California faces a statewide shortfall for primary care providers. In the next decade, an additional 4,100 primary care providers will be needed to meet the state's projected demand.
And a resource that health systems are increasingly relying on to alleviate the shortfall is advanced practice providers — nurse practitioners (NPs) and physician assistants (PAs). These are practitioners with advanced education and clinical training who can diagnose, treat and manage many common health conditions.
"The shortage of health professionals impacts access to care, causing a significant delay in obtaining timely health services and resulting in barriers which negatively affect health outcomes," said Deb Bakerjian, associate dean for practice at the Betty Irene Moore School of Nursing.
A workforce to fill underserved gaps
Bakerjian leads a program that equips new primary care NPs and PAs to serve in under-resourced areas through clinical rotations and education. The Primary Care Advanced Practice Provider (APP) Fellowship is a post-graduate program created in partnership between the School of Nursing, UC Davis Health affiliated centers and clinics, Federally Qualified Health Centers (FQHCs), as well as the Veterans Affairs Administration and Sutter Health.
The program used to be known as the NP PRACTICE Residency program but its new name better reflects that these APPs are fully licensed and nationally certified, Bakerjian said.
During the 12-month fellowship, APP fellows:
- Sharpen their clinical care skills in a mentored, primary care setting
- Enhance their knowledge of relevant primary care topics through online and in-person education sessions
- Learn practice management skills
- Receive wound care training that prepares them to become certified in wound treatment
Mentored approach builds confidence and skills
Bakerjian says the mentored transition-to-practice experience reinforces and enhances new fellows' critical thinking and decision-making skills. Recent graduates agree the program does that and more.
2023-24 cohort graduate Shante Myers noted that the program was challenging, including the transition to independent practice, but that the didactic sessions led by specialists helped boost her confidence. "They encouraged self-guided practice that would have been impossible to develop without participating in the program," she said. "This has really allowed me to be ready to hit the ground running as I began my career as a nurse practitioner."
Fellows practice at a clinical site four days per week and their fifth day is dedicated to educational activities. In clinical practice, mentors teach them continuity of care and practice management. Fellows may also experience select specialty rotations at their assigned clinical site. The immersive curriculum includes online advanced-learning modules, simulation training at UC Davis Health's state-of-the-art simulation centers, and scholarly or creative activities.
"Ultimately," Bakerjian said, "this will enhance the NP and PA professions and expand capacity in provider shortage areas.".
The UC Davis Health service area includes 33 mostly rural counties with 6.1 million residents of ethnically, culturally and linguistically diverse backgrounds. The fellowship addresses UC Davis Health's goals to reduce care disparities and work with other organizations to form partnerships that solve care issues for underserved patients.
New NP and PA graduates who want to serve in primary care and think the program would help them transition into practice can join an informational session webinar on Dec. 3.
The fellowship is one of two innovative programs for new graduate NPs and PAs who seek mentored guidance.
The other program is the UC Davis Health Specialty Care Advanced Practice Fellowship. Its focus is to develop specialty specific skills in trauma acute care surgery, neurological surgery, neurology, inpatient glycemic, oncology, interventional radiology, burn surgery or orthopedics. Applications for 2026 specialty fellowships will be accepted later next year.
Both programs earned three-year accreditation from the Consortium for Advanced Practice Providers in 2023.
