the most out of your PA fellowship, approach it with a proactive and open mindset. Here are some actionable tips:

• Set clear goals: Identify what skills and knowledge you want to gain.

• Seek feedback: Regularly ask supervisors for constructive criticism. Create a schedule for intentional feedback and be open to impromptu advice as well.

• Engage in learning: Participate actively in lectures, workshops, and case discussions.

• Build relationships: Network with physicians, nurses, and fellow advanced practice providers (APPs) and PAs.

• Document your progress: Keep a log of procedures performed and cases managed.

• Stay organized: Manage your time effectively to balance clinical duties and study.

• Prioritize self-care: Fellowship (and any new PA job!) can be demanding; maintain a healthy work-life balance.

  
  

By following these recommendations, you can enhance your clinical competence and prepare for a successful career as a PA.

Looking Ahead: The Future of PA Fellowship Programs

PA fellowship programs are becoming increasingly popular with PA graduates. With growing demand for specialized care and team-based practice, these programs offer a pathway for PAs to meet complex patient needs effectively. According to the 2024 NCCPA Statistical Profile, 5.7% of PAs completed a postgraduate PA fellowship. Emergency medicine fellowships are the most common type of fellowship program, with 24% of PAs choosing a fellowship of that specialty. General surgery and surgical specialties were the next most common, at 12.8% and 12.4%, respectively (2024 NCCPA Statistical Profile).

As more institutions recognize the value of fellowship-trained PAs, opportunities will likely continue to grow, offering more diverse specialties, advanced training models, and, likely, an accredited means of validating their educational advantage. PA fellowships can provide health institutions with dedicated, institution- and specialty-specific onboarding as well asSure! Could you please provide more details about the topic or theme of the post you would like an excerpt for? insight into the best providers for their system, which provides an excellent advantage to both PA and employer when jobs need filled.

For some PAs, completing a fellowship program can be a game-changer, opening doors to leadership roles, academic positions, and specialized clinical practice.