Should You Consider a Nurse Practitioner Residency?

When I graduated from my nurse practitioner program I had never heard of NP residency.  I wasn't aware of any continued learning opportunities for nurse practitioners aside from pursuing a more advanced degree.  After years of schooling, the last thing I was in the mood for after graduating from my NP program was a PhD.  Fortunately for nurse practitioners graduating today, a new residency concept is gaining popularity. 

Last week I discussed the difficult transition from the NP program to practice.  The real world of medicine can be tough.  No matter your IQ or the number of hours you spend at the library, you simply cannot retain the vast level of medical knowledge necessary to work as a nurse practitioner in just a two or three year program.  Like everything in life, becoming a competent nurse practitioner takes practice.  

Nurse practitioner residency programs are the perfect compliment to a nurse practitioner education.  They remove the pressures of on-the-job learning during your first year of practice.  NP residents retain the label of a student while earning a stipend.  I certainly could have used some extra patient care hours before beginning my first job.  Let's do a little nurse practitioner residency Q&A.

How Did Nurse Practitioner Residencies Originate?

Nurse practitioner residencies were first introduced by NP Margaret Flinter in 2005.  Ms. Flinter wisely sums up the challenges of new NP's.  She says "During this critical first year of practice, the new nurse practitioner's development is largely tied to the skills and scope of a colleague whose primary responsibility is not mentorship, but his/her own practice, and who may or may not have the skill, patience, interest and/or time to devote to intensive training and mentoring."  This statement describes the frustration of most first year NP's precisely. 

As nurse practitioners, we all know personally the problem Margaret Flinter is addressing.  Fortunately, the Connecticut-based clinic, Community Health Centers, Inc, where Flinter works instituted the first ever nurse practitioner residency program in 2007. 

Where Can I Find a Nurse Practitioner Residency?

Currently, there are a few nurse practitioner residency programs in the U.S., most geared toward Family Nurse Practitioner graduates.  A few NP residency programs are available to facilitate transition into specialty practice.  The Mayo Clinic in Arizona, for example, offers a program training NP's from any specialty to practice in cardiology.  Johns Hopkins University in Maryland offers an engaging gastroenterolgy and hepatology residency for nurse practitioners seeking proficiency in this field.  Tufts University offers new nurse practitioners a residency in dermatology.  Regions Hospital in Minnesota trains nurse practitioners in pediatric psychiatry while Memorial Sloan-Kettering Cancer Center in New York offers pain and palliative care specialization to nurse practitioners of all backgrounds.  

In 2016, here at MidlevelU, we also launched our own residency-like program for NPs and PAs. This program, titled Midlevels for the Medically Underserved (MMU), matches providers with facilities treating medically underserved populations across the country. You can learn more about MMU here

Keep in mind, some of these kinds of programs are referred to as nurse practitioner fellowships.  Search both terms, residency and fellowship, when looking for post-graduate learning opportunities. 

How Will a Nurse Practitioner Residency Advance My Career?

Completing a nurse practitioner residency will give you a one-up on other candidates when applying for your first job.  It will allow you to highlight an additional year of intensive, hands-on education, invaluable in the eyes of an employer.  

On a personal level, a nurse practitioner residency facilitates a smooth transition from your education to practice.  It allows you to avoid the pitfalls most NP's experience their first year of practice.  Forget the constant stress and anxiety of on the job learning, you will be prepared to treat patients in the work setting. 

Finally, if you plan to pursue specialized practice a residency helps you quickly work your way up professionally.  Many NP's hoping for specialty practice work in a less desirable field for a few years before landing their dream job.  A nurse practitioner residency speeds your learning making you eligible for specialty practice (and likely a higher salary) much sooner. 

Let's Be Honest.  It's All About the Money.  Do the Numbers Favor Completing a Residency or Suffering Through On-the-Job Learning?

You must consider the financial implications of NP residency.  A nurse practitioner resident can plan to earn a stipend of about $40,000.  Forgoing residency and moving straight into practice a new NP would make about double this amount.  While this leaves you at a $40,000 deficit, a residency may allow you to land a higher paying job more quickly offsetting lost income.  Becoming proficient in your practice also holds significant non-financial value. 

If you are graduating from your nurse practitioner program this spring or summer and are concerned about your ability to enter real-world practice, look into NP residencies.  With this additional year of hands-on practice experience under a capable mentor you will come away more prepared for your NP career.  Your first year as a nurse practitioner will be rough.  A residency program promises to facilitate the transition from education to practice saving you endless anxiety.  The rest of us will just have to tough it out. 

Have you completed a nurse practitioner residency?  Share your experiences by commenting below!


You Might Also Like: F.A.Q. About Midlevels for the Medically Underserved



Hi Aaron, 

You can check out more information about Midlevels for the Medically Underserved, our residency-like program for NPs here

Please let us know if you have any questions about the program!

Erin Tolbert

Hi, I am looking for information regarding nurse practitioner residency programs or internships? I live in Michigan currently and have a emergency room background as a nurse. I graduate with my NP this June, and would really be interested in applying for more training in the clinical field as a midlevel provider. Any insight? or thoughts? I would eally appreciate it, please email me at


Each residency has its own application timeline. So, you will need to check with each of your programs of interest. 

For Midlevels for the Medically Underserved (MMU), the final application deadline is March 31, 2017. You may request more information, and view the online application here

Continuing education credits also depend on the program. MMU participants do receive CME credit for many of the education activities. 

Erin Tolbert

I will graduate in May 2017 with an adult/gero NP focus. When is the appropriate time to apply for a residency? Also, does the residency count for CTP-E hours? Thank you!


The salary for the PMHNP residency was very competitive(80k). Most importantly was knowledge, increased comfort level in skills (especially prescribing) and collaborative practice approach gained!


I am completing a PMHNP residency at the VA and it has been an amazing experience. I would have never had the exposure to the different inpatient settings, experience with different treatment styles and inter-professional learning in one comprehensive heavily supervised package. The supervision has been the best part.



The main pro of completing a nurse practitioner residency is that it facilitates your transition from education to practice. It is essentially another year of learning so the curve isn't so steep when you get your first NP position. 

The downside of a nurse practitioner residency is that salaries for residents are low. You could be earning significantly more in a traditional nurse practitioner employment situation.

Erin Tolbert

What are the pros and cons of going thru an NP residency?

KC what didn't you like about your experience?


Hi all. I am completing a Psych NP residency now. It has been just okay. I wish I had not done it.



Thanks for responding to my e-mail so timely and referring me to this link.

After doing some more research I found two more NP residencies/fellowships. They are below:

1) Vanderbilt DNP-ACNP residency:

2) Emory Critical Care PA/NP residency: