Advanced Practice Provider Fellowship—An Effective Approach to Onboarding and Retention in High Acuity Trauma, Critical Care, and Emergency General Surgery Programs

Because of the steep learning curve, advanced practice provider (APP) attrition within acute care surgery (ACS) is high, resulting in low morale and a substantial financial burden on institutions. We created a comprehensive, 1-year ACS APP fellowship to provide training for new APPs to reduce attrition and improve morale. The fellowship consisted of weekly lectures and simulation sessions, structured rotations on ACS and subspecialty services, and assigned mentoring on each service to fellows. To date, 3 ACS APP fellow classes have graduated the program with 80% accepting full-time positions. APP fellowships provide specialized training while eliminating financial burdens preventing adequate training for new providers.