Brigham and Women's Physician Assistant Fellowship Program

Mission

The program's mission is to develop confident, competent, and collaborative clinicians who deliver high-quality and equitable care to patients with varied and complex diseases and socio-economic backgrounds and make an impact on the larger care environment through education, quality improvement, and clinical leadership.

Vision

By harnessing the power of world-renowned healthcare expertise, the Brigham and Women's PA Fellowship will set the standard for advanced practice provider (APP) practice and ignite the growth of post-graduate educational opportunities for APPs.

Values

• Providing an exceptional experience
• Presenting meaningful educational opportunities
• Building collaborative relationships at all levels
• Delivering equitable care to all patients
• Developing a diverse workforce

Goals

The Brigham and Women's PA Fellowship will elevate the reputation and role of APPs in healthcare delivery on a local, regional, and national basis.

Our graduates will be:

• Diverse, well-rounded, and highly skilled
• Confident in their acquired skills in quaternary and tertiary care as well as community-based care
• Well-rounded with various experiences across hospital medicine
• Actively engaged in regional and national APP organizations and causes
• Well positioned to take the Hospital Medicine CAQ
• Trained in quality improvement and internal operations
• Equipped to be both mentors and mentees in their fields

Brigham and Women's will:

• Upon the hiring of our Fellows as full-time PAs, gain diverse, well-rounded, and highly skilled PAs who have been trained by Brigham APPs to work efficiently and effectively within the Brigham Women's system
• Retain current APPs by offering additional opportunities for growth and career development

The fellowship includes over 350 hours of protected time for lectures, simulation, journal club, Grand Rounds, and other educational conferences.

Fellowship-Specific Team Didactics

• Fellowship team education sessions: Weekly didactics and skills sessions specifically designed and exclusive material for Fellows taught by Instructional Faculty or Fellowship staff.
• Fellows' Journal Club: Fellows will periodically be expected to prepare a summary of an item in the hospital medicine literature to update their peers and the faculty members.
• PA Fellowship Simulation Curriculum: Approximately every 2 weeks, Fellows will participate in simulated medical scenarios to complement their clinical learning. Fellows will work together “at the bedside” to manage common acute medical scenarios, practice communication skills, and work in interdisciplinary teams.
• Procedures and skills lab training: Learning series where Fellows can practice common procedures including nasogastric tube placement, ABG, thoracentesis, paracentesis, and lumbar punctures to prepare to perform these procedures at the bedside. Skills like EKG reading, CXR reading, and ABG interpretation will also be developed.

Hospital Medicine Unit and Brigham and Women's Hospital Didactics

• BWH Hospital Medicine Unit Grand Rounds: This is a weekly lecture series that covers high-impact topics in hospital medicine. Sessions are often updates from subspecialties important to hospital medicine.
• Weekly Department of Medicine Grand Rounds: This is a weekly lecture series held for the entire Department of Medicine on topics relevant to the practice of internal medicine.
• Monthly BWH PA Grand Rounds: Monthly lecture series on a wide variety of medical and surgical topics presented by the Brigham medical community.
• BWFH APP Grand Rounds: This is a monthly conference held at BWFH that covers topics of interest to PAs and NPs practicing inpatient medicine.
• Monthly DFCI PA Grand Rounds: Monthly lecture series on a wide variety of oncologic medical and surgical topics presented by Dana Farber Cancer Institute community.
• Harvard Medical School's “Update in Hospital Medicine” Course: Fellows will have the opportunity to attend and audit this 3-4 day CME course directed and curated by the BWH Hospital Medicine Faculty.

Each fellow will rotate through:

• Bootcamp
• 8-12 Weeks of BWH Hospital Medicine Service
• 8-12 Weeks of BWHF Hospital Medicine Service
• 8-12 Weeks of Oncology
• 6-8 Weeks of Cardiology
• Up to 4 Weeks of Elective(s)
• 2 1-Week Vacations

Clinical Rotations

• Fellowship Boot Camp: This is an intensive 1-2 week preparation for clinical rotations, life at the Brigham and Women's hospitals, and joining the fellowship community.
• Hospital Medicine at BWH: Fellows will spend 8-12 weeks on the medicine wards at Brigham and Women’s Hospital on a team with a Hospital Medicine attending and PA preceptor. Fellows will have an escalating patient census over the course of the rotation. On this team, a PA is expected to provide all aspects of hospital care including preparing and presenting on daily rounds, admissions, and discharges.
• Hospital Medicine at BWFH: Fellows will spend 8-12 weeks at Faulkner Hospital practicing in a community teaching hospital environment. The teams consist of a Hospital Medicine attending and an APP preceptor. Fellows will have an escalating patient census and have similar responsibilities as above.
• Inpatient Oncology at BWH, Dana Farber Cancer Institute: Fellows will spend 8-12 weeks on an inpatient Oncology team at Dana-Farber Brigham Cancer Center caring for patients with an active or suspected cancer diagnosis. Fellows will be part of a team with an Oncology attending and an Oncology PA preceptor. They will rotate through different oncologic services, such as solid tumor, and palliative care. Patient census will depend on service.
• Inpatient Cardiology at BWH: Fellows will spend 6-8 weeks on an inpatient Cardiology service and be part of a team with a Cardiology attending and an APP preceptor. They will rotate through inpatient general cardiology with opportunities to work with electrophysiology and cardiac catheterization teams.
• Critical Care at BWFH: Fellows will spend 4 weeks learning critical care basics in the ICU at Faulkner Hospital.
• Elective Rotations: Fellows will have an option to spend up to 4 weeks on an elective rotation which will be selected upon starting the PA fellowship. Options include an extension of a core rotation at BWH and/or BWFH, bedside procedure service, simulation education, and other inpatient subspecialties such as: infectious disease, renal, geriatrics, pulmonology transplant medicine and cardiology subspecialties.

Our PA fellows are fully licensed and credentialed to work in the departments where they will rotate, which means they will have the ability to function similarly to a PA hired in that department with the supervision of an attending physician. PA fellows can write/sign notes, sign orders and write prescriptions. They will not be configured into the staffing model, instead added to the teams. Patient load and responsibility will ramp up throughout the year, with a mid-end goal of being at 80%+ clinical responsibility of a PA working on that team.

Schedules will be rotating, mostly days, but occasional evening/night rotation. Typically, PA fellows will work 4-5 days/week, including some weekends with varying hours (8-12hr) depending on the rotation. This PA fellowship program is compliant with ACGME guidelines.

The PA fellowship offers competitive compensation with full benefits, including malpractice insurance through Mass General Brigham.

Eligibility

To be eligible for this fellowship, you must have the following:

• Graduated from an accredited physician assistant program
• National board certification from NCCPA
• Massachusetts state license
• Current Drug Enforcement Administration (DEA) license
• Current Basic Life Support (BLS) and Cardiac Life Support (ACLS) Certifications

Applicants who have not yet graduated and therefore do not currently have the above prerequisites are encouraged to apply for the fellowship. However, applicants must meet all prerequisites prior to starting the program. See below for more details.

How to Apply

The application cycle is open on a rolling basis. Please forward the requisite documentation to PAFellowship@bwh.harvard.edu.

Anticipated start date for the next cohort is Spring 2024.

Applications for the fellowship require the following documentation:

1. Personal statement (one page) stating your personal interest in the Fellowship
2. Current Curriculum Vitae detailing work and volunteer experiences prior to PA school
3. Unofficial transcript from training program reporting PA school performance
4. Two letters of recommendation with at least one from a clinical rotation preceptor (physician or advanced practice provider)
5. Letters should be emailed directly from the author to PAFellowship@bwh.harvard.edu
6. Four references with at least two from a physician or advanced practice provider preceptor/supervisor, and one from your PA program (e.g. faculty member)

Please send the above documentation to PAFellowship@bwh.harvard.edu. Incomplete applications may not be accepted.

Carla Chipalkatty, PA-C
Program Co-Director, Physician Assistant Fellowship Program
Brigham and Women's Hospital
Department of Medicine
cchipalkatty@bwh.harvard.edu

Danielle Moore, PA-C
Program Co-Director, Physician Assistant Fellowship Program
Brigham and Women's Hospital
Department of Medicine
dmoore17@bwh.harvard.edu

Matthew DiFrancesco, MD
Medical Director, Physician Assistant Fellowship Program
Assistant Director of Simulation for Medicine, BWH STRATUS Center
Brigham and Women's Hospital
Department of Medicine
mdifrancesco@partners.org

Erin McElrath, MBA
Admin Program Manager, Physician Assistant Fellowship Program
Brigham and Women's Hospital
Department of Medicine
emcelrath@bwh.harvard.edu