In regards to subspecialties

[sauce]

The reason I am asking this is for many reasons. I do not see too many sufficient posts about this on the website, since most posts seem to be directed towards pay, job status, how to pass the certification exam, and whatnot. All of those are very important questions, especially for the new grad and still in school practitioner. I will try to present this in a way which may benefit others just as much as myself, so here we shall go.

Most topics about specialties fall into acute care, pych, neonatal, peds, adult, family, whatever NP. These are popular due to the fact there are specific programs for these, so that is understandable. What I am wondering though, is why did these specialties get their own program, and not others.

In the much better organized world of medical education (which my fiance is partaking in hence the reason I know so much about it, relatively) there are tons of sub specialties. In regards to the statement of better organized, some may argue, but we will leave this for another topic.

These subspecialties are not, family, acute care, psych, peds, adult. They are much more diverse. Mostly sectioned into body systems, with a few age related specialties, and of course the broader categories of surgical vs medical.

Why are nurse practitioner programs not like this is my first question. While people say we are here to fill the gaps in primary care, i beg to differ in regards to this. It takes a much longer time to get an appointment in many areas with a specialty provider than it does a general practice provider (at least in the few areas I have lived).

For me personally, I would like to do neurology but like everybody else, I do not want to go back through medical school. The only two reasons is I need to support my fiance, and once she graduates, there is no point. An fnp/physician have the same personal earning potential in most specialty areas when compared to two physicians, excluding surgery of course, in which we cannot partake. Other reason I do not want to take on debt. Anyway, besides reading up on neurology for myself and getting a job in a neurology clinic, there is no way to get any significant certifications in this. This doesn't really bother me at this moment, since I know I could get a job in one, but what does irk me, is again the lack of a certification program or residency for it. Of course we can probably learn everything we need on the job while working at a neurology clinic, especially since it is pretty much a pure medical specialty with very little if any invasive procedures (neurosurgery is for that).

Main point of this is: where are our residency programs? I see a few popping up, but not the nice juicy spectrum in comparison to the medical education.

This is not an attack on medical providers or me attempting to state that we can pop out of a year long residency with the same skill as a neurologist, but in regards to patient care, having a neurology- certified advanced practice nurse working alongside a neurologist would really help to stem the wait times to see a neurologist as an outpatient visit. But most specialists don't want to train an fnp to work their specialty, unless you want to be an overpaid dictation slave (which I don't mind, I make some wicked money tax free on the side doing dictations)

I would love some input on this. Just to see what others think.

Put in the meantime ill be reading my neurology book, and at least working up all my stroke patients and other neurological disorders with relative ease in comparison to the other body systems. And by relative I mean I still dont know anything, but that extra tiny bit of knowledge helps.

Sauce.

[traumaRUs, MSN, APRN]

I apologize in advance but not sure what you are asking?

Why there are no neurology NP specialties?

Why there are no neurology NP residencies?

Or something else?

I can tell you though that in my area (IL) it is impossible to get an appt with a primary care provider because of Obamacare. I am in nephrology and because there are no PCPs taking on new pts that already see a provider, primary care is the place to be in my area.

[zmansc, ASN, RN]

If I understand your question correctly, your asking why there are all these residency programs and board certifications in the MD/DO world but not in the NP world.

My understanding is the MD/DO residencies are federally funded, and there is no equivalent counterpart to fund NP education in this manner. If you look back in history, residencies were only for MDs, DOs fought to be allowed to go and very few opened up for them. Then the feds said any residency that accepted fed funding had to also accept both MDs and DOs. Before that many MDs looked down their noses at DOs, I don't see that near as much today, although there are still some snide jokes between the two.

To me the real question is should the NP profession go down that path? Do we want to be yet another path to physician, and to specialize, require several more years in that specialty? Or do we want to remain different and continue with our current education path, but to specialize, need to utilize a less structure on the job training program?

Currently as far as I can tell, there really is no push to create residencies and board certifications in specialties in the NP profession. There is interest in it, as is evidenced by questions on this board and others, but there doesn't seem to be any push towards changing the education model to include residencies that I can see at this time. The educators I have talked to about it don't seem to have any interest in changing the existing model either.

[sauce]

I apologize for not wording it the best. It seems it was a rather difficult question to ask, but now that I have slept on it, I think zman answered it pretty well in regards to not getting enough federal funding to open new programs.

Unfortunatly the government will not supply the 100k or so toward educating a resident per year it may cost for salary and benefits, but they will hand out freebees to nogooddoers it seems.

I am not sure if the push toward specialist np residencies or programs would be good or not. I guess it depends on the area.