Physician Assistant Postgraduate Residency and Fellowship Programs: The Ultimate Guide

Postgraduate PA School Residency and Fellowship Programs

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 join a team of specialists who may expect us to perform at the level of a seasoned doctor.

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

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

We want to do right by our patients, providing them with the absolute best care in all situations. While on-the-job training is fine and dandy, you may receive a lot (or very little) hand-holding, depending on your practice.

This can be a setup for occupational success, professional and personal growth, or, on the flip side, a frustrating experience.

To help PAs looking to transition into medical specialties successfully, postgraduate PA programs began appearing in the early 1970s. As the profession grows and more PAs enter specialty practice, PA residency programs have adapted to meet our needs.

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.

Over the past five decades that movement has grown up. I track every one of these programs in the PA School Finder postgraduate residency directory, and there are now roughly 130 active PA residency and fellowship programs, spread across more than 40 specialties and 30-plus states — the large majority of them listed with the Association of Postgraduate PA Programs (APPAP).

I'm giving you a range instead of a number on purpose. Programs open, merge, get renamed and quietly close, and I got tired of this post lying to people between edits. So the big table further down is no longer hand-typed — it reads live from that same verified directory every time this page loads. The exact count, the specialties, the stipends: whatever it shows you is what's true today, not what was true the last time I sat down to update this article.

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Written by John Stangl, PA-C, a former PA residency graduate and now Assistant Program Director, this book is a guide to residency and fellowship for advanced practice providers (APPs). I cannot recommend this book enough!

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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 this will likely change with time, here are the two accrediting bodies:

ARC-PA: Seventeen clinical postgraduate programs currently hold ARC-PA accreditation — 14 with Continued status and 3 Provisional — on ARC-PA's own list (I checked it in July 2026; ARC-PA last updated it in April 2026). Two things here have changed since I first wrote this post, and both matter. First, the process is no longer in abeyance. ARC-PA paused postgraduate accreditation in August 2014, but the Commission voted it out of abeyance in September 2017 and has been accrediting programs ever since — several on that list were first accredited within the last three years. Second, the standards are now joint. The current rulebook is the NP & PA Residency Program Accreditation Standards, first edition, effective January 1, 2024 — PA and NP postgraduate training now answer to one shared bar. Accreditation is still entirely voluntary, and it is still rare. Where a program has it, treat it as a real quality signal. Where it doesn't, do not read that as a red flag — the overwhelming majority of excellent programs have simply never applied.

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 specific membership criteria must be met to be eligible. While there are benefits to being registered with APPAP, there are also expensive membership fees that programs may not wish to spend their money on.

So don't cross a program off just because it isn't on the APPAP or ARC-PA list. That absence tells you almost nothing about quality. What it does tell you is that you have to do the homework — and further down I'll show you exactly what to ask.

The Pros and Cons of Physician Assistant Residency Programs

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

Where was the first postgraduate residency PA program established?

Question 1

Where was the first postgraduate residency PA program established?

A	Montefiore Medical Center
B	Norwalk Hospital/Yale University
C	Howard University Hospital
D	Cedars-Sinai Medical Center

Question 1 Explanation: 

Montefiore's Physician Assistant residency is the oldest postgraduate residency program in the country. It was established in 1971 at the Montefiore Medical Center in the Bronx, NY by Marvin Gliedman, MD, Richard Rosen, MD, and Clara Vanderbilt, R-PA. Montefiore became the first hospital to include PAs as house officers on inpatient surgical services. Those PA's quickly became an integral part of the surgical team at Montefiore and their clinical experience was formalized into a 12-month residency in general surgery and surgical specialties. Montefiore PA Surgical Residency Program

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PROS of PA Residency Programs

• Residency programs allow PAs to gain both clinical and didactic knowledge that would otherwise 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 sooner than new graduates.
• You can develop judgment and technical abilities in a specialized practice area, thus increasing your confidence in your chosen specialties.
• Many employers give preference to residency-trained physician assistants.
• Residency programs can be a great way to transition to a specialty practice for a mid-career PA looking for a new challenge.
• Some employers will pay more for a residency-trained PA, particularly in procedure-heavy specialties. Be careful with this one, though — it gets repeated a lot and documented very little. Ask each program where its last three graduating classes landed, and at what salary. A program that's proud of its outcomes will happily tell you.

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.
• The real cost isn't tuition — it's the year you don't spend earning a PA salary. Let's do the honest math. Median total resident tuition for a PA program now runs about $103,700 (live from the PA School Finder directory — see what PA school actually costs), and most of us borrow it. Now look at the table below: among programs that publish a stipend, the median is right around $75,000. Meanwhile the AAPA 2026 Salary Report puts median PA compensation at $140,000, and the Bureau of Labor Statistics puts the median at $133,260. So a 12-month residency costs you somewhere in the neighborhood of $60,000 in forgone income — plus another year of interest on loans you're deferring, not erasing. That's the number to weigh. It may well be worth every penny. Just don't let anyone tell you it's free.
• 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?

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? Yes. These are paid training positions, not tuition-charging programs. Among programs that publish a figure, the median stipend is about $75,000, running from roughly $50,000 at the low end to north of $100,000 at a handful of VA and hospital programs. Here's the catch: fewer than half of programs publish a stipend at all. A blank in the table below never means zero — it means you have to ask. Plan on 40–60 hours a week, more in surgery and critical care.
• How long is a residency? Twelve months is the strong standard — roughly three out of four programs run exactly one year. The rest range from nine months up to a small number of two-year and doctoral-track programs.
• How competitive is it? Very — because these classes are tiny. Among programs that publish a class size, the median is two seats per year. Two. Programs commonly interview 10–30 people for those seats. Apply broadly, and apply early.
• When do I apply? There is no CASPA for residencies. Every program runs its own timeline, and only about two-thirds publish a deadline at all. Most classes start in summer or fall with applications opening the winter before. The "Apply by" column in the table below shows each program's dates exactly as the program words them — including the rolling ones.

PA Residency Program offerings

Below is an exhaustive list of US PA postgraduate residency and fellowship programs

• A few health systems run whole families of fellowships. Atrium Health in Charlotte — you'll still see it in older lists under its former name, Carolinas HealthCare System — has long run one of the deepest benches in the country, spanning critical care and trauma, family medicine, hospitalist, pediatrics and urgent care. Texas Children's in Houston holds three separately ARC-PA-accredited surgical fellowships. St. Luke's University Health Network in Pennsylvania runs accredited emergency medicine and critical care fellowships side by side.
• Mayo Clinic runs a deep network of its own — critical care and trauma, hospitalist, hematology/oncology, hospital internal medicine, and otolaryngology/ENT. Type "Mayo" into the search box in the table below to pull all of them up with current details.

Two places to search, depending on what you're doing. If you want to browse and read full program pages — map, contact details, everything I've verified — use the postgraduate residency directory on PA School Finder. If you'd rather narrow the whole field down fast by specialty, state, stipend and length, use the PA Residency Match tool. Both are free, both read the same verified data as the table below, and neither one asks you for an email address.

PA Postgraduate Residency and Fellowship Programs by Specialty

This table is live. It reads straight from the PA School Finder residency directory every time this page loads, so it can't quietly drift out of date the way the old hand-typed version did. Search by program, hospital or city; filter by specialty, state, ARC-PA status, length or stipend; click any column header to sort. Every program name links to its full page on PA School Finder, and you can download or print your filtered shortlist to work from.

One honest note before you dive in: a blank cell never means "none." It means that program doesn't publish that detail, so you'll need to ask them directly. I'd rather show you an honest gap than a confident guess.

How do you actually choose a PA residency?

A table can narrow the field. It can't tell you whether a program is any good. These are the questions I'd want answered before I gave anyone a year of my life at half pay — and every one of them is fair to ask on an interview.

1. "Can I talk to two of your current residents and one graduate?" This is the whole ballgame. A strong program hands you the list without blinking. Hesitation here tells you more than any brochure.
2. "Where did your last three graduating classes go, and what were they paid?" You're buying a career outcome, not a certificate. Make them show you the outcome.
3. "How many hours a week are protected for teaching?" There's a real difference between a residency and a cheap staffing line with a nice name. Protected didactic time, lectures, simulation, dedicated procedure logs — ask to see the actual weekly schedule.
4. "What does the stipend include?" Health insurance, CME money, licensure and DEA fees, malpractice coverage, paid time off, relocation. Two programs quoting the same number can be $12,000 apart once you total it up.
5. "Do you hire your own graduates?" If a program consistently keeps its residents, that's a powerful vote of confidence. If it never does, ask why — kindly, but ask.
6. "How long has the program run, and who directs it?" A brand-new program isn't automatically a bad one — somebody has to be in the first class. But a first class carries risk, and the honest programs say so out loud.

And one for you, not for them: can you name the specialty you want, out loud, without hedging? If yes, a residency can be a wonderful accelerant. If not, the money and the year are better spent finding a first job with a supervising physician who genuinely loves to teach.

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 the geographic region of intended practice and degree level.

Discussion: Although only one-third of students reported receiving material or information about residency training programs from their faculty, two-thirds of faculty respondents stated that they provide them 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 a short, inexpensive, 2-3 month intensive training program that would allow PAs to gain valuable experience before entering the 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 popular, especially as there seems to be less and less preceptorship to new PAs entering specialty practice.

Like PA schools, long and expensive is probably not the answer. But I'll say something now that I wouldn't have said when I first published this post: the data moved, and I've moved with it a little. Postgraduate accreditation came back out of abeyance, PA and NP residency standards merged into a single rulebook, and the field has grown from a few dozen programs to roughly 130. This isn't a fringe path anymore.

Here's where I land. A residency is a great answer to a specific question and a poor answer to a vague one. If you know you want pediatric surgery or neonatology or emergency medicine, and the alternative is learning it on the fly with nobody watching, then twelve months and roughly $60,000 of forgone income can be the best trade you ever make. If you're considering it because you feel behind, or because you hope a certificate will make you feel ready — please don't. You are not behind. Take the job with the best teaching and the most patient supervising physician, and you will get there too.

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

Additional resources and links

• Browse every program with full details in the postgraduate PA residency directory, or narrow the whole field down in seconds with the free PA Residency Match tool. Still choosing a PA school? That's the PA Program Match tool instead.
• 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.
• Curious what PAs earn once training is behind them? See the current PA salary report, and the PA program rankings by PANCE pass rate.
• Know of a program that isn't in the table? Tell me in the comments and I'll verify it and add it to the directory — which means it shows up here automatically, for everyone, without me ever touching this post again. That's the whole point.

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