Program Background

 

The University of Colorado Division of Hospital Medicine’s Advanced Practice Fellowship (APF) is a 13-month post-graduate fellowship program dedicated to enhancing the development of both early-career Acute Care Nurse Practitioners (ACNPs) and Physician Assistants (PAs) or for those new to hospital-based medicine. Recognizing that ACNPs and PAs are increasingly utilized in inpatient care models, our program’s mission is to provide the knowledge, skills, and attitudes necessary for a provider to succeed in the challenging world of acute care medicine.  Ideal candidates are those interested in working in a hospital-based environment, both in hospital medicine and specialty practices.  Started in 2009, the APF is one of the oldest ACNP and PA inpatient training fellowships based on the successes the Division of Hospital Medicine (DHM) had in developing its Hospitalist Training Program for Internal Medicine Residents. The APF has graduated more than fifty fellows, who now hold positions in Hospital Medicine, Emergency Medicine, the Intensive Care Unit, the Bone Marrow Transplant Unit and in many other Divisions across the University Hospital and the region.

Program Description

The program uses a multiphase approach to develop learners into well-rounded, competent inpatient providers. The DHM has built core clinical teams around fellows in order to provide opportunities for high-yield, bedside clinical instruction from talented Physician and Advanced Practice Professional (APP) faculty.  Though it has a strong clinical core, the APF also utilizes frequent didactic sessions and case-based learning to enhance learner development. Click here​ to view a sample schedule which illustrates the different phases and clinical services more clearly. 

 The three phases are described in more detail below:

Phase 1: Junior Fellowship-Professional Development

The first 4.5 months, termed the Junior Fellowship, includes both Boot Camp and Core Medicine experiences. 

Boot Camp (4 weeks)

During the first four weeks of the program, the fellow will participate in orientations for the University, Hospital, and DHM. These orientations include topics such as billing, benefits, effective communication, computer EMR training, observation experiences, and specific instructions sessions (i.e. how to take a history and perform a physical; the approach to common clinical conditions; documentation training). Fellows also recieve hands-on training sesions through our simulation center. Toward the end of the Boot Camp, the junior fellow will start managing 1-2 patients with close supervision of a senior fellow in the program. 

Core Medicine (14 weeks)

There are two major focuses of this phase: 1) General inpatient medicine clinical experience

2) Didactic Core Medicine talks

For ideal clinical experience, the junior fellow will work on two differently structured clinical teams caring for general medicine inpatients: 1) the Hospital Medicine Service (HMS), a team consisting of a Hospital Medicine Attending, APP faculty member, and one fellow; and 2) the Medicine-3 Service, a team consisting of a Hospital Medicine Attending, Internal Medicine senior resident, and two fellows.  Beginning with two patients and increasing to as many as six, the fellow will be responsible for the care of individual patients. These patients will be presented to the faculty on formal bedside rounds, and patient-based teaching and clinical reasoning instruction will be offered daily. Twice weekly, APP and physician faculty will give didactic instructional talks on general medicine topics ranging from heart failure to acute kidney disease. 

 

Phase 2: Intermediate Fellowship-Skills Enhancement

Over the next 4.5 months, fellows will move beyond daytime general internal medicine services, and will gain experience from the Medical-Oncology service, Consult Medicine service, and Swing/Nights services. Fellows will also start rotations on electives for inpatient specialties.

Swing and Nights (8 weeks) Fellows will spend 4-6 weeks on an afternoon/evening admitting service (Swing) and 2-4 weeks on the Division’s Nights service which focus on cross cover as well as nighttime admissions. There is a didactic teaching session on each swing shift and patient-based clinical teaching by the APP faculty member on each nights experience.  

Emergency Medicine (4-8 weeks)

Fellows will spend one month (and more if desired) in the emergency department learning the clinical aspects of emergency medicine.  There will be weekly didactic lectures in addition to clinically focused teaching.  

Medicine-Oncology (6 weeks)

Fellows will spend about 6 weeks on the Medical-Oncology service which cares for inpatients with active cancer diagnoses or suspected new diagnoses.  This rotation offers fellows exposure to oncology patients, the oncologists and palliative care teams. 

Consult Medicine (4 weeks) Fellows will spend 4 weeks on the Consult Medicine service which provides medical care and consultation to primarily perioperative patients. There is a dedicated curriculum averaging 2 lectures a week.  

Electives (4-8 weeks) Fellows have about 4-8 weeks for elective time. The elective rotations are in 1 or 2-week-long blocks meant to expose the fellows to different areas throughout the hospital.  Fellows can choose from a multitude of specialty rotations including but not limited to cardiology, pulmonary, gastroenterology, palliative care, infectious disease, endocrinology, ICU etc.

 

Phase 3: Senior Fellowship-Skills Refinement

During the final 4 months of the fellowship senior fellows will spend less time on Swing, Nights, Medical Oncology and Consult services and will devote more time to both electives and the Capstone Medicine rotation.

Capstone Medicine (6 weeks) Fellows will spend 4-6 weeks on the Hospital Medicine 3 (HMS3) service, a team consisting of a Hospital Medicine Attending and the fellow. The focus of this rotation is to provide the fellow with a real-world mimic for working as a faculty APP on a hospitalist team. This experience is meant to refine all of the skills learned during the prior phases, as well as to improve confidence and efficiency of the fellow to prepare them for a post-graduate job. During this phase the average daily census for the fellow is 8 patients.

 

Commitment Details

Hours/Workdays

The APF is a rigorous primarily Monday-Friday program with 10 to 12-hour days. However, please note that during the Core Medicine rotation, fellows will spend about one-half of the time on the Medicine Service. As this is a resident service, the fellows have a resident-like schedule of working 6-days a week.  During the third and fourth phases the fellows will rotate on the evening and night shifts as noted above. The Swing shifts are usually from 2:30 until around midnight, but longer shifts can occur, and this rotation is Monday-Friday.  Night shifts are from 7a-7p and when on Nights, the fellows will work 4 night shifts a week.  Some electives will also have the fellows working on weekends. Please click here​ to see a schedule example.

 

Vacation

Fellows will be pre-scheduled a set 5 weeks of vacation throughout the fellowship in one-week blocks (Monday-Friday; including the weekends on either end). Fellows cannot request certain vacation days/weeks off. No vacation is given during the first 16 weeks of the fellowship or the week of Thanksgiving or December 25th.  Days/partial days will be granted off for interviews after the mid-point in the fellowship.  

 

​Salary and Benefits

We offer a competitive fellowship salary of $65,000 for the 13-month program. 

This fellowship has no guarantee of employment beyond the fellowship period nor are graduates required to commit to positions here at the University of Colorado Health after graduation. 

Information on University benefits and eligibility for job title "Faculty Fellow"  is located at: ​http://www.cu.edu/employee-services/benefits​ and the eligiblity matrix at: https://www.cu.edu/docs/benefit-eligibility-matrix

 

Program Didactics/Curriculum

Clinical Skills Course

Weekly during the first phase of the fellowship and then bi-monthly through the next two phases, the fellows will have an hour-long instruction session in topics which include reading ECGs, interpreting chest radiographs, working through acid-base problems and much more. 

 

APF report

Twice monthly fellows will attend APF Report. During this hour-long session, one fellow will present an interesting case and be pre​cepted through to the diagnosis and treatment plan.  Each fellow will be responsible for preparing a case twice during the year. 

 

Internal Medicine Residency Noon Report

Each fellow is invited to attend the daily Internal Medicine Residency report where lunch is provided.  Similar to APF Report, one of the residents will present a case and the Chief Medical Resident will precept the conversation, walking through the case and highlighting learning points. As the University of Colorado hosts one of the most competitive residencies in the western United States, this conference sees high levels of discussion and learning.  Click here to learn about the Internal Medicine Residency Program. 

 

Medicine Department Grand Rounds

Each Wednesday instead of resident report, the Department of Medicine holds its Grand Rounds.  Speakers are invited from the department and around the country to come and offer their expertise to the packed audience. 

 

Rocky Mountain Hospital Medicine Symposium

Each fellow will be registered for free to attend the fall Rocky Mountain Hospital Medicine Symposium.  This two-day conference offers didactic talks on a wide range of topics given by renowned local, regional and national speakers. Click here to view the Symposium schedule from 2018. [UPDATE: RMHMS is not being held this year, 2019]

 

Multi-Disciplinary (MultiD) Week

For one week during Phase 1, fellows will join members of the multidisciplinary team including physical, occupational and speech therapy, with a unit pharmacist, with a bedside nurse, with the MET team and with the care management team.  The goal of this week is to better understand how to work with the talented members of the MultiD team.

 

Journal Club

Fellows are invited to attend the monthly Bottom-Line Journal Club (BLJC) organized by the HTP residency program. Residents and fellows are invited to different Division faculty member’s homes for dinner and to review recent updates in medical literature and learn about different career paths within hospital medicine.

 

​Evaluation

Weekly feedback/Quarterly Evaluation Sessions

A key aspect of the APF is giving fellows frequent and actionable feedback allowing them to grow with an individualized learner focus.  Verbal and written feedback is obtained from faculty weekly.  Every 3 months fellows have one-on-one feedback sessions with the APF leadership to develop an individualized learner improvement plan. 

 

Medical Knowledge Assessment

At the beginning of the fellowship and end of the core medicine rotation (after 4 months), the fellows will take an examination to assess medical knowledge strengths and areas for growth.  This formative tool will allow fellows to focus their independent study.  ​

Program Application

Each year we accept 2 cohorts of 6 fellows. Our cohort start dates are March 1st and September 1st. 

***We are not currently accepting applications. The next available cohort to apply for will begin March 1st, 2021. We will update this site soon with details on how to apply for that cohort. ***

Minimum Qualifications 
  • Must be an ACNP or PA
  • For NPs, must be an ACNP (or be credentialed as an ACNP prior to cohort start date)
  • Must be nationally certified and certification exam results must be provided 60 days prior to start date.​​ 
 
​​Desired Qualifications​​​​​

We look for candidates who express a high interest in acute inpatient medicine as a career trajectory and are looking for an intensive training experience. Since it’s a rigorous and lengthy fellowship, the best candidates are those who truly want to spend an additional 13 months in training as a learner. Any courses and specific rotations that show your interest in and ability to excel clinically in the inpatient/acute setting would make you a competitive applicant. However, your application is viewed as a whole (letters of recommendation, transcripts, personal statement, etc.) and we do take everything into consideration. 

 

Special Instru​ctions to Applicants

The following six (6) documents are required in order to be considered.  Applications missing any of these documents will not be reviewed. Please attach documents to your online application when you submit it. Do not submit documents afterwards via email/mail to the job posting contact.

1. Cover letter

2. Current CV/Resume

3.* 2 -3 letters of recommendation; at least one (1) must be from a clinician that personally supervised the candidate while she/he was caring for patients

4. Contact information for three (3) professional references

5. Transcripts from both your undergraduate college(s) and PA/AG-ACNP school (unofficial is acceptable)

6. A one-page Personal Statement explaining why you would like to be a part of the fellowship.

*Note: If they wish to do so, recommenders can send their letters of recommendation via email directly to Cayleigh Brown at DHM-Education@ucdenver.edu or via mail directly to our office:

Attn Cayleigh Brown, Education Programs Specialist  

Division of Hospital Medicine 

Leprino Bldg, 4th floor, Mailstop F-782

12401 E. 17th Avenue

Aurora, CO 80045​

 

How to Apply

Applications are accepted electronically online via www.cucareers.com

 

 

If you have additional questions, please first review our list of Frequently Asked Questions under the FAQs tab. If you still have additional questions or need information please contact Program Manager Cayleigh Brown at DHM-Education@ucdenver.edu.​

 

​The University of Colorado Division of Hospital Medicine is committed to diversity, inclusion, and equity.  Diversity and equity drive excellence in clinical care, scholarship, and medical education. As a division, we lead and support programs and initiatives that address inequities and injustices in underserved patient populations, as well as inequities within our healthcare workforce.  We are dedicated to working with students, residents, fellows, faculty, and staff from diverse backgrounds to continuously foster a culture of inclusivity.

 

Information on University benefits programs and eligibility for Faculty Fellows is located at: ​http://www.cu.edu/employee-services/benefits as well as the matrix here https://www.cu.edu/docs/benefit-eligibility-matrix​

 
 
 

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.

 

How many cohorts are there each year? When does each cohort begin?

There are 2 cohorts of 6 fellows accepted each year. Cohorts begin on March 1st and September 1st.


 When do applications open/end? Are they on a rolling acceptance at all? Can I reapply?

Applications are NOT taken on a rolling admission. Applications for specific cohorts open approximately 11-12 months before the start dates. Your application will be accepted for a specific cohort and start date only, applying does NOT make you eligible for both cohorts. Application deadlines are typically 7-8 months before the start date to allow for candidate selection and credentialing. Specific dates will be posted on the website. If you are not selected for a specific cohort, we do consider reapplications. If you would like to reapply, please make sure the program manager knows.


What cohort should I apply to?

Application deadlines are typically at least 7 months before the cohort start dates to allow for credentialing. You must provide your licensure exam results at least 60 days before your start date, so if you are only graduating 2 months before the cohort start date, you will not be eligible for that cohort.

 I don’t see an application deadline on the website, why is this?
 

Application deadlines are added once the application opens for a specific cohort. If you do not see a deadline for a specific start date on the website, we are not actively taking applications for that cohort. Check back to the website for updates or email Cayleigh Brown at DHM-Education@ucdenver.edu for more information on future cohorts.

 If I apply, when will I be notified of final acceptance/denial?
 We typically aim to notify applicants within a month after the application deadline. If you do not make it through the initial phases, you will be contacted earlier on. 
  

I submitted my application and have not gotten any confirmation, should I be worried?

You may not hear from us until it is closer to the application deadline. Feel free to reach out if you have any concerns with your application or have questions regarding submitting it. YOU are responsible to make sure all documents are attached properly. The program manager or HR manager will NOT check your application before the deadline date to ensure all documents have been included. 
 

I’m an FNP/ENP, can I still apply and be considered, even if I have significant ER/hospital work experience? 

 Unfortunately, at this time we are not able to accept any NPs other than credentialed ACNPs into the fellowship. Since our fellows rotate on services through the University of Colorado Hospital, we have to adhere to their guidelines and they are currently only accepting ACNPs as employees in the inpatient setting as set by national guidelines.
 

Would I be able to do an ACNP certification while doing the fellowship simultaneously?

Unfortunately, the fellowship is too much of a time commitment to do a dual program at the same time. You MUST be credentialed as an ACNP prior to doing the fellowship, but you can apply to a future cohort with plans to get your ACNP credentialing before the fellowship cohort start date you have applied for.
 

Can I apply for a cohort during my last semester of training, prior to having licensure exam results?

 Yes, you can be accepted into the program before your graduation as long as you have taken and passed your exam 60 days prior to starting the fellowship.
 

Who should I address my cover letter/personal statement/ letter of recommendations to?

You are welcome to address your letters and have your recommenders address letters to “Advanced Practice Fellowship Selection Committee”.
 

Should I submit my letter of recommendation online with my application, or should it be sent directly to you from the recommender?

 You are welcome to submit the letter of recommendation to the job posting. If your recommender wishes to send it to us directly, you may have them email it to Cayleigh Brown at DHM-Education@ucdenver.edu or mail it to our office at the address below. We do suggest that you make us aware of who will be sending any letter(s) to us directly either by submitting a word document on your application stating who or via email, so we can confirm if we have received all your letters and your application is complete when we go to review it.

Advanced Practice Fellowship Committee 

 

Attn: Cayleigh Brown, Education Programs Specialist  

Division of Hospital Medicine 

Leprino Bldg, 4th floor, Mailstop F-782

12401 E. 17th Avenue

Aurora, CO 80045​

 

Can I come and shadow the program to learn more?

Yes, you are welcome to come and shadow to get an idea of what the fellowship would be like and to learn more. This can be scheduled through Cayleigh Brown (DHM-Education@ucdenver.edu). ​ Typically a week day is best for you to get the best experience from shadowing. Paperwork must be completed and turned in 2 weeks before you plan to shadow so please send your request 3-4 weeks before you wish to come and shadow.  If you live out of state and would like to travel to Colorado to shadow, we would be happy to have you, but unfortunately we do not have the ability to reimburse you for any travel costs. 
 

Are there any current or graduated fellows that I can speak with regarding their experience with the fellowship?

Yes, we can put you in touch with either current or past fellows (now faculty) who are willing to discuss their experiences with you. Please contact Cayleigh Brown at DHM-Education@ucdenver.edu directly to request this and she can reach out to the fellows for you. Please keep in mind that current/graduated fellows have busy schedules so we ask you to be respectful of their time.
 

What does the interview process look like if I move on to that stage?

After we review applications, if you make it to the interview stage, then the process begins with a phone call interview. If the hiring committee decides to request a second interview, we would complete this interview via Skype or in-person if you live in the area. If you would like to travel to Colorado to complete an in-person interview, we would be happy to have you, but unfortunately, we do not have the ability to reimburse you for any travel costs.
 

What are you looking for in candidates?

We look for candidates who express a high interest in acute inpatient medicine as a career trajectory and are looking for an intensive training experience. Since it’s a rigorous and lengthy fellowship, the best candidates are those who truly want to spend an additional 13 months in training as a learner.

How can I make my application competitive?
Any courses and specific rotations that show your interest in and ability to excel clinically in the inpatient/acute setting would make you a competitive applicant. However, your application is viewed as a whole (letters of recommendation, transcripts, personal statement, etch) and we do take everything into consideration. 

 

Approximately how many applicants apply for each cohort? 

Typically, anywhere from 30-35 applicants per cohort.

 Are fellows typically from around Colorado, or does the program have fellows from other states?

Fellows are from all around the country/world! It truly depends on the cohort, however, we receive about half of our applications from CO residents or candidates that have previously lived in CO. Cohorts are all different but are usually a mix of about half from CO and half from other states. 

Are most applicants/fellows usually new graduates out of PA/NP school, immediately doing the fellowship, or have they been employed and practicing for a few years? 

Applicants and fellows tend to be both recent graduates as well as those who have held previous employment and have been practicing after PA/NP school. Cohorts usually have a mix of both. Keep in mind that our fellowship is quite rigorous, hence, the best candidates are those who truly want to spend an additional 13 months in training as a learner-focused on hospital medicine. 

 

 I am a PA/NP student interested in doing a rotation with your group, do you have availability for this?
 

Unfortunately, at this time there is not enough space on our clinical teams to take on students from outside of the University of Colorado’s NP and PA schools. We hope we can do this in the future!

 

I see that vacation weeks will be pre-set for me. Would I be able to request a certain vacation week (say, if I had a wedding, important life event, etc.)? 

Unfortunately, no. Your 5 weeks of vacation will be spread out throughout the fellowship in pre-set dates. This decision was made in order to achieve our program vision to ensure the highest educational experience for all fellows. Previously, allowing fellows to choose their own vacation dates caused disruptions in the educational/clinical schedule shifts. Breaks in the schedule for vacations left many fellows working 1-week shifts instead of the needed 2-week shifts to attain familiarity with the workings of a clinical team and to succeed in establishing the role as a fellow on those teams. 
 

Can my student loans be deferred during the fellowship?

 Yes. Once you are accepted to the fellowship​, you can request deferment of loans with our HR Manager. Please note, deferment can only be during your active enrollment of the fellowship (start date to end date), and cannot be started early or extended outside program dates. 
 

Is it easy for people to get a job after they finish the fellowship, and if so, where?

 This fellowship has no guarantee of employment beyond the fellowship period nor are graduates required to commit to positions here at the University of Colorado Health after graduation. Our graduates have had a 100% placement rate, with 42% taking positions within the University of Colorado Health System in Hospital Medicine, 34% in subspecialties such as renal, neuro, ICU, Emergency Department, BMT and others, and another 24% deciding to take positions outside the UCH system.   

 

Will I have a mentor and/or personal preceptor to support me during the program?

You will have a variety of support available to you during the fellowship. The APF Leadership team (co-directors, assistant co-directors, and program manager) will be your main "mentors" to guide you through the clinical aspects of fellowship, performance reviews, job advice, etc. In the first 6 months of the program you will be paired with a senior fellow to guide you through the basics of the fellowship by "showing you the ropes" and providing you with additional camaraderie and moral support. Additionally, you will also be assigned a Clinical Coach, one of our APP faculty members, who will meet with you ~3 times throughout your fellowship to assist you in meeting your clinical goals. 

Is this program accredited? 

No, at this time our program has not been accredited. However, The fellowship curriculum is designed and is based upon the physician "Core Competencies" from the Society of Hospital Medicine.​

 
JANUARY 2019-2020 COHORT:

Nick Birdsey, PA

Cristina Caviglia, NP

Josh Hutchison, PA

Kimone Reid, NP

apf jan 2019

 

MAY 2019-2020 COHORT:​

Megan Gibbs, NP

Ellie Karimkhani, NP

Rebecca Kongs, NP


SEPTEMBER 2019-2020 COHORT:

Alix Armstrong, PA

Haley Briggs, PA

Lindsey Foley, NP

Dayna Johnson, NP

Sarah Kelly, PA

Theodore Simos, PA

APF sept 2019 cohort

"It’s 0200 and the pages from nurses are continuous. Juggling typical calls with the acute issues of hypotension and delirium, there is also an admission waiting to be seen in the emergency department. As I prioritize workflow, voices of various past attending physicians from the fellowship echo in my head. A smile of satisfaction comes to my face as once again I utilize skills and knowledge gained from my superlative fellowship at the University of Colorado. I am filled with gratefulness.

Hi! My name is Susan. I am a nurse practitioner that currently works as a nocturnist hospitalist.  My focus is taking cross-cover and admissions for the medical floors as well as helping direct care in the critical decisions unit overnight. At times it can be quite busy, but even on stressful nights I leave with confidence that I provided excellent care to my patients. This assurance is largely due to the University of Colorado fellowship for Advance Practice Providers. This opportunity helped solidify basic skills and knowledge as well as develop a deeper depth to help me excel in my current position.  The year long fellowship provided a core of knowledge that I use consistently. Learning best practice guidelines and cutting edge treatments, I feel blessed to have been chosen to participate in the fellowship and still feel the richness of that year as I continue to work. 

Coming with a distant experience as an ICU nurse mixed with recent work in the community, I wasn’t sure what to expect from the fellowship.  The positive impact it made on my life exceeded my expectations.  Surrounded by caring physicians who wanted to teach and cheer me on to succeed, my level of knowledge exploded during the thirteen months. The fellowship gave me an opportunity to learn hospital medicine in a safe, controlled environment with close observation of physicians and other advance practice providers who were there to support and help me learn. I loved being able to soak in knowledge while having a controlled workload that allowed time to attend educational lunches and other learning opportunities. It also created space in the day to learn indepth information about my patients and the details of their various diagnoses that would not be feasible during a typical job. In addition, I was also able to work with a variety of specialties in various rotations to further deepen my knowledge and medical skills.

As I reflect back to this year, the word that comes to mind is gift... an unrivaled gift.  It was one of the best educational opportunities I’ve had. I learned more in that one year than all of my time obtaining a masters. Practical, hands-on learning at the University of Colorado gave me a solid foundation that I will continue to build off of for the rest of my life. This elite opportunity made all the difference in my professional career.  I am forever thankful for the physicians and other staff members that invested their time into my learning to help me provide each patient I now see with confident and exceptional care."

Susan King, AGPCNP-BC, MSN, RN

September 2016 Graduate

Susan King headshot