Much needed career advice.

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    Hey, looking for some career advice here! Right now I work as a paramedic and have realIzed I love medicine and would like a acquire a much deeper understanding of medicine and physiology in general. I want to go to DO route but my spouse doesn't really want me to. I am 23 and have a daughter and am planning on having another one soon. Just recently had the epiphany I want I be a physician, formerly just wanted to be a ER nurse.... So this wasn't really in our plans. With a family, me going to med school would put a lot of pressure on my wife while i attend school and she doesn't seem to want that, although she said she would support me on whatever.


    This has lead me to seriously consider the DNP route, but honestly I know little about it. I tried googling and didn't find much that helped. I've heard ACNP is the path I'd want to take, as it goes into the more advanced medical sciences. Is there a DNP-ACNP? I am pretty sure everyone who goes for ACNP has at least at some point strongly considered being a physician.

    So with that being said do you feel satisfied as being a DNP/ACNP as opposed to going to med school? I am afraid I will get this far and realize I wish I went to med school because I didn't get a good enough medical education. What opportunities is there for a ACNP? At my hospital they hired them to work in urgent care/observation/fast track ER. What other options are there outside this?


    Thanks a ton for any advice!!
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  3. 6 Comments so far...

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    hey sublime...you need to go shadow. Really. shadow, a lot in a lot of different areas. NP's work in all kinds of areas, but again so do PA's. both are going to require a bachelors. while you are deciding go start chipping away at gen ed and sciences.

    In many area's the pa's and np's are doing more hands on and the md is doing more supervision to save money. In my ER we have np/pa seeing all the pt's with one doc overseeing.

    np's/pa's work in many specialties, from neuro to cardiac surg, ortho, psych and everything between.

    either way, as you are starting from scratch, it is going to be a ton of school. I assume 10+ for DO, 7+ for pa/np depending on if you are doing master's or doctorate, and more years if you are looking at crna.

    I know in my er the pa/np people get along decently with the md's but I know for me personally it would aggravate me to continually have to ok my treatment plan with the md and accept if they decide to change it.

    go shadow many different types of providers to plan your future. basically you will have to do doctorate no matter what, as many pa schools are already there or at least at the masters, and all advanced practice nursing is going to doctorate eventually.

    good luck
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    One more thing. DNP is an academic degree (Doctor of Nursing Practice); is is not a role or a certification.

    I agree with missnurse's comments: you will need to shadow various roles (PA, NP, RN -- and maybe resp tech, rad tech, and PT/OT too). I encourage folks to shadow the same role (NP, PA) in different settings so that you can see more about the role/responsibilities and not about how things are done in one particular setting).

    Then see what education you will need. It will be a multi-year pathway, but you should first determine if you want the medical, nursing, physical therapy or other pathways first.
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    I also think you and your spouse should go to couples counseling and work on the issue together before you make a decision. Couples counseling is not just for couples in trouble, it is to help avoid trouble! You are at a crossroads in your life and want to make a choice that she does not fully support. Yes, she said she will, but also said she doesn't want you to go. I've been married 32 years. That means no. And I suspect neither of you has any idea of what medical school will demand. She will basically be a single parent for 10 years, and she will resent you for it, I promise, especially since she effectively told you don't go. And if you don't go, you will resent her for holding you back. So no matter what you decide career wise, you had better work this out, because it is a pretty big issue that you two need to clear up and get past or it will haunt you for years to come and create a lot of heartache. Best wishes on both counts!
    llg likes this.
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    To be an NP you would need a BSN at least plus at minimum a masters (you don't need a DNP but if you want to be called doctor then go for it :P).
    The BSN would be comparable to medical school in the sense of you are constantly in class, when you're not in class you're constantly studiyng and when you're not studying you are doing random clinical rotations at all hours of the day and all days of the week.

    Then if you chose to do the MScN with NP route, it's about 3 years and you are first year heavy theory work, second year heavy theory with some clinical rotations (at more stable hours than in your BSN however) and at the final year heavy heavy clinical rotations.

    Either way, you are going to place tremendeous psychological and financial stress on your relationship so you need to prepare accordingly. If you went the MD route you can avoid an undergraduate degree that is really heavy (you can do an undergraduate in biomed or something that is just theory based with no intense clinical rotations and not that much studying). But then medical school is just insane.
    Nursing would definetly get you to prescribing medications and making medical diagnoses sooner than a physician, but really it just depends on the role.
    Also, if you chose nursing, you would get a job as an RN out of your BSN while going to do your masters. Which I think pays more than a medic (at least here in Canada RNs earn significantly more than medics). But .. oh ... I forgot to mention before you can do your DNP or MN, you generally require at least 2 years of RN experience to be an NP.
    So to sum

    NP via MScN = 9 - 10 years (including your years of experience required)
    Np vis DNP =10 - 11 years (including your 1 to 2 years of experience required)

    MD = 11 - 14 (assuming you get accepted right away and assuming you specalize in ER medicine)

    OH but one REALLY important thing.
    If you want to be an MD be an MD. Don't go into nursing as a substitute because you will loath and dispise it. And I didn't do nursing because I wanted to be a doctor. Nursing isn't a profession you just do because "medicine is too hard" or "medicine is more of a commitment i am willing to make" because nursing itself is a really difficult and heavy committment.
    zmansc likes this.
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    As a paramedic myself I would suggest you look into becoming a physician's assistant. I became an NP because I was already an RN, and it made made more sense for me. However, had I not been an RN, I would have gone the PA route. I have known several paramedics over the years who went the PA route, and it was good fit for them.
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    Just to throw this out there for another option. CRNA is also a good choice if you enjoy the critical care aspect of the medical profession from being a paramedic but want autonomy.

    The schooling is intense, you'd have to take 2-3 years off from work to obtain it but that's better than the financial strain it may put on your family going to med school. They focus heavily on pharmacology and pathophys which many med schools do and will allow you to get the medical (anesthesia) education you want (if anesthesia is your thing), also some schools even merge med students and CRNA students during their first few semesters if you take a front-loaded program (didactic first).

    The pay can be equivalent to a Family MD and you get the heirachy of being a CRNA! Also, you would be required to work in an ICU for a year or two prior, so that could afford you some time to save up and decrease the finiancial strain on your family even more.

    Sometimes you can't have everything and be happy so sacrifcing your family for your career could come back to bite you once your done with your career, not to mention time away from family for pre-med, med-school, residency and specializing (yuck!). At least with CRNA family may have to pause for 26-36 months, which is a small sacrifice for a large reward, and in the end you'd still be able to balance family life and career goals! Just my 2 cents!


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