Long-term retention outcomes of a specialty care fellowship program

Postgraduate education for advanced practice team members has emerged as a viable way of gaining critical experience needed for specialty practice. Residency and fellowship training programs have been part of the landscape for medical education for decades but have only recently become available to advanced practice team members. Most programs provide a year of structured learning, but there are few published reports of their value. We provide a description and outcome data of our specialty practice fellowship at an academic medical center over a 5-year period. A fellowship advisory board with representation from numerous specialties defined entry criteria, curriculum, and clinical site placement. Participant and preceptor experience was measured monthly to optimize rapid acquisition of skills. The curriculum was modified through rapid cycle quality improvement in response to scores lower than 70%. In total, 30 fellows have participated in the advanced practice nurse practitioner and physician assistant fellowship program between 2019 and 2023, among 8 specialty tracks. Of the participants from 2019 to 2023, 28 fellows graduated with successful program completion. Ninety-six percent were employed in specialty care settings at the time of graduation or within six months post program completion. The overall postfellowship retention rate at the training site was 79%. This outcome data supported the return on investment. This article provides data and insight into postgraduate fellowship programs with 5 years of cohort data, long-term outcomes, retention rates, and return on investment. In addition, it informs educators and employers with insight into programmatic design, evaluation, and outcomes in transition to practice programs.