The Physician Assistant Life

Physician Assistant Postgraduate Residency and Fellowship Programs The Ultimate Guide

Physician Assistant Residency and Felowship Programs - The PA Life

As a new, or even experienced PA, it is normal to feel uncomfortable with the thought of jumping into a medical specialty.

Often we have had little more than 30 days of training in a particular field, and we are joining a team of specialists who expect us to perform at the level of seasoned doctor.

PA training is generalist in nature with the ability to pick and choose among rotations as a student that may help one gain more experience in a particular field of study prior to graduation.

If you have been practicing in a field for some time and want to change directions, it can be very intimidating.

We want to do right by our patients, providing them with the very best care in all situations. While on the job training is fine and dandy, depending on your practice you may receive a lot or very little hand holding. This can be a setup for occupational success, professional and personal growth or, on the flip side, failure!

To help PAs looking to successfully transition into careers of medical specialty postgraduate PA programs began popping up in the early 1970's. As the profession grows and more and more PAs are entering specialty practice, PA residency programs have adapted to fit our needs.

Over the past four decades the PA postgraduate training movement has slowly expanded, and in 2017 there are more than 84 postgraduate PA programs with 70 of those listed on the Association of Postgraduate PA Programs programs (APPAP) website.

All of these postgraduate training programs also referred to as residencies or fellowships, provide some form of advanced learning in various medical and surgical specialties.

PA Residency Program Accreditation

Unlike PA schools across the country which must undergo a rigorous accreditation process through the ARC-PA, PA residency programs do not require a formal accreditation to exist. Although I think this will change with time, here are the two accrediting bodies:

  • ARC-PA: There are currently only 8 accredited clinical residencies for PAs in the US, listed on ARC-PAs website here. Accreditation is voluntary through ARC-PA and does ensure a certain level of educational standards, but it is not required and offers no current benefit. Since 2014 The ARC-PA has placed the accreditation process for clinical postgraduate PA programs in abeyance while it studies a different type of process to recognize program educational quality.
  • Association of Postgraduate PA Programs (APPAP): At the American Academy of Physician Assistants Convention in Los Angeles in May 1988 a group of postgraduate PA programs met to formalize a national postgraduate PA program organization. Bylaws were written and approved by the eight founding programs and the Association of Postgraduate Physician Assistant Programs (APPAP) was formed to further specialty education for PAs. Programs are not required to be registered with APPAP and certain membership criteria must be met to be eligible. While there are benefits to being registered with APPAP, there are also very expensive membership fees that programs may not wish to spend their money on.

Do not be hesitant if the program you find interesting is not on APPA's or ARC-PA website. In 2017 this says very little about the quality of the postgraduate program.

The Pros and Cons of PA Residency Programs

There are pros and cons to completing a residency program, but it is the decision of each individual PA to choose to participate, which greatly depends on the specialty.

PROS of PA Residency Programs

  • Residency programs allow the physician assistant to gain both clinical and didactic knowledge that would take years of on-the-job training to attain.  It provides a faster paced, formalized training program of supervised practice, which allows physician assistants to be utilized much faster than new graduates.
  • The PA can develop the judgment and technical abilities in a specialized practice area, thus increasing their confidence in their chosen specialties.
  • Many employers give preference to residency-trained physician assistants.
  • Residency programs can be a great way to transition to specialty practice for a mid-career PA looking for a new challenge.
  • It is also recognized that most employers are willing to pay more for a physician assistant who completed a residency program.

Emory University Critical Care Residency

PA Surgical Residency Personal Account
PA Cardiology Residency Personal Account

CONS of PA Residency Programs

  • PAs who jump into specialty without residencies claim you can get paid 2-3 x as much, work less, and learn just as much while getting your training on the job.
  • Even though employers are willing to pay more for a PA who completed a residency, the salary maxes out and becomes equal to those who did not do a residency program.
  • Residency requires more education thus increasing duration of school and structuring the profession more like a physician. Tuition for a Physician Assistant Program is around $78,000 for didactic months and the clinical year. If a student has to take out a loan for $36,000 for two semesters, and, with seven total semesters, our total debt at the end of our physician assistant program is around $126,000. This does not include any interested accumulated. Adding on more expenses and loans for residency programs may put the PA graduate in more debt and leave one with more accumulated interest that is more difficult to pay off in a timely fashion.
  • A negative aspect of employers’ rewarding those who complete residency programs with a larger salary is that it could become mandatory for physician assistants to complete specialty residency training in order to compete for the positions since more applicants may apply for higher paying jobs than lower paying ones.
  • Residencies require more education, therefore delaying those practitioners from entering the clinical setting on a full-time basis. This delay limits the number and availability of physician assistants as mid-level practitioners, exacerbating the lack of health care providers to meet the increasing demands of the population for health care.

As you can see, this can turn into a contentious debate! What do you think, are fellowship programs here to stay?

Cast Your Vote: Are PA Residency Programs a Good Idea?

PA program residency quick facts:

  • What about my loans? You can defer student loans during your residency and some programs offer loan repayment.
  • Do I get paid during my residency? Most residencies provide stipends of 40 - 75 k and require 40-80 hours per week up to 6 days per week.
  • How many hours will I be required to work? The average program length is 12 months but some programs are up to 24 months long.
  • How competitive is the process? 10-30 people interview at each program annually and accept on average 1-4 residents.

PA Residency Program offerings

US Postgraduate PA Residency Programs

Checkout the all new PASchoolfinder Postgraduate PA Residency Guide

Below, is an exhaustive list of US PA postgraduate residency and fellowship programs as of January 2017.

I have added a brand new section for Postgraduate PA residency programs as part of the PA School finder website. You can now search by program and specialty via a geographical search console or use the new interactive perfect match tool.

PA Postgraduate Residency and Fellowship Programs by Specialty (Updated January 2017)

Items in Yellow indicate ARC-PA Accreditation

All links will take you to the official PA postgraduate residency/fellowship website.

Name of Program Location Duration Class Size

Acute Care Medicine PA Residency

University of Missouri Columbia, MO 15 months 2
Carolinas Healthcare System Center Charlotte, NC 12 months 28

Cardiology PA Residency

Mercer-Piedmont Heart Atlanta, GA 12 months 2

Cardiothoracic PA Residency

St. Joseph Mercy Hospital Ypsilanti, MI 12 months 1
Dartmouth-Hitchcock Medical Center Lebanon, NH 12 months 2
Methodist DeBakey Heart and Vascular Center Houston, TX 12 months 2 to 3

Critical Care/Trauma PA Residency

Carolinas Healthcare System Center Charlotte, NC 12 months 28
Intermountain Medical Center Murray, UT 12 months 1
Einstein/Montefiore Division of Critical Care Medicine Bronx, NY 12 months
Emory Critical Care Atlanta, GA 12 months 2
Johns Hopkins Hospital Baltimore, MD 12 months 6
St. Joseph Mercy Hospital Ypsilanti, MI 12 months 1
St. Luke's Hospital Bethlehem, PA 12 months 4
Mayo Clinic Arizona Phoenix, AZ 12 months 1
WakeMed Health and Hospitals Raleigh, NC 12 months 3
Winthrop University Hospital Mineola, NY 12 months 1

Dermatology PA Residency

Medical College of Wisconsin Milwaukee, WI 12 months

Emergency Medicine PA Residency

Albany Medical Center Albany, NY 12 months 5
Albert Einstein Medical Center Philadelphia, PA 18 months 2 or 3
Arrowhead Regional Medical Center Colton, CA 14 months 15
Baylor College of Medicine Houston, TX 12 months 4 to 6
Brown Alpert Medical School Providence, RI 12 months
Carilion Clinic Roanoke, VA 12 months 3
Eastern Virginia Medical School Norfolk, VA 12 months 2 to 4
St. Luke's Hospital Bethlehem, PA 12 months 4
Jane R. Perlman / NorthShore University Health System Evanston, IL 12 months 2
Johns Hopkins - Bayview Hospital Baltimore, MD 18 months 1 every 6 months
Lakeland Regional Health Lakeland, FL 12 months 4
Marquette University - Aurora Health Milwaukee, WI 12 months
University of Missouri Columbia, MO 13 months 2
New York Presbyterian-Weill Cornell Medical Center New York, NY 12 months 4
Regions Hospital St. Paul, MN 18 months 2
Staten Island University Hospital Staten Island, NY 24 months 4
Team Health EMAPC Fellowship Oklahoma City, OK 12 months 2 to 3 every 6 months
University of Iowa Iowa City, IA 18 months
University of New Mexico School of Medicine Albuquerque, NM 18 months 2
UCSF Fresno Fresno, CA 18 months 2
The US Army/ Air Force-Baylor Emergency Medicine Physician Assistant (EMPA) Residency

  • Must be Active Duty Army or Air Force, with a minimum of 4 years (Army) or 2 years (Air Force) active commissioned service as a Physician Assistant.
JBSA Fort Sam Houston, TX 18 months
Yale New Haven Hospital New Haven, CT 18 months 2

Family Medicine PA Residency

Carolinas Healthcare System Charlotte, NC 12 months 28 per cohort, variable
Carilion Clinic Urgent Care and Rural Health Daleville, VA 12 months 2

Geriatric Medicine PA Residency

Michael E. DeBakey VA Medical Center - Houston, Texas - Physician Assistant Post-Graduate Residency in Geriatric Medicine

Houston, TX 12 months

Hematology/Oncology

Mayo Clinic Arizona Phoenix, AZ 12 months 1
MD Anderson Cancer Center - The University of Texas Houston, TX 12 months 2-Jan

Hospitalist PA Residency

Carolinas Healthcare System Charlotte, NC 12 months 28 per cohort, variable
Mayo Clinic Arizona Phoenix, AZ 12 months 1
Regions Hospital St. Paul, MN 12 months 1

Internal Medicine PA Residency

Carolinas Healthcare System Charlotte, NC 12 months 28 per cohort, variable

Neonatology PA Residency

Children's Hospital of Philadelphia Philadelphia, PA 12 months 2
University of Kentucky Lexington, KY 12 months 2 to 3

OB-GYN PA Residency

Arrowhead Regional Medical Center Colton, CA 12 months 6
Montefiore Medical Center Bronx, NY 12 months 2

Orthopedic Surgery PA Residency

Arrowhead Orthopedics Redlands, CA 12 months 4 to 6
Carilion Clinic Roanoke, VA 12 months 2
Illinois Bone and Joint Institute Park Ridge, IL 12 months 5 to 7
DMC Orthopaedics and Sports Medicine Warren, MI 12 months 2
UCSF Fresno Fresno, CA 13 months 2
Riverside University Health System Moreno Valley, CA 12 months
Navy PA Graduate Training: Orthopedics - Career military physician assistants Portsmouth, VA 12 months 2-4

Otolaryngology PA Residency

Mayo Clinic Arizona Phoenix, AZ 12 months 2

Pediatrics PA Residency

Carolinas Healthcare System Charlotte, NC 12 months 28 per cohort, variable

Primary Care PA Residency

Shasta Community Health Center Redding, CA 12 months 2-3
North Florida-South Georgia Veterans Health System – University of Florida Physician Assistant Residency in Primary Care Gainesville, FL 12 months
The Emory Physician Assistant Program and The Veterans Atlanta Medical Center (VAMC) Atlanta, GA 12 months

Psychiatry PA Residency

Nationwide Children's Hospital Child and Adolescent Psychiatry PA Program Columbus, OH 12 2
University of Iowa Iowa City, IA 12 2
The Cherokee Mental Health Institute (CMHI) Cherokee, IA 12

Surgery PA Residency

Bassett Healthcare Cooperstown, NY 12 months 2
Duke University Medical Center Durham, NC 12 months Varies
Hartford Healthcare Hartford, CT 12 months 2 to 4
Johns Hopkins Hospital Baltimore, MD 12 months Up to 11
Montefiore Medical Center - Albert Einstein College of Medicine Bronx, NY 14.5 months 5
Norwalk Hospital/Yale Norwalk, CT 12 months 12
Texas Children's Hospital Pediatric Surgery Houston, TX 12 months 6
University of Florida Gainesville, FL 12 months 4
University of Pittsburgh Medical Center Pittsburgh, PA 12 months 2

Urgent Care PA Residency

Carolinas Healthcare System Charlotte, NC 12 months 28 per cohort, variable
Carilion Clinic Urgent Care and Rural Health Daleville, VA 12 months

Urology PA Residency

Carolinas Healthcare System Charlotte, NC 12 months 28 per cohort, variable
UT Southwestern Medical Center Dallas, TX 12 months 1

Other Fellowships

Hepatology Physician Assistant Fellowship - Alexandria, VA
  • Department of Veteran Affairs (VA) - Nationwide, including Puerto Rico (paid)
  • Community Health at Drexel University - Philadelphia, PA (paid)
  • HHS/CDC - Atlanta, GA (unpaid)
  • HHS/NIH - Bethesda, MD (unpaid)
  • HHS/Office of Minority Health - Rockville, MD (unpaid)
Public Health Physician Assistant Fellowship - Atlanta, GA

  • Epidemic Intelligence Service (EIS) - Seeks physician assistants with a master of public health (MPH) or equivalent degree with an interest in public health and a commitment to public service. 2-year full-time program in Atlanta. Applications are accepted in May of each year.

 Gastroenterology Fellowship - Phoenix, AZ

By the Numbers - What do the studies say?

According to this PAEA study:

PA postgraduate residency education provides an important educational vehicle for training graduate PAs in specialty care. A substantial proportion of residents proceed directly from entry-level to postgraduate training. Residents report satisfaction with their programs generally and specifically in terms of knowledge and skills acquired. More information comparing the differences between academic and internship models of residency education is needed as is consideration of greater standardization in program record-keeping and support for research into the longitudinal outcomes associated with postgraduate education.

According to this PAEA study:

Although most students (89.3%) were aware of residency training programs, results indicated that few (7%) had definite plans to attend. Two-thirds of students stated that they received no information on residency training programs at school (journal ads were the most popular information source). Student perceptions of residency training programs were mixed. Their opinions varied according to their program level (p<0.03) and intended region of future practice (p<0.007). Additional significant variables related to student perceptions included student graduation date, age, and gender. However, these factors were not as significant as geographic region of intended practice and degree level.

Discussion: Although only one-third of students reported receiving material or information related to residency training programs from their faculty, two-thirds of faculty respondents stated that they provide students with residency information. Of those providing information, only 32.5% of faculty stated that they actually encourage their students to attend postgraduate training. Like their students, faculty members had mixed positive and negative perceptions of residency training programs

Final Thoughts

Personally, I have mixed feelings about residency programs for PAs.

I see the benefits for PAs, supervising physicians and patients. But, I fear that residency programs may become a requirement rather than an option.

This will lead to increase cost and time in school which is one of the key differentiators of the PA and MD profession.

An alternative model would be very short, inexpensive, 2-3 month programs that would allow PAs to gain valuable experience prior to entering specialty.  I would love a quick ER or orthopedic "refresher" if I were to change specialty at this point in my career. I think programs like this would be very popular. Especially as there seems to be less and less preceptorship to new PAs entering specialty.

Like PA schools, long, expensive programs are probably not the solution. I am curious to see how this all plays out.

Do you have an opinion? I would love to hear in the comments section!

Additional resources and links

  • If you haven't already don't forget to check out my Postgraduate PA Residency Section of the PA SCHOOL FINDER website and the new PA School Match Tool that allows you to narrow down your program search in real time!
  • Residency programs can be competitive and often only have 1-2 available seats per application cycle. We are more than happy to help you with postgraduate application materials/essays through our personal statement collaborative.
  • Do you know of additional residency programs not listed in this table? Let me know in the comments section and I will add them ASAP!

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