1. ATP, Training the Next Generation
Ana Marie Torres, ANP, MSN, RN University of California San Francisco

2. I have no relevant financial relationships to disclose
Disclosure
I have no relevant financial relationships to disclose

3. Expectations
It is expected that new ATP graduates are going to function at the same level as their experienced colleagues
If they do not know how to do a task or an answer to a question, it is assumed that they are not smart and are not capable of fulfilling the role of an ATP

4. Increase in Demand for ATPs
The Affordable Care Act of 2010
New educational requirements for health care providers and the increase in complexity of the patient population
With this requirement, comes a need for increasingly flexible and well-trained clinician workforce
ATPs can provide continuous high-level care and understand the continuum of care and facilitate interdisciplinary collaboration
Cost of training of ATPs is less than that of physicians

5. ATP Transplant Fellowships
When first reviewed by the ATP committee 5-6 years ago, there was only 1 in existence
In preparation for this lecture, a cursory review revealed at least five:
UCSF
Mayo Clinic Arizona
AASLD
Vanderbilt
University of Maryland
Others………….
Significant increase in a short period of time

6. New Graduated Nurse Practitioners
The knowledge and skill acquired during graduate nursing training needs to expanded
With more experience comes more confidence
At UCSF, the need for a UCSF Surgical and Critical Care Fellowship Program was identified by the then Chief of Transplant and Current Chair of Surgery, Dr. John Roberts, as well as the Associated director of Surgical Residency Program, Dr. Ryutaro Hirose and then Chief Nursing Officer and current Senior Vice President of patient services, Sheila Antrum, Critical Care Nurse Practitioner Supervisor Tom Farley and Adult Nurse Practitioner, Kerry Decker
The program was piloted in
The curriculum for the program is an integration of the nationally recognized competencies utilized for practice as an Allied Health Professional at UCSF
The program has been working towards ANCC accreditation since its inception and it was achieved with distinction last month.

7. UCSF Critical Care and Surgical NP Fellowship
Expand upon the knowledge and skills acquired during graduate nursing training.
Provide care for adults in critical care and surgery with emphasis on advanced assessment, planning, negotiation and collaboration skills.
Practice full-scope with an experienced NP
Meet for monthly seminars: Presenting, calling for consultations, ethics, communication, stress management, role transition
Skills Workshop: imaging studies
Attend a conference during their fellowship
Experience of rotating thru many clinics
Carry full patient load
Exposed to different NP roles and practices
Networking with previous NP fellows
Monthly meetings with faculty

8. Rotations Critical care Kidney Transplant Liver Transplant
Lung Transplant
General Surgery
Thoracic Surgery
Vascular Surgery
Neurosurgery
CT Surgery
Gyn Onc Surgery

9. Qualifications Graduate of ACGNP program in the last 18 months
Highly recommended by faculty and supervisors
Demonstrated initiative and leadership
Desire to specialize in surgery or critical care

10. NP Fellowship
100% of  graduated fellows recommend the fellowship.  In review of their clinical site rotations, the fellows recommended  95% of the existing rotations, and strongly recommended  90% of the rotations.  
Rotations that were evaluated as agree to recommend in have since moved to strongly agree in
A recent graduate of the fellowship stated, “It helped me transition from a scared and inexperience NP to a confident and I think competent provider.” 
Preceptors are very satisfied with the fellows. One preceptor stated, “Having an NP fellow is like having an extra set of hands- they are ready to go.”
Retention rate is 100%.
We have decreased vacancies at medical center from 40->33% in 3 years.

11. ATP Transplant Fellowships
American Association for the Study of Liver Disease (AASLD)
Application Deadline: February 1st Award Amount: $78,000 Award Term: One year Award Type: Clinical training fellowship Career Level: Advanced Practice Providers
Designed to increase the number of associate providers in clinical hepatology and provide support for certified and licensed NP or PA pursuing a full-year of training focused on clinical care in hepatology.

12. Mayo Clinic Arizona NP or PA Abdominal Organ Transplant Fellowship
Program length: 12 months
Prerequisites: Graduate of an accredited nurse practitioner or physician assistant program, current Arizona state licensure or eligibility, current Drug Enforcement Administration licensure or eligibility, Advanced Cardiac Life Support and Basic Life Support certifications
Granted: Mayo Clinic School of Health Sciences certificate of completion
Patient interaction: High
Placement outlook: Excellent
Designed to provide the AP with specialty training in the medical and surgical aspects of liver, kidney and pancreas transplantation. Mastery of the principles of immunosuppression.

13. University of Maryland Medical Center
Applicants may choose a Critical Care Medicine, Transplant Medicine or Trauma Track. This is a 9 month Fellowship. Graduates are expected to give a 2 year commitment to work at STC/UMMC upon successful completion.
Nurse Practitioner Fellows become full time employees, with full time benefits.
The University of Maryland Medical Center and the R. Adams Cowley Shock Trauma Center are now offering a post-graduate, Critical Care Fellowship for Nurse Practitioners either newly graduated or new to the Critical Care areas. Applicants may choose a Critical Care Medicine or Trauma Track.
Nurse Practitioner Fellows become full time employees, with full time benefits. 

14. Vanderbilt University Medical Center Nurse Practitioner (NP) Fellowship Program
Nurse Practitioner (NP) Fellowship Program in Solid Organ Transplantation
The one year fellowship prepares the new graduate, as well as the experienced nurse practitioner to provide quality, evidence-based patient care within a diverse and complex health care
Emphasis on leadership development
Immersion into environment of collaborative multidisciplinary care that assures cost effective, quality, patient centered care
Rotations in Liver, Kidney, Heart, and Lung Transplantation
2080 clinical hours

15. Summary Curricula vary but are largely clinically focused
Emphasis on Leadership topics varies
Commitment to full-time hire varies from program to program

16. Future Trends Organ Specific fellowships
Fellowship opportunities increasing in number
Accreditation

17. Thank you

18. Questions?