Hospital Medicine APP Curriculum Overview

The Advanced Practice Provider Fellowship in Hospital Medicine is a 1-year program focused on providing the novice nurse practitioner or physician assistant with further education on caring for the hospitalized patient. Fellows will be guided through the foundations of hospital medicine focusing on current evidence-based practice fostering curiosity, independent education, and a structure for lifelong learning. Fellows will complete both didactic and clinical experiences with rotations in Palliative Care, Nephrology, Interventional Radiology, and within the Internal Medicine Clinic.

Didactic curriculum

  • Boot Camp on Demand
  • Hospital Medicine APP Case Reviews
  • Topics in Medicine - Monthly presentations through the Office of Advanced Practice Providers
  • Weekly Grand Rounds
  • Weekly M&M
  • Daily Bedside Roundings

Weekly didactic lecture topics

  • Cardiovascular Medicine
  • Dermatology
  • GI
  • Hem/Onc
  • Infectious Disease
  • Neurologic Disease
  • Pharmacology/Toxicology/Environmental
  • Psychiatric
  • Pulmonary Disease
  • Renal/Endocrine/Metabolism
  • Rheumatology
  • Skills/Procedures/Imagine/EKG/US
  • Transitions of Care

Clinical curriculum

Months 1-2

The focus of the first two months of fellowship will be on orientation to the hospital and establishing an educational foundation in hospital medicine. The APP fellow will complete the Boot Camp on Demand. By the end of month 2, the APP fellow will be following 2 patients.

Months 3-6

Months 3-6 will focus on applying knowledge gained in months 1-2 to patient care. The APP fellow panel should be up to 5 patients by the end of month 6.

Months 7-9

During months 7-9, the fellow will have responsibility for an increasing patient panel. During this block of time, the APP fellow will spend 1 month in General Internal Medicine.

Months 10-12

During the last two months of the fellowship, the fellow will be developing increasing autonomy. By the completion of the fellowship, the fellow should be able to follow 8 patients. The fellow will also develop a case study and present their case at the monthly hospital medicine APP case review.

During the final two months, the fellow will be introduced to the operations at Alice Peck Day Memorial Hospital (APD), a critical access hospital within the Dartmouth Health system also located in Lebanon, NH. This patient population is less complex than the medical center and allows for more independent practice. By the end of their fellowship, the fellow should be able to work independently at APD.

Evaluation structure

  1. Quarterly milestone evaluation of the fellow by the program director with feedback from physicians who work within hospital medicine
  2. Rotation-specific evaluations of the fellow by 2-3 faculty.
  3. Ongoing formative evaluation that occurs in “real-time” during clinical practice, check-ins, and informal faculty feedback
  4. Ongoing APP fellow evaluation of the program at large as well as fellow evaluation of individual rotations Evaluation and

Expectations of the fellow

  1. Clinical Practice
    1. How the fellow synthesizes pathophysiology, patient presentation, patient assessment, differential diagnosis, and patient management into caring for hospital medicine patients. The fellow will demonstrate inquisitive thought and analytical thinking skills in clinical situations and patient care
    2. How the fellow manages an acutely decompensating patient
    3. How the fellow communicates with the multi-disciplinary staff as well as patients and their families
  2. Systems-based Practice
    1. The fellow will demonstrate an awareness of responsiveness to the hospital medicine patient and provide coordinated patient care that balances quality and cost while maintaining the primacy of patient safety and care
  3. Professionalism
    1. The fellow will demonstrate a high level of responsibility, ethical practice, and adherence to legal and regulatory requirements. Exemplary communication skills are imperative, including verbal, non-verbal, written, and electronic exchange of information as well as effective interpersonal communication with patients, families, physicians, other care providers, and other members of the interdisciplinary healthcare team.
  4. Efficiency with the EMR