This directory lists 115 programs aimed at experienced RNs rather than new graduates. The reason they are hard to find is mostly vocabulary.
Residency vs fellowship — the actual definitions
ANCC, which accredits both, defines them plainly: an RN Residency is designed for newly licensed RNs with less than 12 months of experience, and an RN Fellowship is designed for experienced licensed RNs with six months or more of experience. Two things follow that are worth knowing. The fellowship bar in ANCC's own definition is six months, not a year. And the two categories overlap — at six to eleven months you could plausibly fit either.
The cleanest line we found is in a union contract rather than an accreditation standard. The WSNA agreement covering Tacoma General defines a resident as a nurse with under twelve months of post-graduation clinical experience, and an RN Fellow as one with twelve or more months of acute care experience who is changing specialties.
But employers use the words inconsistently
Do not filter on the word alone. Mount Sinai's “Emergency Department Nursing Fellowship” requires a BSN and passing NCLEX before the cohort starts — it is a new-graduate programme called a fellowship. The University of Maryland Medical Center's OR and PACU “fellowships” are explicitly for new graduates and nurses with no perioperative experience, while its Cardiac Fellowship requires a year of cardiac experience and is professional development within a specialty rather than a route into one. The Emergency Nurses Association's programme is called a residency and serves both new graduates and experienced nurses new to the ED.
Read the eligibility line, not the title.
How much experience do they actually want?
Less than the folklore suggests. Across the programmes we checked the published bar clusters at six months or one year — UT Southwestern asks for a minimum of six months; Children's Health Dallas, Mount Sinai South Nassau, Memorial Hermann and Children's Hospital Los Angeles ask for about one year. Nothing we found required two years.
Does med-surg “count” toward ICU or ED?
The published requirements are generic rather than specialty-matched, which is the opposite of what most nurses fear. Children's Health accepts transitions “from any clinical setting” into critical care, cardiology, haematology or oncology. Mount Sinai South Nassau asks for a year of experience in an “acute care environment,” not ED or ICU experience specifically. UCHealth's labour-and-delivery, NICU and mother-baby fellowships are explicitly for experienced nurses with no experience in that specialty. The WSNA contract language is the same: acute care experience, changing specialties.
No primary source we reviewed — ANCC, AACN, ENA, AORN, or any employer page — states that med-surg experience is a prerequisite for ICU or ED. If a specific posting requires it, that is that employer's rule.
What the transition actually looks like
Two specialties have well-documented standard curricula. For critical care, AACN's Essentials of Critical Care Orientation is widely used — the ICU path runs eighteen modules. For the operating room, AORN's Periop 101 runs twenty-three online modules for 39.8 contact hours, most learners finish in three to six months, and more than 12,000 novice and specialty-switching nurses enrol globally each year.
Programme length varies widely because hospitals wrap clinical time around the didactic core: Children's Hospital Los Angeles runs twelve to sixteen weeks; Memorial Hermann four months; UCHealth ranges from six weeks for behavioural health to twenty-four for perioperative; Kaiser's Periop 101 implementation runs about twenty-four weeks at forty hours a week.
Does your pay drop?
This is the question that stops people applying, and the answer for RN fellowships is: it should not. ANCC requires learners in accredited programmes to be paid employees — they must be paid at least minimum wage as part of employment and cannot be required to pay to participate. A PTAP-accredited fellowship is a job, not tuition.
Where a union contract governs, the position is clearer still. The WSNA agreement covering Tacoma General contains no separate wage scale for residents or fellows: they sit on the standard staff nurse schedule, and nurses hired during the agreement are given full credit for continuous recent nursing experience when placed on it.
The pay-cut belief seems to come from advanced practice fellowships, which are a different thing. UCHealth's APP fellowship pays a flat $70,500 for thirteen months with no guarantee of employment afterwards — that is a nurse practitioner or physician assistant programme, not an RN fellowship. Do not generalise from it.
What can legitimately change is your differential exposure. One contract allows a nurse in a fellowship to be temporarily assigned to a shift other than their regular one for training purposes. If you currently work nights, ask specifically what happens to your shift and your differential during the training period — and get the answer in writing.
Read the commitment before you sign
Fellowships carry service commitments more often than people expect. Memorial Healthcare System requires a two-year commitment signed as part of new-employee paperwork. Memorial Hermann expects fellows to remain on the new unit for at least twelve months after completing. Mount Sinai's ED fellowship asks for a two-year engagement. Several fellowship pages publish no commitment language at all — but absence from a web page is not absence from an offer letter, so ask.
One genuine advantage for internal movers: under the WSNA contract, a nurse transferring into a fellowship does not restart a probationary period, while an external hire does. If you are choosing between switching internally and moving employers, that is a real difference.
Finding these programs here
Every listing in this directory shows the career stage it targets. You can also work from the specialty pages to see where programmes cluster, and comparing two offers covers weighing a switch against staying put.