Advanced Practice Fellowship in Hospital Medicine


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.

Started in 2009, the APF is one of the oldest APP inpatient training fellowships based on the successes of the Division's Hospitalist Training Program for Internal Medicine Residents. The APF has graduated more than seventy 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

The fellowship 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. All shifts/clinical rotations are solely located on University of Colorado Anschutz Medical Campus at the UCHealth Hospital. 

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): Fellows complete orientations for the University and Division, topics include 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 receive hands-on training sessions 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, and 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. 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:  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 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 nights experience.  
  • Emergency Medicine (~4-8 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.  
  • Medicine-Oncology (~6 weeks) Fellows rotate on the Medical-Oncology service which cares for inpatients with active cancer diagnoses or suspected new diagnoses, and offers fellows exposure to oncology patients, the oncologists and palliative care teams. 
  • Consult Medicine (~4 weeks) Fellows rotate 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) The elective rotations are usually 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.

Phase 3: Senior Fellowship-Skills Refinement: During the final 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 be 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. 

Hours/Vacations

The APF is a rigorous primarily Monday-Friday program with 10 to 12-hour days. However, while on the resident Medicine Service, fellows have a resident-like schedule of working 6 days a week. Also, during phases 2 and 3, fellows rotate on swing/night shifts. Swing shifts are usually M-F from 2:30pm --midnight (but longer shifts can occur). Night shifts are usually M-R 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 blocks (M-F, including weekends on either end). Fellows cannot request certain vacation days/weeks off. This decision was made in order to achieve our program vision to ensure the highest educational and clinical experience during the fellowship. 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/Benefits 


We offer a competitive fellowship salary of $65,000 for the 13-month program ($5000/month). 

Information on University benefits and eligibility for job title "Faculty Fellow"  is located at: ​https://www.cu.edu/employee-services/benefits​ and the eligiblity 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 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. Additionally, an APP faculty member is assigned to you as a clinical coach and will help you meet your clinical goals. 

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:


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.

Social Events: Quarterly, we hold social events or nights out. 

Applications for our March 2022 cohort are now OPEN. The deadline for application submission for this cohort is Thursday, July 15th at 11:59pm MST.

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 the year before from mid-April to mid-July with interviews in Aug and offers given by Sept.

For Sept start dates, applications are open the year before from mid-Oct to mid-Jan with interviews in Feb and offers given by March.

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.edudirectly 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.

  1. Share how well you know the candidate and in what capacity. 
  2. Please share your perspective of the candidates medical knowledge, clinical skills, communication ability and professionalism.
  3. Include the statement: “The candidate waived the option to review this letter.”
  4. 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.
  • APPLY at CU Careers Here: CU Careers, or search for job posting: 20906
  • 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.

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 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 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 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. 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.

  1. Share how well you know the candidate and in what capacity. 
  2. Please share your perspective of the candidates medical knowledge, clinical skills, communication ability and professionalism.
  3. Include the statement: “The candidate waived the option to review this letter.”
  4. 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 1 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. 


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 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 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. 

 

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. ​

Program Leadership

: Program Manager

Frannie Lorenzi, PA-C: Assistant Director

Rudy Moravek, PA-C: Assistant Director

Kinsey Wimmer, PA-C: Director

Brian Wolfe, MD: Director
 

Current Fellows


APF current facesheet

 

 

"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