Orthopaedic Advanced Practice Provider Fellowship Program

The UNC Advanced Practice Provider Orthopaedics Fellowship is a 12 month post-graduate program intended to give learners an exposure to advanced orthopaedic care in preparation for a career in orthopedic practice.

APP fellows are members of the orthopaedic team and are involved in the continuum of musculoskeletal care. Training is focused on sports medicine and primary care orthopaedics with opportunities for intra-operative and peri-operative patient care across all orthopaedic sub-specialties. The fellowship is designed to provide advanced didactic education and a focused orthopaedic clinical experience so that graduates have the skills and knowledge to provide high quality musculoskeletal care across the life span. The fellowship is ideal for recent APP graduates who are planning a career in musculoskeletal care and for practicing nurse practitioners or physician assistants who wish to redirect their careers toward orthopaedics.

The ideal candidate is a registered nurse with a graduate degree, certification as a family nurse practitioner and has a strong interest in a career in musculoskeletal care or a graduate from a physician assistant program

PRIMARY LEARNING OBJECTIVES:

The goal of the program is to provide advanced practice providers a pathway into Orthopaedics practice and at the end of the program participants will be expected to:

  • Demonstrate competency in advanced orthopaedic nursing practice across the lifespan
  • Apply principles of musculoskeletal care in a variety of settings (community, acute/sub-acute, office practice, and rehabilitation)
  • Synthesize knowledge from the best available evidence and temper it with clinical experience to provide patient centered care
  • Collaborate with client, family and other health care clinicians to promote musculoskeletal health and improve patient outcomes
  • Participate in organization and leadership management within health care system
  • Function as a practice specialist/consultant in collaborative knowledge-generation and promotion of research findings to advance the APP role in musculoskeletal care
  • Develop and implement an application-oriented quality assurance or practice improvement project and submit for publication

PRE-REQUISITES:

  • Master’s degree or higher in nursing or a physician assistant program
  • Graduation from an accredited institution granting graduate-level academic credit for all course work that includes both didactic and clinical components.
  • National certification as family nurse practitioner or physician assistant program. In Orthopaedics, we treat musculoskeletal conditions across the lifespan and F-NP / PA-C certification is essential.
  • Hold an unrestricted license to practice as a registered nurse or physician assistant in North Carolina.
  • One page narrative stating why you are interested in postgraduate training.
  • Current resume including any orthopaedic experience.
  • Three (3) letters of recommendation reflecting you clinical and academic work

PROGRAM CURRICULUM:

Didactic Learning

The didactic curriculum includes weekly post op conferences, monthly Grand rounds and M&M conferences. There is an additional core curriculum to include all orthopaedic sub-specialties with opportunities for basic science, research and musculoskeletal seminars.

Clinical Experience

Fellows will have experience in outpatient clinics in the area of general musculoskeletal care throughout the program. Fellows will have additional clinical rotations in orthopaedic subspecialties, including sports medicine, trauma, hand, pediatrics, spine, joint replacement and tumor services. While learning sub-specialty care, fellows will gradually transition from supervised to independent practice.

Example Program Schedule

Example APP Fellow Rotation Schedule
Month Rotation
September OrthoNow and APP clinics
October Sports surgical and non-surgical
November
December Peds surgical and non-surgical
January
February Hand
March
April Foot/Ankle
May Trauma
June Tumor
July Spine
August Total Joint
Fellows participate in off-service rotations including radiology (adult & peds), rheumatology, OT (hand) and PT throughout subspecialty rotations.
Fellows receive formal orientation to ASC, Main and Children’s OR. They will scrub on appropriate cases. OR skills checklist includes surgical attire, OR roles and etiquette, aseptic technique/gowning/gloving, universal protocols.
Fellows are expected to attend morning conferences including grand rounds, post-op conference, M&M and selected didactic content per academic calendar.
Comprehensive competency evaluations occur at 1, 6 and 12 months. Each subspecialty rotation includes 360 degree evaluation of fellow and faculty performance.

Example Schedule Weeks 1 – 4. Specific days and rotation will vary.

Focus on clinic flow, EPIC documentation, imaging modalities. Orientation to clinic/ORs.

Month 1 MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY
AM Conference Selected didactic content per academic calendar Post-Op Conference/Grand Rounds Selected didactic content per academic calendar
Week
1 -4
AM PM AM PM AM PM AM PM AM PM
APP Clinic Shadow PT Shadow OrthoNow Shadow MSK Radiology and Imaging Splinting, casting, injection skills APP Shadow Clinic
Evening

Example Schedule Weeks 5 -12. Specific days and rotation will vary by subspecialty.

Focus on skill acquisition (injections, splinting/casting), communication with subspecialists. Fellows serve as supplemental (nonbilling) OrthoNow provider and begin subspecialty rotations. Functions within experienced clinician template.

Months
2-3
MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY
AM Conference Selected didactic content per academic calendar Post-Op Conference/Grand Rounds Selected didactic content per academic calendar
Weeks
5-12
AM PM AM PM AM PM AM PM AM PM
OrthoNow Supplemental provider Subspecialty rotation APP Clinic Supplemental provider Subspecialty Rotation Subspecialty Rotation
Evening Evening coverage as needed (with experienced clinician)


Example Schedule after Week 12

Fellows serve as additional (billing) OrthoNow provider and continue subspecialty rotations. Begin fellow clinics for OrthoNow follow-up and new patient visits (limited number of patients with gradual increase as competencies met). Experienced clinician is identified as primary support. One half day of administration time each week.

Months
4-12
MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY
AM Conference Selected didactic content per academic calendar Post-Op Conference/Grand Rounds Selected didactic content per academic calendar
Weeks
5-12
AM PM AM PM AM PM AM PM AM PM
OrthoNow Additional Provider Subspecialty Rotation Fellow Clinic* Admin Subspecialty Rotation Subspecialty OR OrthoNow Additional Provider
Evening Evening coverage as needed (with experienced clinician)

 

SALARY AND COMPENSATION:

The fellow will be paid at a rate of $55,850. The fellow will be classified as a full time faculty member with the rank of Clinical Instructor of the University of North Carolina, and will have access to all benefits assigned.

TIMELINE

The timeline for the 2018 – 2019 program is as follows:

  • Application Open: February 14 2018
  • Application Deadline: April 15, 2018
  • Notification of Acceptance: June 1, 2018
  • Program Start Date: September 1, 2018 or January 1, 2019*

*Dependent on graduation from nurse practitioner/ physician assistant program

To Apply

Apply online: Apply Here

Please attach a copy of your resume (include graduation dates), one page narrative, and letters of recommendation to your online application.

Contact Information:

Tom Bush, DNP, FNP-BC, FAANP
Associate Professor
University of North Carolina at Chapel Hill
Schools of Nursing and Medicine
Orthopaedic APP Fellowship Program Director
Email: OrthoNP@med.unc.edu

ARTICLES

Post Graduate Nurse-Practitioner Education: Impact on Job Satisfaction