Should you pursue a physician assistant fellowship? It’s a big question, and the answer depends on where you are in your career and what you want next.
For some PAs, a fellowship offers specialized training, confidence, and a competitive edge. For others, it can mean extra time, lower pay, and delayed independence.
In this guide, we’ll break down the real pros and cons of pursuing a physician assistant fellowship, what to expect during one, and how to find the right fit if you decide to apply!
But before we get into the details, let’s start with the basics. What exactly is a PA fellowship, and why do some graduates decide it’s the right move for them?
Why pursue a physician assistant fellowship?
While PA school provides you with a solid foundation of medical knowledge, you’ll still face a steep learning curve once you graduate and start practicing. This is true regardless of the specialty you choose, but it can especially be an issue for those opting to pursue specialized areas of medicine.
One way to make the transition a bit easier is to do a post-graduate fellowship. For those who may not be familiar with them, fellowships are an advanced training program designed to give PAs an opportunity to gain further skills and knowledge in a specific field prior to practicing independently.
Fellowships are most commonly pursued by new graduates, but many applicants are practicing PAs looking for a specialty change.
How long is a physician assistant fellowship?
Physician assistant fellowships usually last anywhere from six months to two years, with most being 12 months long.
What are the pros and cons of pursuing a fellowship?
Whether you decide to pursue a fellowship comes down to what your priorities are. To help you see the pluses and minuses of doing a fellowship, I’m going to share some of what I experienced when I did mine.
Here’s how I break it down:
The Pros
1. Additional Experience
During my fellowship, I gained a lot of knowledge and clinical experience. I was taught how to confidently manage complex patients, run rapid responses, and some bedside procedure skills.
2. More Awareness
Additional experience will give you a better idea of what you’re looking for in a new position. You’ll be more certain of what it is you want out of your career and what really excites you as a PA. This can only make it more likely you’ll end up in a job you really love!
3. Incredible Post-Grad Prospects
Doing a fellowship gave me some truly great opportunities. Immediately following completion, I was given a full-time position at the facility where I trained. It’s common for physician assistant fellowships to end in a permanent role, though this isn’t always the case. Most fellowships will advertise if completion results in a position.
Regardless of whether you land a permanent role, a fellowship will definitely give you an upper hand when applying for jobs in your chosen field. In my case, after about one year of work as a hospital medicine and critical care PA, I was able to get a position in cardiothoracic (CT) surgery. I’d applied for a number of CT surgery positions as a new graduate, but it wasn’t until I had ICU experience, procedural experience, and overall experience as a provider that I was able to land a CT position.
While you don’t have to pursue a fellowship to land your dream job, it remains true that doing one can make it easier to get into a desired field if there’s an institution or location you’re passionate about.
4. Negotiation Leverage
A fellowship can also give you the upper hand in future job negotiations. Oftentimes as a new graduate without provider experience, there’s less room for negotiating, but with some experience under your belt you’ll become a better applicant the company will be willing to work a bit more for.
The Cons
I’ll be the first one to say I got a lot out of my fellowship. But I have to be honest about the downsides to doing it, too!
In hindsight, I’d say they were the following:
1. Additional Sacrifices
After dedicating so much of your life to education, it can be hard to opt for more after you graduate from PA school. It was definitely bittersweet to see my fellow new graduate friends thriving in their positions with celebratory trips and free time, but the knowledge I gained has really benefited me in my career thus far and made me a more confident provider.
2. Long Hours
My first position actually started with a six-month fellowship and, I won’t lie, it was difficult. I was working in hospital medicine and critical care, and my shifts were overnight. The schedule was tough. I worked 12-hour night shifts five days a week, making for a 60-hour work week.
3. Earning Less
Doing a fellowship usually means you’ll have a reduced income. Luckily for me, even though my position was hourly at a reduced rate, I worked so many extra hours it evened out to be about a normal new graduate salary.
Alternatively, many physician assistant fellowships are salary-based, and the average salary is somewhere around $70,000. When dealing with a salaried position, it’s important to inquire about average weekly hours worked. A downside of many fellowship programs is that lower salaries are paired with a long work week, which significantly reduces what you’re earning for your time.
While the purpose of the fellowship is to learn and the program is dedicating their time to teach you and further your career, the reduced income is a significant down side. Especially when most applicants are just completing a very costly education and have loans they have to pay back.
4. Little Time Off
You also often can’t take any (or are allotted minimal) vacation during a fellowship. This can be tough, especially when you’ve had a grueling schedule for months on end.
I think a fellowship is the right move for me. How do I apply?
Applying for a fellowship is much like applying for any other job. It requires a resume, references, and doing an interview. Some physician assistant fellowships may ask you for more, including letters of recommendation and personal statements.
Are there any prerequisites?
Yes! You have to graduate from an accredited PA program and pass your national certification exam before you can start a physician assistant fellowship. Most fellowships will let you apply while you’re finishing up your education.
Where can you find PA fellowship opportunities?
You can find fellowship opportunities on hospital career pages or through professional program websites such as the Association of Postgraduate Physician Assistant Programs (APPAP). Certain fellowships at highly rated institutions or in sought after specialties can be very competitive.
The bottom line: a fellowship isn’t always necessary!
At the end of the day, I don’t regret anything when it comes to my own fellowship experience. I was so thankful to have had the opportunity to train in a supportive environment and learn so much in such a short time! It gave me knowledge that has stuck with me throughout my career.
That said, pursuing a physician assistant fellowship isn’t always necessary—there are a lot of places that’ll take new graduate PAs or PAs switching specialties and train them at their full salaries. And you absolutely don’t need to pursue a fellowship in your dream specialty to secure a job! If you’re willing to travel for a good opportunity, with time you’ll find what you’re looking for.
The bottom line is, a fellowship can be a wonderful opportunity to get into your chosen specialty and learn a lot. However, I encourage you to also apply for regular positions in your chosen field and consider all the opportunities available to you!
Whatever you decide, good luck out there!
Preparing for the PANCE and struggling to remember key concepts? Download our FREE study sheet with mnemonics that our PA instructors use during our Live PANCE Review Course!
And for more (free!) content to help you through the PA journey, check out these other posts on the blog:
