Primary Care Nurse Practitioner Residency Program (PCNPR)

The mission of the residency is to prepare novice NPs to work as independent practitioners within the VA HCS. Residents will be provided the opportunity to accelerate their growth beyond entry-level professional competence in patient-centered care, operational services, and leadership skills that can be applied to address the complex needs of the Veteran population in any practice setting.

As a healthcare system, Northern California VA, along with its training programs, is committed to fostering a learning environment that is diverse, inclusive, and equitable for all trainees and staff. This includes individuals who identify with one or more groups that are underrepresented in the health professions. Our goal is to actively recruit and retain trainees and faculty from diverse backgrounds, promoting an environment that consistently values, honors, and respects the identities of others. This commitment is upheld through ongoing dedicated training and continuous improvement of systems.

The overarching goal of the residency program is to provide newly graduated, licensed, and board-certified NPs a foundation for a practice embedded with scientific knowledge, clinical expertise, and professionalism. The residency program hopes to recruit, educate, and retain NPs to improve the quality and accessibility of healthcare services and accessibility for Veterans.

1. Integrate evidence-based knowledge and clinical excellence in advanced practice nursing while caring for the Veteran population. 
2. Develop the role of the independent advanced practice nurse with a commitment to excellence and quality outcomes. 
3. Train residents in a model of Veteran-centric care that is compassionate, valued, and effective in promoting health and preventing illness. 
4. Increase the confidence of residents in new role as independent practitioner. 
5. Develop collaborative skills through interprofessional relationships and team-based care approaches.

The VA is dedicated to enhancing the care provided to the nation's Veterans and is investing in innovative programs to improve training for healthcare providers. The primary objective of the residency is to contribute to optimal care for our Veterans by providing comprehensive, evidence-based educational processes and activities designed for successful implementation throughout the year. Structured around four curricular anchor themes, the residency encompasses:

• Advanced Practice Registered Nurse (APRN) role development 
• Interprofessional collaboration
• Systems improvement and leadership
• Self-reflective practice

The above four curricular anchor themes are the framework for the overarching program goals and are unique to our Residency training curriculum. Advanced clinical education of the PC NP has yet to be a part of the fabric of VA training, historically. Therefore, it is important to scaffold the residency objectives, starting with the individual and leading to systems-level impact. Throughout the year, the residency will do the following to meet the curricular goals:

1. Provide didactic and experiential learning opportunities in conjunction with UCD. 
2. Engage with interprofessional colleagues and build collaborative experiences in workplace-based environments to build competency and focus on team-based care. 
3. Provide opportunities to impact systems and build leadership through focused evidence-based practice experiences and a capstone project. 
4. Engage learners in mentored self-reflective practice and critical reflection to build a culture of self-awareness of lifelong learning. 
5. Contribute to building and supporting the ongoing scholarship and quality improvement culture within advanced practice nursing. 

Under the clinical supervision of faculty NPs and MDs, residents will provide care via face-to-face, video, and phone to Veterans onsite at Mather,  McClellan or Stockton. The following list is an example of clinical offerings (may change at any time depending on faculty availability):

• Primary Care
• Women’s Health
• Environmental Exposure
• Gerontology

Each resident will rotate through multiple settings, providing a comprehensive experience to prepare the graduate to work and lead in a complex healthcare environment. Below are the rotation types, examples of clinical settings, and the approximate number of hours in each setting.

Continuity Clinic: designed to give the resident an opportunity for long-term panel management. NP residents will manage the primary care of approximately 200 patients, conduct routine follow-up, new patient, telephone and video-based care, and urgent care visits. The resident will spend the largest block of time in this clinic. 

• Clinic examples: Primary Care
• Number of hours per week: approximately 10-20
• Number of weeks: 52

Specialty Blocks: designed to help residents gain more confidence in specialty exams, interpreting labs and understanding when it is appropriate to refer.

• Clinic Examples: Women’s Health, Gerontology, Environmental Exposure, Mental Health, Orthopedics
• Number of hours per week: approximately 5-10
• Number of months: 1-3

• Must be a U.S. Citizen or naturalized U.S. Citizen
• Must have graduated from an advanced practice Adult-Gerontology Primary Care NP or Family NP program within the 12 months preceding the residency start date. 
• The residency must be your first position serving as an NP in the same specialty as the program’s focus 
• ANCC or AANP board exam completion within 90 days of employment 
• Have current, full, active, and unrestricted registration as a Registered Nurse in a State, Territory or Commonwealth (i.e., Puerto Rico) of the United States, or the District of Columbia, before program start 
• Nurse practitioner state licensure with prescriptive/furnishing license and DEA number must be obtained within 90 days of program state date 
• Current BLS certification
• Proficient in written and spoken English 
• Completion of the following by program start: security/professional background investigation as required by the VA, pre-employment health screening, tuberculosis skin testing, up-to-date vaccinations for healthcare workers as recommended by the CDC and VA or applicable waiver according to VA policy, and possible random drug testing

• Curriculum vitae 
• Graduate school transcripts 
• Application Packet which includes:
  • VA Form 10-2850d Health Professions Trainee Data Collection Form
  • Signed Eligibility Checklist
  • Three (3) letters of recommendation (structured form to be filled out by recommender) submitted directly from letter authors. Please do not submit more than three letters.
    • One from a faculty member of your graduate program
    • One from a clinical preceptor
    • One from an employer/supervisor/coworker that can speak to your abilities as an advanced practice provider