Advanced Practice Fellowship in Hospital Medicine
Started in 2009, the Advanced Practice Fellowship is one of the oldest Advanced Practice Provider inpatient training fellowships based on the successes of the Division's Hospitalist Training Program for Internal Medicine Residents. The APF hospital medicine program has graduated more than 100 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. Ideal candidates are those interested in working in a hospital-based environment, both in hospital medicine and specialty practices.
Program Phases
This Advanced Practice Provider Fellowship program uses a multiphase approach to develop learners into well-rounded, competent inpatient providers. The Division of Hospital Medicine (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 Provider (APP) faculty. In addition to a strong clinical core, the APF utilizes frequent didactic sessions and case-based learning to enhance fellow development. All clinical rotations are solely located on the University of Colorado Anschutz Medical Campus at the University of Colorado Hospital.
Boot Camp: Introduction to the Hospital and the Fellowship
(weeks 1-4)
In the first two weeks fellows will complete orientations for the University of Colorado and DHM, topics include billing, benefits, effective communication, computer EMR training, observation experiences, and specific instructions sessions (for example: history and physical instruction; approach to common clinical conditions; documentation training). Fellows also receive hands-on training sessions through our simulation center on emergency situations. In the third week, fellows will start managing two patients per day with close supervision of a senior fellow in the program. And in the final week of boot camp, fellows will manage two
patients under the supervision of our physician and APP faculty.
Phase 1: Junior Fellowship: Professional Development
(weeks 5-16)
Core Medicine: There are two major focuses of this phase: General inpatient medicine clinical experience and Core Medicine Didactics.
Junior fellows will work on two differently structured clinical teams caring for general medicine inpatients offering both autonomy and support while gaining basic hospital medicine knowledge and skills.
- Hospital Medicine Service (HMS) is a team consisting of a Hospital Medicine Attending, APP faculty member, and one fellow.
- Medicine 3 Service (Med3) is a team consisting of a Hospital Medicine Attending, Internal Medicine resident, and two fellows.
Beginning with two patients /day 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 rounds, and patient-based teaching and clinical reasoning instruction will be offered daily.
- Core Faculty Lectures
APP and physician faculty will give scheduled didactics on general medicine topics ranging from heart failure to acute kidney disease. We are now offering CME credit to our fellows for their completion of Core Faculty Lectures!
Phase 2: Intermediate Fellowship: Skills Enhancement
(weeks 17-24)
Fellows will move beyond daytime general internal medicine services and will gain experience from the Medical-Oncology, Consult Medicine, and Swing/Nights services. Fellows will also rotate
on electives for inpatient specialties.
- Swing and Nights ( ~10 weeks) Fellows rotate on an afternoon/evening admitting service (Swing) and the 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 night experience.
- Emergency Medicine ( 2 weeks) Fellows rotate in the emergency department learning the clinical aspects of emergency medicine. There are weekly didactic lectures in addition to clinically focused teaching.
- Medical Oncology (~6 weeks) Fellows rotate on the Medical-Oncology service which cares for inpatients with active cancer diagnoses or suspected new diagnoses, offering fellows exposure to oncology patients, the oncologists and palliative care teams. Weekly scheduled lectures are given by oncology fellows, pharmacy, physicians and APPs.
- Consult Medicine (~4 weeks) Fellows rotate on the Consult Medicine service which provides medical care and consultation to primarily perioperative patients.
- Electives (~4- 8 weeks) The elective rotations are 1 to 2-week-long blocks meant to expose the fellows to different areas throughout the hospital. Fellows can choose from inpatient specialty elective rotations dependent on availability and schedules. Click here to read more about electives.
Phase 3: Senior Fellowship-Skills Refinement
(weeks 25-56)
During the last half of the fellowship, senior fellows devote more time to both electives and the Capstone Medicine rotation.
- Capstone Medicine (~6 weeks) Fellows will be assigned one of several hospital medicine services or return to the Medicine 3 service as the solo 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 with increasing autonomy. This experience is meant to refine the skills gained 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 -10 patients per day.
Covid impact
We have tried to minimize the impact of Covid on the fellowship and respect fellow’s personal wishes. All fellows must be vaccinated per University and Health System policy. We have excellent personal protective (PPE) equipment stores/access and will fit all fellows for N95-level masks. We avoid having fellows on Covid patient services for the first half of the fellowship and then in the later phases of fellowship give fellows the opportunity to care for Covid patients as many seek this opportunity.
Hours/Vacations
The APF is primarily a Monday-Friday program. For approximately 10 weeks of the year, fellows will work on the Internal Medicine Resident Service in place of an intern and will have a resident-like schedule of working six days a week. During phases 2 and 3, fellows rotate on swing/night shifts. Swing shifts are Monday through Friday starting at 1:30pm. Night shifts are usually Monday through Thursday from 7:00pm -7:00am. Some electives will also have the fellows working on weekends.
Five (5) weeks of vacation are spread throughout the fellowship in pre-scheduled week-long blocks. Days/partial days will be granted off for interviews after the mid-point in the fellowship.
Salary/Benefits
We offer a fellowship salary of $70,500 for the 13-month program.
Information on University benefits and eligibility for job title "Faculty Fellow " is located at: https://www.cu.edu/employee-services/benefits and the eligibility matrix at: https://www.cu.edu/docs/benefit-eligibility-matrix
Please note, 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.
Program Evaluation
A key aspect of the APF is giving fellows frequent and actionable feedback allowing them to grow with an individualized learner. Verbal and written feedback is obtained from faculty weekly. Every three months fellows
have one-on-one feedback sessions with the APF leadership to develop an individualized learner improvement plan. Additionally, an APP faculty member is assigned to each fellow
as a clinical coach to help fellows achieve their individual professional goals.
Please review all the following information on how to apply, minimum qualifications, and documents required. If you have additional questions, please check our FAQ tab prior to emailing.
Application Cycles
Each year we accept 2 separate cohorts of 5-6 fellows. Our cohort start dates are March 1st and September 1st. Your application will be accepted for a specific cohort and start date only, applying does NOT make you eligible for BOTH cohorts.
Timelines are as follows and are subject to change. Any changes will be reflected on the website if so.
For March start dates, applications are open from July 1st - September 30th.
For September start dates, applications are open from January 1st - March 31st.
Program Qualifications
Minimum Qualifications:
- Must be an ACNP or PA
- For ACNPs, must be a credentialed ACNP prior to cohort start date
- For ACNPs and PAs: must be nationally certified and certification exam results must be provided 60 days prior to start date (due to credentialing, this is a strict timeline)
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.
Required Application Documents
The following .pdf documents are required to be considered.
1. Cover Letter which addresses the job requirements and outlines qualifications
2. Current Resume/CV
3. Two Separate Personal Essays:
A. A one-page (~700 words) personal statement explaining why you would like to be a part of the fellowship.
B. A half-page essay (~500 words) which answers the following: Our fellowship fosters an appreciation and awareness of diversity, inclusion, and equity for all. How would your personal life experiences, background, or perspectives enrich and contribute to the diversity of our fellowship?
4. Reliable contact information for three (3) professional references--at least one (1) must be from a clinician that personally supervised clinical duties within 1 year of the application submission. Please include your relationship with each reference given.
5. (2 - 3) Confidential Letters of Recommendation*; at least one (1) MUST be from a clinician that personally supervised and observed clinical duties while the candidate was caring for patients. Please
have the letter writers include the following language: “[applicant name] has waived the applicant’s right to review this letter prior
to submission.” Letters should be emailed as .pdf
to DHM-Education@ucdenver.edu directly from the letter writer. Please see below or our FAQs for guidelines. Please include a list of your letter writers in your application to confirm who we will receive them from.
6. Transcripts from your PA/AGACNP school/master's programs only [official is not required, unofficial is acceptable/preferred]
Instructions to Letter of Recommendation Writers:
Thank you for agreeing to write a letter of recommendation for an Advanced Practice Fellowship candidate. Please review the following guidelines.
- Share how well you know the candidate and in what capacity.
- Please share your perspective of the candidates medical knowledge, clinical skills, communication ability and professionalism.
- Include the statement: “The candidate waived the option to review this letter.”
- Send the letter as a PDF file directly to the following email address:DHM-Education@ucdenver.edu
Directions for Submitting Application/Documents
Please read the following directions for submitting your application carefully:
- If you have additional questions, please first review our list of Frequently Asked Questions under the FAQ tab
- Applications are only accepted electronically via CU Careers. Do NOT submit your documents via email or mail to the job posting contact.
- Please submit all required documents outlined above as .pdf attachments to your online submission, except for letters of recommendation which will be emailed directly to us.
- If you have trouble with your CU Careers online submission (i.e. adding documents/updating documents) please review the CU application submission FAQs here. Job Posting contact will not assist in updating your submission.
- If you still have additional questions or need information please contact Kelsey Keil at DHM-Education@ucdenver.edu.
- APPLY at CU Careers Here: CU Careers, or search for job posting: 28747
- After you submit your application, you'll receive an automated confirmation email response from CU HR. Please note, applications are not reviewed until the deadline date, so if you apply early you may not hear anything from the program until closer to the deadline date.
This fellowship has no guarantee of faculty employment beyond the fellowship period nor are graduates required to commit to positions here at the University of Colorado after graduation.
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: https://www.cu.edu/employee-services/benefits as well as the matrix: 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.
Clinical Didactics/Curriculum
Clinical Skills Course (CSC): Weekly during Phase 1 of the fellowship and then bi-monthly through the next two phases, fellows receive 1 hour CSC instructional sessions covering topics such as: reading ECGs, interpreting chest radiographs, pulmonary function testing, interpreting liver test lab, working through acid-base problems, etc.
Education Mondays: After Phase 1, fellows will get ~5 full-day non-clinical educational didactic sessions occurring bi-monthly. Session topics include health disparities, wellness, ultrasound, clinical skills, guest speakers, field trips, etc.
Longitudinal Didactics: During Phase 1, fellows receive almost daily 1 hour lectures from the fellowship's APP Core Faculty. Lectures include the following clinically relevant topics:
Procedure/POCUS Rotation: Fellows can choose to spend two weeks on our Procedure team learning point of care ultrasound techniques and bedside procedures, including paracentesis, thoracentesis, lumbar puncture, line placement and others under the supervision of credentialed hospital medicine proceduralists.
Additional Didactics/Curriculum
APF Report: Twice monthly fellows are required to attend the 1 hour APF Report. Each session, one fellow presents an interesting case and is precepted through to the diagnosis and treatment plan. Each fellow will be responsible for preparing a case twice during the year.
Department of Medicine 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. Click here to learn more and see the schedule.
Internal Medicine Residency Noon Report: Each fellow is invited to attend the daily Internal Medicine Residency Noon 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.
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. Learn more about MultiD Week here.
Social Events: Quarterly, we hold social events or nights out.
Program Leadership
Director- Frannie Lorenzi, MMS, PA-C
Frannie grew up in the suburbs of Chicago and completed her undergraduate degree in Biomedical Sciences at Marquette University in 2012. She then went on to receive her Masters in Medical Science at Northwestern University's Feinberg School of Medicine in 2014. She joined the University of Colorado's Division of Hospital Medicine in March of 2015 as an APF and has been a faculty member since completing her fellowship in hospital medicine. She is an Assistant Professor in the Division of Hospital Medicine, and her focus lies in Post Graduate Medical Education as well as APP Faculty Development. Clinically her interests lie in inpatient medical oncology and general medicine patients. She hopes to spark other APPs interest in medicine through innovative post-graduate training.
Director- Brian Wolfe, MD
Brian
attended Emory and Henry College where he obtained a degree in chemistry and biology, obtained a medical degree from Johns Hopkins University School of Medicine, and completed an internal medicine residency and chief residency at Dartmouth-Hitchcock
Medical Center. Prior to joining the faculty here at the University of Colorado in 2010, he held faculty appointments at first Vanderbilt University and then Temple University. As a passionate medical educator, leading the APF has been
his greatest honor. He feels lucky to be along with each individual as they start their personal journey toward clinical excellence and is confident that each will leave a lasting mark on the field of medicine.
Associate Director- Erin Szemak, AGACNP-BC
Erin
Szemak, DNP, APRN, AGACNP-BC is an instructor within the Division of Hospital Medicine. She received her Bachelor of Science in Nursing here at the University of Colorado in 2009. Thereafter, she was an ICU nurse in a variety of settings including
medical, trauma, and neurosurgical. In 2017, she received her Doctorate of Nursing Practice at the University of Utah and became board certified in Adult/Gerontology Acute Care. She returned to her home state of Colorado and completed the
Advance Practice Fellowship in Hospital Medicine in 2019. Immediately after completion of the fellowship, she became faculty with the Department of Medicine. She is passionate about training future APPs and quality improvement.
Rudy
grew up in Minnesota where he received his undergraduate degree in Psychology with a minor in Community Health at St. Cloud State University. Afterward, he moved to Maine where he completed his Master
of Physician Assistant Studies at the University of New England in 2013. After working for a brief period as a Physician Assistant at Montefiore Hospital in New York, he moved to Colorado. He initially joined
the University of Colorado team as a fellow through the Advanced Practice Fellowship in Hospital Medicine. He is currently an Assistant Professor with the Division of Hospital Medicine, where he has been since
2017. Aside from his clinical duties, he continues to work with medical learners of various levels (NP/PA students, Advanced Practice Fellows) in hopes of guiding them toward their goals in medicine.
Program Coordinator- Kelsey Keil, M.Ed.
Kelsey
is a Colorado native who grew up in Arvada and now lives in Thornton. She majored in Elementary Education at the University of Northern Colorado. After 9 years of teaching at the elementary level and a Master's degree in Learning
and Technology, she wanted to pursue opportunities in higher education. She is excited to join the Division of Hospital Medicine and support the education programs!
Applying
When do applications open/end? Are they on a rolling acceptance? Can I reapply?
Applications are not taken on a rolling admission. Applications for specific cohorts open approximately eight 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 five 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 update your online submission and make sure the program manager knows.
What cohort should I apply to?
Application deadlines are typically five 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. Unfortunately, the 60 days is a strict deadline due to the University’s credentialing timelines.
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!
I submitted my application, but why have I not received any confirmation from you?
After you submit your online application you will receive an automated response from CU HR.
However, you may not hear from us regarding updates 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.
Who should I address my cover letter/personal statement to?
You are welcome to address your letters and have your recommenders address letters to “Advanced Practice Fellowship Selection Committee”.
What are the guidelines for letters of recommendation?
Updated April 2021: Letters are now required to be confidential and should be emailed as .pdf to DHM-Education@ucdenver.edu directly from the letter writer. We do suggest that you submit a document with you application on who will be sending any letter(s) to us directly so we know if we have received all your letters and your application is complete when we go to review it. Please see below for instructions for your letter writer:
Thank you for agreeing to write a letter of recommendation for an Advanced Practice Fellowship candidate. Please review the following guidelines.
- Share how well you know the candidate and in what capacity.
- Please share your perspective of the candidates medical knowledge, clinical skills, communication ability and professionalism.
- Include the statement: “The candidate waived the option to review this letter.”
- Send the letter as a PDF file directly to the following email address:DHM-Education@ucdenver.edu
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.
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.
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.
Can my professional references be the same people that write my letters of recommendation?
This is entirely up to you! If you make it to the final round of interviews, we will contact your references so be sure you have reliable contact information, and at least one has personally observed you in the clinical setting.
What does the interview process look like if I move on to that stage?
After we do our initial review of applications, if you make it to the interview stage, then the process begins with a phone call interview. If the hiring committee decides to accept you to the next stage they will request a second interview which is held via Zoom 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. [*Update: Due to COVID, we can only hold interviews via Zoom]
When will I be notified of final acceptance/denial?
We typically aim to notify applicants within a month and a half after the application deadline. If you do not make it through the initial phases, you will be contacted earlier on.
Can I come shadow to see what the APFs do on a daily basis?
You are more than welcome to come shadow if the hospital is allowing shadowing (this will depend on COVID numbers). If you are interested please reach out to us at DHM-Education@ucdenver.edu. Please note, the shadowing is not mandatory and will not positively or negatively effect your application, ability to apply, or be accepted to the program.
Program Details
How many cohorts are there each year? When does each cohort begin?
There are 2 cohorts of 5-6 fellows accepted each year. Cohorts begin on March 1st and September 1st.
Approximately how many applicants apply for each cohort?
Typically, about 35-40 applicants per cohort.
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.
Can I come and shadow the program to learn more?
UPDATE: Due to COVID, UCH has temporarily suspended their shadowing program. Once they resume we will be able to accommodate a request.
I’m not an ACNP. 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.
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/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 maximize continuity
between fellows, faculty, and patients.
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 sub-specialties 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.