Podiatry resident to DNP

Advanced Practice Columnist / Guide · Jan 30, 2013

With med school out of the equation, I agree that your options are NP vs PA.

What I could surmise based on your post is that your interest is in Trauma and NICU.

Here's my take on your chances...

NP route:

Trauma NP's are typically advanced practice nurses with extensive ED and SICU experience before becoming NP's themselves. This is just the nature of this field because the more experience you gain and the more people you know in the field, the better chance you have of getting hired in the field. New grad nurses used to be able to get hired in Level I Trauma ED's or have New Grad Internships in SICU's easily in years past. Unfortunately, it's not the same now. Whether it's the economy or an oversupply of nurses, it's a fact. Bottomline, you may have difficulty breaking into the field as an RN to begin with. There are also Post-NP residencies in Trauma. One popular one is with the University of Maryland. You have to be an NP to get in and based on the popularity of this program, there may be intense competition from already experienced NP's with ICU backgrounds as RN's.

NICU NP's or Neonatal NP's have some degree of demand in large medical centers that have them on staff to provide 24/7 coverage of high acuity NICU's. I've worked in large medical centers as an NP and in all the places I've worked there is a NNP group in the NICU. There aren't many NNP programs in the US and all require NICU experience as an RN prior to acceptance. Again, breaking in to a job as an NICU RN can be tough given the amount of nurses new and experienced trying to get those positions.

PA route:

Could be viable if you want to break into a Trauma role. PA training follows a condensed medical school model. It's not specialty focused like NP training (PA: generalist, NP: primary vs acute, across the age continuum vs age-focused, all tracks lead to a specialized focus). Your scope of practice as a PA is dictated by the supervising physician not your training. There is also a significant surgical field exposure which helps with Trauma (Trauma itself is a subspecialty of General Surgery).

NICU might be a bit tough to break into as a PA. There are PA's in NICU's I'm sure. However, I've not come across any in the places I've worked for. That said, I've worked for medical centers with an affiliated NNP program that feeds the NICU's with its graduates.

Hope these help.

myelin · Jan 30, 2013

Since you're already in a lot of debt, the NP route confers you significant advantage, since you can go part-time which could help you to and avoid taking out more loans. To save money, I'd do an ADN program (while working as a podiatrist?) And then do ADN-MSN (or ADN-DNP), while working part-time as either a RN or podiatrist. Best of luck. PA school would be harder money-wise, since I don't think they allow you to go part-time and/or work during the program.

eta: If you want to work as a pediatric primary care provider, then I'd just go straight into nursing, no questions. If you want to work inpatient, it might be different. Hmm. I think without significant RN experience, working inpatient as a NP might be challenging. The PA route seems more straightforward if you want to do emergency medicine or work in trauma. However, it will likely cost you more. You could always go rural after your ADN and find a job in a ER or ICU as a new grad, work for a few years, and then do the ADN-MSN afterwords. I'm not sure how much of a hurry you're in, though... good luck!

zoidberg, BSN, RN · Jan 31, 2013

friend of mine did PA school straight out of undergrad biology, graduated, and just started a job in trauma surgery without doing a fellowship. PA school can cost less if you would want to go to a big name school for your MSN/DNP (Drexel, Vandy, etc)