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Nurse Practitioner and Physician Assistant ... - California

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California Correctional Health Care Services Nurse Practitioner and Physician Assistant Residency Training Program 2022–2023 California Correctional Health Care Services (CCHCS) is accepting applications for the Nurse Practitioner and Physician Assistant Residency Training Program. The class of 2022–2023 will begin in September 2022. The application deadline is March 15, 2022. CCHCS is committed to leadership, transformation, and innovation in health care. This residency is designed for new Nurse Practitioners (NPs) and Physician Assistants (PAs) interested in careers grounded in the delivery of quality care for vulnerable and special populations. The Nurse Practitioner and Physician Assistant Residency Training Program has the following goals: Prepares NPs and PAs to assume full responsibility for the primary care of complex underserved patient populations in multiple settings. Build on the education and practice base acquired in the candidate’s educational program leading to certification as an NP or PA, by developing the clinical and operational confidence necessary for efficient, effective, and productive practice as a key member of the health care team. Increase the number of NPs and PAs choosing to build long-term careers in correctional and safety-net settings, while enhancing their capability for leadership positions within those organizations and within the healthcare system of the future. About the Facility The 2021-2022 class has two residents who are based at California Medical Facility (CMF). CMF is a medium security medical facility for men located in the city of Vacaville in Solano County. Vacaville is located 37 miles southwest of Sacramento and 65 miles northeast of San Francisco. The majority of patients at CMF reside in an outpatient setting and receive health care in an outpatient clinic. Patients who require 24-hour nursing care are housed in a licensed medical correctional treatment center (CTC). CMF also operates a 400 bed psychiatric CTC, a 50 bed mental health crisis bed CTC, and the first licensed prison hospice in the United States. In the 2022- 2023 academic year the program will continue at CMF.
Transcript

California Correctional Health Care Services Nurse Practitioner and Physician Assistant Residency Training Program

2022–2023

California Correctional Health Care Services (CCHCS) is accepting applications for the Nurse Practitioner and Physician Assistant Residency Training Program.

The class of 2022–2023 will begin in September 2022. The application deadline is March 15, 2022.

CCHCS is committed to leadership, transformation, and innovation in health care. This residency is designed for new Nurse Practitioners (NPs) and Physician Assistants (PAs) interested in careers grounded in the delivery of quality care for vulnerable and special populations. The Nurse Practitioner and Physician Assistant Residency Training Program has the following goals:

Prepares NPs and PAs to assume full responsibility for the primary care of complex underserved patient populations in multiple settings.

Build on the education and practice base acquired in the candidate’s educational program leading to certification as an NP or PA, by developing the clinical and operational confidence necessary for efficient, effective, and productive practice as a key member of the health care team.

Increase the number of NPs and PAs choosing to build long-term careers in correctional and safety-net settings, while enhancing their capability for leadership positions within those organizations and within the healthcare system of the future.

About the Facility

The 2021-2022 class has two residents who are based at California Medical Facility (CMF). CMF is a medium security medical facility for men located in the city of Vacaville in Solano County. Vacaville is located 37 miles southwest of Sacramento and 65 miles northeast of San Francisco. The majority of patients at CMF reside in an outpatient setting and receive health care in an outpatient clinic. Patients who require 24-hour nursing care are housed in a licensed medical correctional treatment center (CTC). CMF also operates a 400 bed psychiatric CTC, a 50 bed mental health crisis bed CTC, and the first licensed prison hospice in the United States. In the 2022-2023 academic year the program will continue at CMF.

2022–2023

California Correctional Health Care ServicesNurse Practitioner and Physician Assistant Residency Training Program

PROGRAM APPLICATION CHECKLIST Application: Complete the attached application. Type or legibly print all responses and complete the application below in its

entirety. All supplemental essay questions must be answered. Resumes, CVs and other documents will not replace the essay questions. You may not indicate “SEE CV”, etc., for response.

Letters of Recommendation Three (3) letters of recommendation from professional references (supervisor, program director, chair

of the department, CMO). Each letter writer must directly send the letter to [email protected]. Letters of recommendation sent from the applicant will not be accepted.

Supporting Materials: As indicated by the checkbox below, current copies of the following documents must accompany your application. Please make sure all copies are legible.

CV with MONTH & YEAR for WORK & EDUCATION history sections Undergraduate and graduate diplomas Official graduate/professional school transcripts If applicable, written and signed explanation of any gaps in work history over three (3) months California Registered Nurse (RN) and Advanced Practice Registered Nurse (APRN) license or evidence

of eligibility (NP applicants)* California PA license or evidence of eligibility (PA applicants)* License(s) from any other state Federal Drug Enforcement Administration (DEA) certificate* X-waiver Certificate* ACLS card (must be from American Heart Association)* American Nurses Credentialing Center/American Association of Nurse Practitioners certification (NP

applicants) or National Commission on Certification of Physician Assistants certification (PA applicants), or evidence of eligibility

Driver’s license Proof of COVID-19 vaccination If applicable, non U.S. residents must provide a copy of their permanent resident card/VISA/proof of

eligibility

*If you are currently an NP or PA student in the class of 2022, licensure and credentialing materials (i.e., Board Certification, CA licenses, DEA license, X-waiver, and ACLS) are not required when applying, simply write “pending”. Licensure and credentialing materials are conditions of program participation and must be provided, not later than, August 20, 2022.

Electronic applications should be emailed to [email protected]. Simply download the PDF, complete all fields, save, and attach it to the email along with supporting documents.

For more information, please contact [email protected] | (916) 430-8576

Nurse Practitioner and Physician Assistant Residency Application

General Information Please complete all relevant fields.

First Name Middle Name Last Name Suffix

Contact Email Address Cell Phone Home Phone

Home Address Please enter your home address in full.

Home Address Line 1:

Home Address Line 2:

City: State: Zip:

Other Names Please enter any other names by which you have been known including those appearing on professional diploma and licensure.

Other First Name Other Middle Name Other Last Name FromDate (mm/yy) ToDate (mm/yy)

Other First Name Other Middle Name Other Last Name From Date (mm/yy) ToDate (mm/yy)

For Non U.S. Citizens Please provide information on your immigration status.

Country or Citizenship Visa Visa Number Visa Date

Language(s) Please list all non-English languages you speak and indicate your level of fluency (Basic, Intermediate, and Advanced).

Language 1: Speak: Read: Write:

Language 2: Speak: Read: Write:

Language 3: Speak: Read: Write:

( ) ( )

Nurse Practitioner and Physician Assistant Residency Application

Education Please provide information on your undergraduate, graduate, and professional education below.

Education Type:

Degree Earned:

From (mm/yy):

To (mm/yy)

Institution Name:

Address Line 1:

Address Line 2:

City: State: Zip:

Contact Phone:

Education Type:

Degree Earned:

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To (mm/yy):

Institution Name:

Address Line 1:

Address Line 2:

City:

State: Zip:

Contact Phone:

Education Type:

Degree Earned:

From (mm/yy):

To (mm/yy):

Institution Name:

Address Line 1:

Address Line 2:

City:

:

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( )

State: Zip:

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Contact Phone:

Nurse Practitioner and Physician Assistant Residency Application

Experience Please list your work experience.

Experience

Company/Agency:

Job Title:

From (mm/yy): To (mm/yy):

Address Line 1:

Address Line 2:

City: State: Zip:

Contact Phone:

Supervisor Name:

Experience

Company/Agency:

Job Title:

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City: State: Zip:

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Supervisor Name:

Experience

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City: State: Zip:

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Supervisor Name:

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Nurse Practitioner and Physician Assistant Residency Application

Professional Reference Please list the names and addresses of three references. Please include a reference from each of the following:

Program Director—graduate program

Clinical Preceptor

Professional Reference—preferably a manager

Program Director

Name:

Institution/Relationship: Specialty:

Address Line 1:

Address Line 2:

City: State: Zip:

Contact Phone:

Email:

Clinical Preceptor

Name:

Institution/Relationship: Specialty:

Address Line 1:

Address Line 2:

City: State: Zip:

Contact Phone: ( )

Email:

Professional Reference

Name:

Institution/Relationship: Specialty:

Address Line 1:

Address Line 2:

City: State: Zip:

Contact Phone:

Email:

( )

( )

Nurse Practitioner and Physician Assistant Residency Application

Essay Question Please submit a 250-500 word response to each of the four following questions. This is an opportunity to reflect upon and communicate your personal statement of qualifications, interest, and motivation for applying to this Residency. Additional space is available at the end of this application if needed.

A. What personal, professional, or educational experiences have led you to choose healthcare as a profession? Why have you chosen the role of a nurse practitioner or physician assistant as your career goal? What do you hope to gain from this Residency program? What is your vision and planning for your short and long-term career development?

Essay Question

B. Compare what you know about the goals/objectives of the CCHCS NP/PA Residency Program and your own experience, knowledge, and skills. What areas do you need to develop? What specialty experiences interest you most? How do you see this experienceintegrated into your future practice? [250-500 words]

Nurse Practitioner and Physician Assistant Residency Application

Nurse Practitioner and Physician Assistant Residency Application

Essay Question

C. Tell us about why you want to provide care in a correctional healthcare setting and/or for underserved populations. Describe any experience you have had with correctional/incarcerated patients or patients from underserved populations. What apprehensions, concerns, or hesitations might you have? [250-500 words]

Nurse Practitioner and Physician Assistant Residency Application

Essay Question

D. What strengths and personal attributes do you possess that you think will be an asset to this program and how will the attributes contribute to the success of this program, you, and your co-residents? [250-500 words]

Nurse Practitioner and Physician Assistant Residency Application

Application Attestation I attest that all information provided in this application is true and complete to the best of my knowledge and belief. I will notify CCHCS within 10 days of any material changes to the information I have provided in my application or authorized to be released according to the credentialing process. I understand that corrections to the application are permitted at any time prior to a determination or affiliation by CCHCS, must be submitted online or in writing, and must be dated and signed by me.

Electronic Signature – Type full name

Date

Nurse Practitioner and Physician Assistant Residency Application

Essay Question Please use the additional space (if needed) to continue your essay. Please indicate Essay Question A, B, C, or D. You may duplicate this page if needed.

Essay


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