Advanced Practice Provider Fellowship Training Program at UPMC Children’s

A new training program for advanced practice providers (APP) within the Department of Pediatrics at the University of Pittsburgh School of Medicine and UPMC Children’s Hospital of Pittsburgh is providing focused, specialty-specific, and general pediatrics training to APPs that will increase their level of expertise in their subspecialty and also provide additional general- and cross-training in other areas of pediatric medicine. 

The goals of the program are to provide an advanced level of training to APPs, allowing them to function autonomously within their division, seeing patients and, thereby, expanding access to needed subspecialty care for patients and families.

The Pediatric APP Fellowship Program cultivates a mastery of pediatric fundamentals, including acute care, ambulatory care, procedure performance, and principles of pediatric subspecialty medicine. Pediatric APP Fellows are employed, paid learners, and the goal is to provide them with the manual skill, fundamental knowledge, and critical thinking skills they’ll need to make sound clinical judgments on a daily basis. Pediatric APP Fellows are trained to provide autonomous comprehensive pediatric care within the scope of their license and in collaboration with their supervising physician.

The Pediatric APP Fellowship features a year-long curriculum of both didactics and clinical rotations. Fellowships currently exist in 15 different pediatric medical subspecialties, with expansion into surgical disciplines likely to occur in the future.

“Each medical specialty has developed its curriculum for APP fellows who will eventually be practicing in that specialty. This training works in tandem with the more general pediatrics training fellows receive as part of the program,” says Amanda Flint, MD, assistant professor of pediatrics in the Division of Pediatric Endocrinology, Diabetes, and Metabolism, who serves as the APP Fellowship Program director for the Division’s program.

Supporting Dr. Flint in the Division’s program are two co-directors who are APPs in the Division of Endocrinology, Diabetes, and Metabolism — Erica Cordell, CRNP, and Kathleen Sorkin, CRNP.
“Erica was instrumental in helping to spearhead the development of the written endocrinology curriculum along with Diana DeArment, PA-C, from our Division. Kathleen’s primary role as co-director has been to mentor the new APPs as they start the program and monitor their progress.

“The written curriculum we have developed is a comprehensive battery of lectures and readings and tests that span the full breadth of the Division’s clinical work. This written curriculum is assigned during the first six months of the fellows’ training. The written curriculum is complemented by clinical experience in all of the different clinics we have in our Division, so APPs receive a very well-rounded education,” says Dr. Flint.

Fellows must keep a patient logbook to document their cases and ensure they are exposed to an adequate amount of case variety. Additionally, fellows are given the opportunity to work on a quality improvement project as part of their training, and they take part in a four-week boot camp early on in the program that covers much of the general training and rotations in other divisions.

“The boot camp covers all of the basics that any good pediatric APP ought to know and be proficient at regardless of their specialty,” explains Dr. Flint.

The Division’s first endocrinology APP fellow began training in the spring of 2019 and will soon complete the program. Three other endocrinology APP fellows are currently in training at various stages of progression.

To ensure that trainees are progressing and attaining the clinical competencies needed, a formal evaluation system is in place that captures and assesses a fellow’s performance in a variety of domains, including medical knowledge, clinical skills, and interpersonal interactions.

“The Department of Pediatrics and UPMC Children’s have invested heavily in this program because of its ability to transform the way we train our practitioners to become independent clinicians, which, in turn, can expand our ability to care for more people. Many subspecialties struggle with not having enough physicians to meet patient demand. This is one way we can help to solve that problem and open up access for more patients while continuing to provide excellent care,” says Dr. Flint.