Post-Master's FNP versus Med School

Specialties NP

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I am an RN with a BSN and MS degree in nursing administration. I completed my MS degree about 3 years ago and I've had a few interesting leadership and administrative roles since then. However, I'm not fully satisfied with my career path and lately I've been thinking about returning back to school for either post-master's FNP or med school. To start at the beginning:

I graduated as valedictorian of my high school class. In high school, I was always interested in the health care field and everyone assumed that I would choose pre-med and go to medical school. I ultimately decided on nursing because I was in a serious relationship in college and I wanted to have a family-friendly career (in retrospect, this was very poor reasoning). After the first year of nursing school, I was having second doubts about my choice of major. I wasn't enjoying nursing at all, but I decided to stick it out because I didn't want to be a year behind if I chose another major. I rationalized that I could always go onto medical school or graduate school after I graduated. After graduation, I got married and started working as an RN in the ER. I HATED that job. I took a job on a med-surg unit and I HATED that job even more. Eventually, I did find a specialty that I enjoy (home health and hospice), but I still knew I had to go back to school for something that would allow me to move beyond the staff nurse role. At that time I was very torn about beginning the process for applying to med school. My husband (now ex) did not want me to go to medical school because he wanted to start a family and basically did not want to support me throughout the long process. I applied and was accepted to an FNP program. I finished a semester of FNP school, but I was so unsettled about the decision as to if I would be fully satisfied with the NP training and scope of practice. No offense to any of you that are NPs, because you do play a very important and critical role in health care. I've had an NP as a primary care provider, so I do think that NPs are wonderful! But at that time, I was convinced that it would ultimately bother me that I would be in a very similar role as a physician in primary care, but without the ultimate responsibilty, scope of practice, and level of pay. And I was unimpressed and disappointed with the foundational FNP courses that I took at a very prestigious university. I didn't think that I would be happy with the lack of depth of knowledge in the FNP program. So instead of doing the NP program, I decided to do a master's program in administration. I've had a few interesting jobs in administration since graduating, but it still isn't as fulfilling as I would like and I keep having the feeling that I've chosen the wrong career path.

Recently, I've been thinking again about beginning the process to apply to med school or to start looking into NP programs again. At this point, I am nearing 30 (but not there yet), single, and I have no children. I do have significant student loan debt from my master's degree though and the loan burden of med school does concern me. I also have concerns about the time burden of residency in particular- to be honest, I have lots of interests outside of work and I do wonder how happy I would be working 60-90 hours week while in residency, being on-call, etc. Although I'm now single, I still do hope to have a family someday (hopefully within the next 8 years or so). The post-master's FNP is looking very appealing because of the low cost and time burden. It would allow me to earn a decent salary, have better hours than MD/DO, and I do think that I would enjoy the work.

I'm frustrated that I still seem to be in the same situation that I was in while trying to make this decision in college. I feel like I should be past this point in my life! Any feedback into my situation would be helpful.

I'm frustrated that I still seem to be in the same situation that I was in while trying to make this decision in college. I feel like I should be past this point in my life! Any feedback into my situation would be helpful.

Perhaps you might benefit from reading "Stop Your **** Shoveling" by Carl A. Hammerschlag, M.D.

Specializes in ICU.
Perhaps you might benefit from reading "Stop Your **** Shoveling" by Carl A. Hammerschlag, M.D.

Well, I just youtubed him and he seems like he knows his ****. Pun inteneded. OP go for it if you want to and you think it will complete your life. the university @ kansas has a DO program that is "accelerated"

Perhaps you might benefit from reading "Stop Your **** Shoveling" by Carl A. Hammerschlag, M.D.

I googled him and the book does sound interesting. I will definitely check it out :)

Specializes in Critical Care, Emergency, ACNP, FNP.

Here's my $0.02 :specs:

WARNING: These are just MY PERSONAL OPINIONS based on MY PERSONAL EXPERIENCES and MY PERSONAL UNDERSTANDING at I CURRENTLY KNOW IT. OK, here goes...

MD or DO

Do you have to do or redo the minimal premed classes (1 yr gen bio, 1 yr gen chem, 1 yr physics w/lab, 1 yr org chem)? If so, assuming you want to do family practice or internal medicine without a subspecialty, you're generally looking at:

1-2 years to complete premed classes

4 years of medical school (a few might have year-round intensive classes/clinicals making them a little more than 3 yrs long)

1 year of internship (perhaps)

3 years of residency

So, you're looking at a minimum of 7 years to as much as 10 years (not counting subspecialties or fellowships). If you do family practice, you'll generally come out with a ridiculous amount of debt making between $120K to $220K. If you own your own practice and work shrewdly, you can obviously make way more. Most importantly, you'll have the deepest most comprehensive knowledge of physiology, pathophysiology, microbiology, and obviously medicine (the discipline not the generic sense of the word). You'll also have the most autonomy, social respect, professional privileges, and financial rewards relative to other disciplines in healthcare.

Top Pros: more in-depth natural science knowledge, more money, more autonomy, more social/professional respect

Top Cons: more debt, more difficult to have/raise family during and even after, many many years of schooling, totally rebuilding your knowledge base (very different approach, assumptions, and values relative to nursing)

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Post-Masters FNP

Typically, you can complete these in 4-5 semesters (1.25 - 2 yrs) full-time or 2.25 to 4 years part-time. If you add the DNP curriculum, you're looking at about 2.5 to 3 years full-time to a maximum of 5 years (typically no more time than this is permitted).

You'll graduate with moderate to no extra debt, in a much shorter space of time, making between $60K to $150K (ER NPs typically make between $90K and $150K). If you own your own practice (and you can in most if not all states) and work shrewdly, you can make way more. However, you will have more barriers to practice (although these will get less and less over time). You'll have the most comprehensive nursing knowledge but only a decent amount of medical knowledge (meaning the discipline, not the general sense of the word); and decent but relatively cursory knowledge of physiology, pathophysiology, and microbiology. You'll have more autonomy than undergraduate nurses but less than MDs/DOs, some social respect, unpredictable levels of professional privileges, and generally only moderate financial rewards relative to medicine.

Top Pros: more in-depth human science knowledge, potentially really good money relative to years spent in school, more family-friendly (most students are older nontraditional students with family responsibilities), builds on your nursing base

Top Cons: practice barriers (legal, social, institutional, regulatory, etc.), less natural science knowledge base, less traditional earning potential relative to MDs and DOs

Conclusion

I was in the similar predicament and chose the postmasters FNP. I prefer nursing's holistic patient-centered value system and the heavy emphasis on human science. While these are now en vogue even for the medicine disciplines, it has always been fundamental to the nursing discipline. I also love the family-friendly (relatively speaking) life-adaptable nature of nursing education. I'll just have to get the clinical experiences and the deeper natural science understanding after the fact! Those things I crave but not more than what the nursing route gives (not to mention the ability to still maintain family responsibilities).

Certainly there are exceptions to almost everything I've written, but they are just that--exceptions. Anyway, I hope this is somewhat helpful. Remember my warning: These are just MY PERSONAL OPINIONS based on MY PERSONAL EXPERIENCES and MY PERSONAL UNDERSTANDING at I CURRENTLY KNOW IT. :idea:

@KurtNP: Are you a NP in the ER? Is FNP the way to go for that or will ANP or ACNP be ok too? Do they normally want the NPs to have ER experience as a RN before they will hire you or consider you for an NP position?

Specializes in Reproductive & Public Health.

I struggled with this choice as well. I am 29 and have two kids, and ultimately decided to do APN, and maybe go back to medical school when I am 50 or so. You are still so young; if you really want to have a family in the next few years it might make sense to do a shorter degree and re-enter school when you are older.

I struggled with this choice as well. I am 29 and have two kids, and ultimately decided to do APN, and maybe go back to medical school when I am 50 or so. You are still so young; if you really want to have a family in the next few years it might make sense to do a shorter degree and re-enter school when you are older.

MED School at 50!

Specializes in Nephrology, Cardiology, ER, ICU.

I know a surgeon who won a Grammy with Miami Sound Machine prior to going to med school at 50. Yep, can be done.

OP, I had people in my class who started medical school at age 44. We had multiple people in their 40s and tons in their 30s.

You will probably always wonder "what if" if you don't pull the trigger and go to medical school. From your post, it sounds like you wish you started that path in college. Don't waste more time.

Know that the time commitment is extreme. You will probably need to do 2 years of undergraduate courses just to fullfil the pre-recs for medical school. The most common set of pre recs include: a year of each chem/biology/physics/organic chemistry + a year of lab for each, + a year of english (you probably have this) and a year of college level math (ie no less than calculus).

Then you will have to take the MCAT. Add 4 years of medical school and at least 3 years of residency.

So from here, it is at least 9 years. Know though, that life doesn't stop during the education. There are plenty of women who have kids in medical school and residency.

Full disclosure: I am a doctor.

I struggled with this choice as well. I am 29 and have two kids, and ultimately decided to do APN, and maybe go back to medical school when I am 50 or so. You are still so young; if you really want to have a family in the next few years it might make sense to do a shorter degree and re-enter school when you are older.

I know a surgeon who won a Grammy with Miami Sound Machine prior to going to med school at 50. Yep, can be done.

It can be done, yes, but for the vast majority of people, it's going to be extremely difficult, if not downright impossible. Med school and residency aren't things you can do part-time or as a "hobby." I was in my 20s when I went through med school and, even as a youngster, it takes an incredible toll on your body. My sleep schedule is completely screwed up, I feel like I've aged far more than the 4 years it took to get through med school, etc.

At the age of 50, are you willing to put in the 7+ hours of studying every day, including weekends? Are you willing to miss holidays, weddings, birthdays, funerals, etc, because you either have to study or you can't take even an afternoon off during a rotation? Are you willing to come in to the clinic even when you're sick and just want to get some rest? Taking sick days is very frowned up, at least during the training stages of med school and residency; I remember, during one of my 3rd year rotations, one of the residents was walking around in the inpatient service with an IV attached and still rounding on his patients. Are you willing to struggle through a minimum of 7 years of this? Are you willing to work 80+ hrs/week again when you're 50 years old? Are you financially set to be able to pay off 100k+ in loans (and that's a conservative estimate, without taking interest into account)? Are you willing to wake up at 3:30 am everyday during your surgery rotation (typically 2-3 months long during 3rd year) to get to the hospital by 4:30 am so you can pre-round on your patients before the intern comes in? Are you willing to put in 16 hours/day (as an intern...longer, once you're PGY-2) and then go home and study afterward?

None of those things are exaggerated btw. Yes, you can do it when you're 50; we had someone who was 48 yrs old in my med school class. It's going to be a whole lot more difficult when you're older and have more wear-and-tear on your body, when you already have a family to take care of, etc. I'm not saying this to dissuade you from medicine; I'm just trying to give you a realistic idea of what it'll be like. Medicine can be incredibly rewarding, but it also take a lot from you. The highs are high and the lows are very, very low. Keep these in mind as you make your decision. If you're still relatively young (ex. less than 30 yrs of age) and have a strong interest in medicine, look into it now rather than telling yourself you'll do it when you're older. It'll be much harder to get into med school at 50, let alone get through it. Best of luck.

Specializes in Reproductive & Public Health.
MED School at 50!

Why not?!?

studentdrtobe, I am a mother of two young children, one who has ataxia telangiectasia. I imagine when I am 50, if I decide I want to go back to school, that it will be darn easier than it is now. Obviously med school is not a "hobby" but many of us had kids when we were young, and our lives have followed a much more circuitous path than college-career-kids.

I am fairly certain that I will change careers in 20 years or so, and based upon my career and academic paths so far, medical school would be the obvious next step. There is no way I would put my young family through the hell of residency right now (not judging those who do), but when my kids are grown I will get the opportunity to be selfish again!

I hope to high heaven that I won't be too old and tired at FIFTY to change career paths.

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