A CRNA fellowship is optional post-graduate training in one area of anesthesia, such as pain management or pediatrics. You complete it after you are certified, to build deeper skills than school alone provides.
The Council on Accreditation (COA) accredits a small number of fellowships. As of its December 2025 list, there were seven: four in pediatric anesthesia and three in pain management.
Do you need a fellowship?
Most CRNAs practice without one. Your doctorate and NBCRNA certification already qualify you to practice across anesthesia.
A fellowship can help if you want to:
- Focus your career on a specialty, such as pediatrics or pain
- Build confidence and case numbers in a specialty before taking a job in it
- Meet a credential requirement, such as the coming pain fellowship rule for NSPM certification (see below)
COA-accredited fellowships
COA started accrediting post-graduate CRNA fellowships under standards adopted in 2014. This accreditation sits outside COA's federal (USDE) and CHEA-recognized scope, which covers degree programs.
COA reviews fellowships through a self-assessment and a virtual site visit. Only fellows who enroll after accreditation is granted graduate from an accredited fellowship.
Accredited fellowships, December 5, 2025 list
| Fellowship | Location | Focus |
|---|---|---|
| Nemours Children's Hospital Pediatric Nurse Anesthesia Fellowship | Wilmington, DE | Pediatric |
| University of South Florida Advanced Pain Management Fellowship | Tampa, FL | Pain |
| Ann & Robert H. Lurie Children's Hospital of Chicago Pediatric CRNA Fellowship | Chicago, IL | Pediatric |
| Boston Children's Hospital Pediatric Nurse Anesthesia Fellowship | Boston, MA | Pediatric |
| Children's Hospital of Michigan Fellowship Program in Pediatric Nurse Anesthesia | Detroit, MI | Pediatric |
| Middle Tennessee School of Anesthesia Acute Surgical Pain Management Fellowship | Madison, TN | Acute surgical pain |
| Texas Christian University Post-Graduate Advanced Pain Management Fellowship | Fort Worth, TX | Pain |
COA updates this list during the year. Check the current list on coacrna.org before you apply.
Pain management fellowships
Two accredited fellowships, at USF and TCU, cover advanced pain management. The MTSA fellowship focuses on acute surgical pain. Check each curriculum to see how much chronic, interventional or perioperative pain care it includes.
The 2027 NSPM rule
NBCRNA offers a voluntary subspecialty credential in Nonsurgical Pain Management (NSPM-C). Starting January 1, 2027, new applicants will need to complete a COA-accredited post-master's pain management fellowship.
NBCRNA names the fellowships at Texas Christian University and the University of South Florida as currently qualifying. It says new pain fellowships will qualify once COA accredits them.
The initial NSPM exam has 200 questions over 240 minutes. From October 2026, CRNAs who hold the NSPM-C maintain it through extra quarterly questions in MAC Check.
If chronic pain is your goal, plan your fellowship around this rule.
Pediatric fellowships
Four of the seven accredited fellowships are in pediatric anesthesia, all at children's hospitals. They give you concentrated time with infants and children, including complex cases.
Each program sets its own length, start dates, pay and admission rules. Check the fellowship's own site, or contact it using the details on the COA list.
Regional, cardiac and obstetric programs
As of the December 2025 list, COA has not accredited a fellowship focused on regional anesthesia, cardiac anesthesia or obstetric anesthesia. Programs in these areas may be offered by hospitals, groups or universities without COA accreditation.
An unaccredited program can still be useful. Before you commit, ask:
- Is it accredited, and by whom?
- How long is it, and is it paid?
- How many cases or blocks will I do, and of what types?
- Who teaches it, and what are their credentials?
- Do I need a license in that state before I start?
- Will I earn a certificate, and does it count toward NBCRNA requirements?
- Do I have to sign a work commitment or non-compete afterward?
You can also build skills through workshops and continuing education. Approved activities with an assessment count as Class A credits toward your MAC Ed requirement. See CRNA recertification.
How to apply
Contact the program director early. Expect to be asked for items like:
- An active RN license and APRN or CRNA authority, often in the program's state
- Current NBCRNA certification
- A CV, references and a statement of goals
Requirements differ, so confirm on each fellowship's site. If you need a license in a new state, see licensure by endorsement.
FAQ
Do fellowships pay?
It varies. Ask each program whether it pays a salary or stipend, or charges tuition.
Will a fellowship raise my salary?
There is no official data on that. It may help you get a specialty role, so ask employers in that specialty how they value it.
Are there fellowships for new graduates?
These are post-graduate CRNA fellowships, so expect to need NBCRNA certification first. Ask whether the program wants prior work experience.
Is a fellowship the same as a post-master's DNP?
No. A fellowship is clinical training in one specialty. A post-master's DNP is an academic degree.