Residency and Fellowships
Advanced Practice Provider (APP) Fellowship Program
The mission of the APP Fellowship Program at Seattle Children’s is to support newly graduated APPs in successfully entering their practice in a complex, highly collaborative pediatric setting. This one-year program will build on graduate academic training to strengthen and develop skills in a variety of domains critical to successful practice. Seattle Children’s has a diverse and often complex patient population. APPs work in a variety of settings including inpatient; ambulatory clinics; diagnostic and surgical areas; critical care; ED; and urgent care. Learning opportunities include hands-on patient care and formal and informal didactic opportunities.
Education is aimed at:
- Strengthening critical thinking, evidence-based practice, procedural skill and confidence in a professional clinical setting
- Clinical practice with a variety of pediatric patient populations
- Development of a self-directed, life-long approach to learning
- Acquisition of an individual practice style developed by exposure to multiple mentors and continuous feedback
- Exposure to a variety of APP roles and their contribution to care teams
- Bolstering resilience and acquiring skills to prevent burnout, including the use of a narrative medicine format of storytelling
There are approximately 300 APPs at Seattle Children’s working in a variety of pediatric specialties and subspecialties. APPs are an integral part of patient care and APP opportunities are expanding. Our fellowship program is designed to prepare newly graduated APPs to successfully enter their practice with a solid knowledge base in pediatric acute care. The fellowship has three cohorts per year and one group of PA fellows in the NICU track. This approach ensures new hires have a support group of peers, many of whom are new to the Seattle area.
Additional support for new hires includes the Seattle Children’s APP Council. This group offers a chance for all APPs across divisions to connect in ways which increase our sense of community. Subcommittees of the council include social, service, research, education and equity. Events include APP teaching rounds, community service projects, social meetups and learning more about the role of APPs in research activities. Membership on the council is voluntary and open to all APPs, including fellows.
- Shannon Fitzgerald, ARNP, APP chief, advanced practice providers
- Ronna Smith, ARNP, APP fellowship director
- Angela Forbes, ARNP, APP fellowship chief clinical officer
- Lisa Musso, ARNP, APP fellowship faculty and supervisor
- Catherine Boellaard, ARNP, APP fellowship faculty and supervisor
- Bridgette Hines, APP fellowship program coordinator
The APP fellowship combines:
- Practice as a fully credentialed provider, seeing patients independently with mentorship and feedback
- Rotations through related services
- Didactic opportunities, including lecture, simulation and case-based learning
The year-long fellowship:
- Provides a comprehensive introduction to family-integrated pediatric healthcare at Seattle Children’s
- Is structured so fellows’ time is spent:
- 70% doing the work with feedback
- 20% learning by observing others
- 10% on didactic, including evidence-based best practices
- Provides a minimum of 1,500 mentored clinical hours with specific feedback tailored to your goals
- Introduces you to Seattle Children’s workplace culture and processes
- Practices 360-degree evaluation, inviting feedback from you on mentors and the fellowship program
- Is designed to increase your clinical independence as the program progresses
All fellows spend the first four weeks in Boot Camp. Boot Camp is a period of intensive introduction to the practice environment at Seattle Children’s. During Boot Camp, fellows will learn about the core rotations and electives and begin making their choices of assignments that will begin after the initial inpatient assignment.
After Boot Camp, the next four months are spent on an inpatient team working side-by-side with physicians, nurses, respiratory therapists, pharmacists and other direct care providers. Fellows rotate through at least two inpatient care teams during this time period. These assignments are made by the fellowship faculty and are mandatory for all fellows.
After these initial inpatient rotations, fellows will begin doing eight-week core rotations. Examples of these rotations include ED, Orthopedics Inpatient, Cardiac Surgery, Overnight Surgical Hospitalists, Urgent Care, Cancer Care, various inpatient medical teams, Neurology and Developmental Medicine. Fellows will have the opportunity to select their choices of rotations during Boot Camp.
In addition to these core rotations, fellows can choose from multiple specialty areas for electives. Examples of electives our fellows have done include Medically Complex Care Team, Palliative Care Team, Pain Medicine, Pulmonary and Sleep Clinic, Otolaryngology, Urology, General Surgery, Craniofacial and many more.
Fellows spend approximately 1,500 hours in clinical practice during their fellowship year. All rotations provide transferable skills to any pediatric hospital-based setting. Examples of these skills are history gathering, physical exam, medical decision-making, clinical reasoning, presenting to a preceptor, creating a treatment plan, documentation, ordering, writing prescriptions, discharge planning, patient and family education and working within a care team. Clinical independence increases throughout the progression of the fellowship year. Preceptors from all practice areas communicate frequently and share information about fellows across practice settings so that growth can be continuous and aimed at identified areas of opportunity.
Evaluations are frequent and include everything from informal, in-the-moment feedback to formal, timed, structured feedback.
Didactic sessions are held twice monthly and all fellows attend all sessions. Content is spread out over the course of a year, so no matter which cohort a fellow is in, fellows attend all lecture topics. Lectures are delivered by a variety of disciplines across multiple specialty areas. Because Seattle Children’s is a teaching hospital, there are multiple additional didactic opportunities that will be accessed throughout the course of the year.
Didactic sessions include the opportunity to participate in narrative medicine courses, creating a unique opportunity to share our experiences with our colleagues. We use these writing opportunities to help us stay engaged with our work in a meaningful manner.
In addition to clinical preceptors, fellows will be assigned to a fellowship supervisor who will act as their mentor throughout the course of the year. An important aspect of the APP Fellowship Program is the acquisition of professional behaviors and skills that will support a successful entry into practice. The fellowship mentor guides this process.
See the Deadlines section for upcoming start dates and application deadlines.
- Neonatology: Prepares PAs to practice in the Neonatal Intensive Care Unit (NICU). This track is open to PAs only and starts in the fall.
- APP Fellowship: With the exception of Neonatology, all fellows start in a general pediatric acute care role. Some fellows will identify a specialty interest early on in their year. The fellowship leadership team will work with each fellow individually to maximize their learning with the understanding that we strongly believe in the concept of cross-team, interprofessional training and that all patient care activity during the fellowship year will help the fellow obtain transferable skills useful for whatever job they apply for.
Seattle Children’s is committed to the concept of values-based behavior and the APP Fellowship incorporates these values in all of our activities. These behaviors are expected from the fellows, the leadership team and clinical mentors and preceptors. These six core values are universal across all departments at Seattle Children’s, and the following are some examples of how our fellows exemplify them:
- Compassion: We treat others with dignity and understanding in each and every encounter. We listen with humility and seek to understand.
- Excellence: We practice at the highest standards of quality and safety. We learn from experience and commit to continually improve.
- Integrity: We do what we say we are going to do. We are accountable for our actions.
- Collaboration: We partner with others to help us succeed. We recognize the value and skills of others.
- Equity: We create an environment where everyone feels heard, respected and engaged. We address biases and work to overcome stereotypes.
- Innovation: We are inquisitive and have a desire to make things better. We are open to trying new things.
- NPs and PAs who finish the fellowship will be prepared to practice in settings such as specialty clinics, hospital medicine, urgent care and emergency departments.
- You will gain experience working in a licensed credentialed provider role for a minimum of 1,500 supervised clinical hours.
- Dedicated time for learning supports you as you grow into your professional role.
We help prepare you for a job in pediatric healthcare.
- Without completing a fellowship, new graduate PAs are not likely to qualify for pediatric subspecialty positions. Although some new graduate nurse practitioners with clinical experience do get jobs immediately, a fellowship increases your chance of being hired for a regular position.
- Working in Seattle Children’s collaborative environment, you will learn from other APPs, physicians, nurses and other healthcare providers. Read more about our workplace culture.
- Seattle is a fantastic place to live and work in. See details.
- Fellowships are for one year, for both nurse practitioners and physician assistants.
- Schedules are planned in advance and you can expect to work days, nights, weekends and holidays.
- Fellows are fully credentialed providers who can see patients independently with mentorship and feedback.
- Fellows are employees of Seattle Children’s, with salary and full benefits.
- We offer a $2,500 continuing medical education allowance for license fees, professional association dues, textbooks, journals or conference expenses.
- If you are chosen for a regular position after completing the fellowship, we will award a $15,000 bonus.
To be eligible for the program, candidates must:
- Have graduated from an accredited nurse practitioner or physician assistant program.
- Hold credentials/licensure required by the State of Washington.
- Nurse practitioners: Active, unencumbered registered nurse and advanced registered nurse practitioner licensure in the state of Washington, plus active Drug Enforcement Authority registration.
- Physician assistants: Active, unencumbered physician assistant licensure in the state of Washington and NCCPA board certification, plus active Drug Enforcement Authority registration.
- Some positions will require advanced life support training, such as Pediatric Advanced Life Support (PALS) or Neonatal Resuscitation Program (NRP).
- Candidates must have the listed credentials in place by the start date. It is acceptable for these credentials to be pending at the time of application as long as there is enough time between the application date and the start date for the credentials to be completed. Please contact us if you are not sure of the timing.
We prioritize candidates who are:
- Are newly graduated nurse practitioners or physician assistants with a strong background in hands-on pediatric acute care
- Are NPs with acute care certification
- Have a stated interest in pediatrics and a career at Seattle Children’s
NP or PA candidates who are interested in a critical care concentration must have hands-on critical care experience outside of school clinical rotations.
Fellowship cohort start dates are staggered throughout the year. New grads do not need to be licensed yet to apply, but you must have adequate time to take boards, get licensed and complete the credentialing process before your start date. Typically this all takes about 3 months from graduation. Please plan to apply for the first cohort that is at least 3 months from your graduation date. Exceptions may be granted for local candidates who currently hold a Washington State RN license, please reach out to fellowship staff to discuss. Upcoming cohorts and dates:
- Applications accepted between January 12, 2019 and May 3, 2019
- Cohort start date: September 9, 2019
- Application accepted between May 4, 2019 and September 26, 2019
- Cohort start date TBD
Interested candidates can review job postings and apply on our website. Select “Advanced Practice Provider” from the “Category” dropdown menu.