Going for a MD program from FNP

gwapo · Nov 5, 2012

Hi, Nurses:
I am applying for MD school after completing my FNP as I am not really impressed with quality of certification in FNP. The AANP review board are more with nurses, and I wish they had M.D. in nursing board. When I took my FNP courses, I had few instructors who were M.D. and I really fared well in those courses. So after completing the FNP program, I realize that I fit well in M.D. group rather than DNP/Nurses group.
Please suggest what school should I go in US or Caribbean.

Ummm. You may get better responses at http://www.alldoctors.com but i'm not saying nobody will have input here though.

mahaandai · Nov 20, 2012

Thank you gwapo for your suggestion of going to doctors' website. I will definitely look into it.

My point is why can't we have more MD, Ph.D. in Nurse Practitioners' Board panel?

I see now that AANP and AANC are being integrated together beginning January 1, 2013- which is a big step for Nurse Practitioners representing their point of view to Congress.

Why is Nurse Practitioner profession considered as nurses-only domain when we take similar theoretical courses as in MD program? Also, in my FNP program we had the Professors who were teaching in both MD and Allied Health departments. I noticed that

Professors with MD background in my program were more logical and rational in teaching than Professors who came from nursing background, e.g., RN, MSN, DNP. It seems to me that nurses don't want to renounce their authority as FNPs and they are more than unwilling to accept MDs as leaders for NP.

The fact is that our forefather MDs envisioned NP programs. They created it.

More MDs prefer to work with NPs. So why not make NP as an associate branch of MD rather than making it "nurses only" world.

mrmedical, ASN, BSN · Nov 21, 2012

As far as schools are concerned look for a DO school or MD school in the US. Residency spots are tight right now, and with many more FMG (foreign medical grads) who generally have a better education than Caribbean grads are getting those spots, leaving many Caribbean MD students in the dust with no residency, a ton of debt, and wasted 4 years of their life.

Some Caribbean students DO get a residency, but their most likely top of their class, from the top 1-2 schools in the Caribbean, and generally go into Family Medicine, Internal Medicine, or Pediatrics or some other lower ranked and less competitive specialties, so keep that in mind if you want to get in to a more prestigious specialty.

I suspect, that we will never see MD/DO incorporated into NP education because that would demand that NP education be regulated and held to the standard of the Boards of Medicine and not under "advanced practice nursing" where they can have more leeway in expanding (for good or for bad) their scope of practice as they see fit without medicine oversight.

I also think on the physician side of things, they are getting more resentful towards ARNPs (at least newer and younger physicians) because of fear of mid-levels taking over their specialties and the demands to be made primary care providers at the expense of less actual education and training as a provider with only a handful of studies done that do not examine long term out comes and have poor qualitative methodology. What was once meant to physician extenders and physician assistants are now vying for the same privileges and billing authority.

Several med [student] friends that I have express disdain for mid-levels if only for the reason that they feel their encroachment is insulting do to the fact that they have put in so much through academia, time, and money only to have the same privileges granted to those who have a fraction of the expertise and then have the audacity to call themselves 'doctor' on top of it.

I feel a lot of this resentment has come from the large increase of NP schools and those that are willing to accept students without clinical experience and no/low barrier to entry (GRE's, admission tests, ect) though, arguments could be made if floor nursing really effects APN competence.

Plus, keep in mind that most current schools of nursing have a big philosophy of showing everyone how they are not like medicine and not like other fields of healthcare. As a FNP graduate, I'm sure you've been parroted that "nurses care more" and are "more holistic" a million times throughout your nursing career, and students just eat it up.

NPjh · Nov 22, 2012

I worked with a graduate of a Caribbean medical school. She worked as a medical assistant for several years, trying to get a residency. So, I agree with the previous poster on these medical schools. I have heard about an NP to MD program in Australia. Although, I have not heard good things about it. I am sorry that you feel your NP education was inadequate. I was very impressed with my program. I chose a program that required prior experience, a high GPA, and more clinical hours than others I looked into. I am not a fan of some of the programs that have low expectations. Good Luck

mahaandai · Nov 25, 2012

Thank you mrmedical for your excellent advice on pursuing medicine. Hmm, so it appears that grass is not green at other side as well.

I can understand the frustration of new medical graduates from US schools, who have to be compete with foreign medical graduates as well as NP/PA graduates with less qualifications and experience. It is really sad, but in the end it is plain economics that rules.

Well, as a student FNP I was just venting my frustration on the NP program in schools all over US. Each NP school is teaching in its own way. Lack of standardization in NP courses. In school, NPs are not even allowed to work on corpse like in MD schools, yet in the real-world we are supposed to diagnose live patients. Also, during the program I had to search for Clinicals by myself, whereas MD/PA students were sent for rotations to hospitals directly from their schools. It is funny as a student FNP, when I tried contacting hospital staff for rotations, they redirected my call to nurses' supervisor, who was a nurse and didn't know how to put student NP on rotation schedule in hospitals. "Sorry, we can only put M.D. students on rotations, not NPs", she rudely said.

There were meaningless courses about writing research papers, citations, which didn't help me in getting the job at all.

NPjh, you are lucky to have enjoyed your NP program. But I can vouch that almost 90% NP programs in US schools lack standardization in their coursework, and they have poor admissions criteria, and less Clinical hours for their students. NP schools should have centralized website like CASPA for PA students, where students can submit their GRE/MCAT scores/references/transcripts/experience certificates/etc. This centralized website could direct the prospective NP students to different schools in US. I also think more M.D., Ph.D., should be put in NP certification board.

Please help save reputed NP profession.

myelin · Nov 25, 2012

Well, as a student FNP I was just venting my frustration on the NP program in schools all over US. Each NP school is teaching in its own way. Lack of standardization in NP courses. In school, NPs are not even allowed to work on corpse like in MD schools, yet in the real-world we are supposed to diagnose live patients. Also, during the program I had to search for Clinicals by myself, whereas MD/PA students were sent for rotations to hospitals directly from their schools. It is funny as a student FNP, when I tried contacting hospital staff for rotations, they redirected my call to nurses' supervisor, who was a nurse and didn't know how to put student NP on rotation schedule in hospitals. "Sorry, we can only put M.D. students on rotations, not NPs", she rudely said.

Not all NP schools are like this. I attend a program that provides all of its students with clinical rotations, as it should be. I would never pay to attend a program that didn't provide the entirety of my education. It sounds like you went to a crappy NP program, which is unfortunate. However, not all NP programs are crappy and some are extremely competitive and provide an excellent education. Don't paint them all with the same brush.

NPjh · Nov 25, 2012

I did my homework and spoke with several NPs before I decided on a program. It has nothing to do with "luck." I agree that there should be standardization regarding admission criteria and clinical hours. However, there is also a lack of standardization in PA programs. I recently worked with some PA students from a Pennsylvania program. Their program sent them waaay out west at the last minute. They were completely lost when they got here (skills and knowledge wise).

elkpark · Nov 26, 2012

I suspect, that we will never see MD/DO incorporated into NP education because that would demand that NP education be regulated and held to the standard of the Boards of Medicine and not under "advanced practice nursing" where they can have more leeway in expanding (for good or for bad) their scope of practice as they see fit without medicine oversight.

(FYI, plenty of states require NPs to be licensed and regulated jointly by both the state BON and BOM (although the trend for years has been away from that), and there is no state in the US in which nursing can expand its scope of practice, advanced practice or generalist, "as they see fit." Scope of practice changes are a lengthy, complicated legislative process which includes all stakeholders (including physicians, hospital administrators, and the general public), not just nurses.)

Adenium · Nov 26, 2012

My program too provides clinical placements. Both ANP and ACNP have placements in local hospitals, and I may even do an inhouse rotation with a cardiologist etc. as part of my FNP program. I agree as well that standardization needs to be increased and there should be much higher standards for admission and completion of the program.

I also chafed under research and policy papers, but not all my instructors were Ivory Tower academics - many are very sharp and practical clinicians. It all depends on the instructor and this is why it's helpful to research programs and talk to those who are in them or who have graduated in the recent past. But if you've already completed an FNP program, I'd make the best of it. I might have enjoyed med school too, but as I never could have afforded it and wanted marriage and a family I'm expanding my knowledge to the best of my ability via the nursing pathway. I don't feel having MDs on board would "fix" nursing education - NPs and RNs and the various layers of accrediting and licensing boards need to get their act together. We could do it without MDs, but it seems those in power don't feel standardization is really of value.

And in the end, those who want a medical degree can get a medical degree. I can't complain my program doesn't teach me as doctors would be taught because I'm not in medical school.

mahaandai · Nov 27, 2012

And in the end, those who want a medical degree can get a medical degree. I can't complain my program doesn't teach me as doctors would be taught because I'm not in medical school.

Adenium, how do you justify the quality of training to your patients when you tell them you have not been to medical school? The point is that there is big gap between MD and NP training, and that void has to be filled in NP schools by bringing more M.D., Ph.D.s in schools as faculties, clinicians and instructors.

When we become FNP, we are no longer a nurse-RN since our professional liability is much more with our scope of practice.

I agree elkpark's views that plenty of states require NPs to be licensed and regulated jointly by both the state BON and BOM (although the trend for years has been away from that), and there is no state in the US in which nursing can expand its scope of practice, advanced practice or generalist, "as they see fit."

elkpark · Nov 27, 2012

Adenium, how do you justify the quality of training to your patients when you tell them you have not been to medical school? The point is that there is big gap between MD and NP training, and that void has to be filled in NP schools by bringing more M.D., Ph.D.s in schools as faculties, clinicians and instructors.

Advanced practice nurses do not have to "justify the quality of training" to clients on the basis on not having attended medical school. We are not educated as physicians, and we do not present ourselves to the public as having been educated as physicians. We are educated as advanced practice nurses, with our own, entirely separate system of education, licensure, practice, and regulation. Nursing schools do not use many physicians as faculty, and there is no reason to do so. We study nursing, we practice nursing, and we are eduated by nurses.

It's not that there is a "gap between" physician and nursing education that needs to be filled; they are two different entities entirely. If there were some issue with advanced practice nurses' practice being unsafe due to inadequate education, there might be some point to be made here. But I'm not aware of any evidence suggesting that that is the case.