Any advantage that AGNP has over FNP?

FullGlass, BSN, MSN, NP · Mar 27, 2019

AGNP Primary Care advantages:

1. Shorter time to get it

2. Good choice for people who absolutely do not want to work with children less than 13 years old

As for being more limiting, not necessarily. There is overall a much higher demand for adult healthcare. In addition, an AGPCNP can easily get a Post-Master's Certificate for an FNP in less than one year.

While all the job ads seem to specify FNP, many will accept an AGNP. I am one and got 9 job offers as a new grad. The only clinics that would not consider me were very small clinic where there were only 1 or 2 providers, so the providers had to see all ages.

Dodongo, APRN, NP · Mar 28, 2019

There are plenty of primary care clinics that only see adult patients, or their population has limited pediatrics. These practices have no problems hiring an AGPNP. The AGPNP is better trained in adult internal medicine/primary care than the FNP, so these clinics, if they know the difference, would/should hire an AGPNP preferentially.

djmatte, ADN, MSN, RN, NP · Mar 28, 2019

22 hours ago, Dodongo said:
The AGPNP is better trained in adult internal medicine/primary care than the FNP

Arguable for sure.

Train for the population you want to care for. None of them are limiting. But FNP is just as well trained in adult geri primary care as any agnp. Any difference lies in the quality of the school.

Dodongo, APRN, NP · Mar 29, 2019

2 hours ago, djmatte said:
Arguable for sure.
Train for the population you want to care for. None of them are limiting. But FNP is just as well trained in adult geri primary care as any agnp. Any difference lies in the quality of the school.

I fail to see how a NP that devotes 1/3 of their didactic and clinical training to the primary care of adults, is just as well trained as a NP that spends the entirety of their didactic and clinical education with adults.

How does that work? Are you just as well trained as a PNP or WHNP?

djmatte, ADN, MSN, RN, NP · Mar 29, 2019

2 minutes ago, Dodongo said:
I fail to see how a NP that devotes 1/3 of their didactic and clinical training to the primary care of adults, is just as well trained as a NP that spends the entirety of their didactic and clinical education with adults.
How does that work? Are you just as well trained as a PNP or WHNP?

I would argue that most of our training is geared toward adults in areas across all specialties that touch primary care. Much like an AGNP is trained to deal with WH issues as well and some pediatrics (13+). Are you suggesting that AGNP should just throw their hands up when they get a WH patient? Maybe I should just kick every pap/pelvic to GYN. Though I admit PNP has far more focus on pediatric issues by nature of their specialty. It isn't the same compared to AGNP.

It was already suggested here you can complete an AGNP degree in a shorter timeframe than FNP. Meaning they have less didactic time overall (probably the same FNPs spend on the adult side of the house) and likely similar requirements in clinicals. They are just as obligated to be knowledgeable about women's health issues and being able to tackle those assessments. Look at Duke University who has both an FNP and AGNP program. FNP has 49 credit hours and clinical requirements of 728 compared to AGNP's 42/560 respectively. I am willing to bet the majority of those classes are the exact same except for the additional classes added on for peds.

There is nothing different in the training of an FNP and an AGNP. Simply put, FNPs have the added burden of adding pediatrics into our curriculum. It doesn't make our training particularly less than. What's clear is you have a false assumption of FNP training when you classify what we learn in thirds across three patient populations. That or you are simply letting your disdain for FNPs cloud your opinion. I'm thinking the latter is likely given your post history.

Dodongo, APRN, NP · Mar 29, 2019

11 hours ago, djmatte said:
I would argue that most of our training is geared toward adults in areas across all specialties that touch primary care. Much like an AGNP is trained to deal with WH issues as well and some pediatrics (13+). Are you suggesting that AGNP should just throw their hands up when they get a WH patient? Maybe I should just kick every pap/pelvic to GYN. Though I admit PNP has far more focus on pediatric issues by nature of their specialty. It isn't the same compared to AGNP.
It was already suggested here you can complete an AGNP degree in a shorter timeframe than FNP. Meaning they have less didactic time overall (probably the same FNPs spend on the adult side of the house) and likely similar requirements in clinicals. They are just as obligated to be knowledgeable about women's health issues and being able to tackle those assessments. Look at Duke University who has both an FNP and AGNP program. FNP has 49 credit hours and clinical requirements of 728 compared to AGNP's 42/560 respectively. I am willing to bet the majority of those classes are the exact same except for the additional classes added on for peds.
There is nothing different in the training of an FNP and an AGNP. Simply put, FNPs have the added burden of adding pediatrics into our curriculum. It doesn't make our training particularly less than. What's clear is you have a false assumption of FNP training when you classify what we learn in thirds across three patient populations. That or you are simply letting your disdain for FNPs cloud your opinion. I'm thinking the latter is likely given your post history.

Perhaps I should have been more specific when saying women's health. No, I wouldn't expect an AGNP to turn away a female patient, clearly. I meant obstetric patient or "care of emerging family" patient.

So, then by your example with Duke's FNP and AGNP program, let's break down the hours. If you are saying the FNP and AGNP program have the same number of hours in adult IM/primary care, that leaves 80 hours for the FNP to spend in pediatrics and 80 for OB. Ugh. So FNPs are even less prepared to work with those populations than I thought.

Look, my point is, if FNPs want to be seen as a "jack of all trades" or a generalist, then there needs to be significantly more time put into those programs. You are competing with PAs who typically have a much more well rounded generalist education. The only saving grace other NP tracks have against that educational model is they are truly specialist and can say all of their training is in a specific population and/or setting. IMO family practice/primary care is probably the most demanding specialty, and again, IMO, I don't feel FNP programs reflect that.

djmatte, ADN, MSN, RN, NP · Mar 29, 2019

2 minutes ago, Dodongo said:
Perhaps I should have been more specific when saying women's health. No, I wouldn't expect an AGNP to turn away a female patient, clearly. I meant obstetric patient or "care of emerging family" patient.
So, then by your example with Duke's FNP and AGNP program, let's break down the hours. If you are saying the FNP and AGNP program have the same number of hours in adult IM/primary care, that leaves 80 hours for the FNP to spend in pediatrics and 80 for OB. Ugh. So FNPs are even less prepared to work with those populations than I thought.
Look, my point is, if FNPs want to be seen as a "jack of all trades" or a generalist, then there needs to be significantly more time put into those programs. You are competing with PAs who typically have a much more well rounded generalist education. The only saving grace other NP tracks have against that educational model is they are truly specialist and can say all of their training is in a specific population and/or setting. IMO family practice/primary care is probably the most demanding specialty, and again, IMO, I don't feel FNP programs reflect that.

FNPs don't generally work nor train for OB. Women's health is encapsulated within adult/geri in general. The biggest part of our WH part was paps and pelvics and primary-care oriented clinical requirements. Birth control, breast examinations, care of abnormal uterine bleeding, etc. All things an AGNP should be expected to be educated in and able to perform. We did have a small portion dedicated to care of pregnancy, but it was exceptionally small and nothing I would ever consider on par with someone who should work in a straight OB practice. It was more for familiarity with expectations should primary care be involved. I would presume that AGNP has requirements for women's health primary care issues baked in its curriculum and main clinical. I also bet there are some AGNPs out there who like and prefer to work in WH roles and probably could given how few WHNPs are coming out of the pipe these days. The likely difference in those duke programs is the extra clinical hours are particularly peds heavy.

I empathize with the sentiment that far too many FNPs work in areas that they shouldn't. You took the time to certify to work in a specific area that for well before ACNP was a thing, FNP was the default to pick up the load. We have worked in primary care since the 60s in an era where education was even more lacking and not as structured as it is now. Could we benefit from more education? Absolutely. But the same could be said for all NP education. But that's a whole other topic.

Regardless, there is absolutely nothing that an AGNP is more qualified in the primary care realm or adult geri care than an FNP. To suggest otherwise insults almost 60 years of FNP efforts and minimizes the degrees and hard work many FNPs do on a daily basis caring for their communities. You may not like the education system, but you have no grounds to talk like we are somehow not prepared or fit to practice.

FullGlass, BSN, MSN, NP · Mar 29, 2019

At my school, the AGNPs were trained in basic Women's Health rolled into our regular Adult and Geri curriculum. We did not have an Ob/Gyn clinical rotation. I got a lot of pelvic exam experience b/c one of my rotations was in a very busy Urgent Care that also served as de facto primary care for that population. However, we did not get any prenatal care training. I can do a Women's Wellness annual exam w/pap and take care of UTIs, check for STDs, prescribe birth control, minor women's issues. No prenatal care and complicated issues go to Ob/Gyn.

My peers who were in the FNP program took 1 more semester to graduate. They had didactics and clinical rotations in Ob/Gyn and also in Peds. So a grand total of 1.5 more clinical rotations, as the Ob/Gyn was a short rotation, plus about 4 extra didactic classes. Many of my FNP colleagues refuse to do prenatal care for liability reasons and refer to a WHNP or Ob/Gyn.

For primary care, I am not convinced the PA training is superior. PA school is 2 years and it includes a lot of acute care rotations. So I am not convinced they get better training for primary care than we do. I've worked with PAs and they don't seem any better to me.

Bumex, DNP, NP · Mar 31, 2019

I have said this before- I’m an AGNP and I got my job over FNPs. I was more extensively trained in internal medicine, which worked very well for a IM/Nephro practice.

Kerush · Jul 22, 2020

Bumex,

I aspire to be work in a Nephrology clinic/office as an NP.I have already decided that the AGNP will be more applicable for this role and will be starting my NP in the Spring.

I have 2.5 years of medsurge experience.Iam currently looking for a dialysis job.Do you think this will help me when I start working as an NP.Which is the best experience as a nurse would you advise one to pursue to be best prepared for the Nephrology NP role?

Thanks.

Bumex, DNP, NP · Jul 22, 2020

I think nephrology clinic nursing might also be a consideration. That way you can learn bread and butter CKD cases and management. HD patients are complex as well, but I feel that management is fairly redundant after awhile. Both are good options.