Blended Practices

hello and welcome! i actually share similar career aspirations and questions as you do. i also know from my own experience that the answer to your question is not 100% black and white. basically though, to achieve the type of practice you are looking for (combined psychiatry and family practice) you really would need credentials in both areas. that holds true if you pursue your md or np. there are just a handful of combined psychiatry-family medicine residencies across the country which provide eligibility for dual board certifications. graduates of these programs generally provide the type of care you are describing. this type of practice would also be possible as a nurse practitioner yet would still require dual specialization. you are correct that this would nearly double the amount of schooling required. since there are no combined np programs for psych and family practice (to the best of my knowledge and personal research) you ought to pursue your msn with one specialty and either practice for a bit to gain some experience or return to school immediately for a post-master's certificate in the other specialty. though it may not be what you want to hear, that really is the only way to be a competent and qualified clinician in any two clinical specialties. yes, there would be some overlap. in an fnp program, mental health should be discussed but psychotherapy and psychopharmacology are generally considered outside the scope of practice for an fnp. similarly, in a pmhnp program, physical assessment and illnesses will be covered yet it would certainly be beyond the scope of practice to treat purely physical ailments such as dm, htn, etc... if it helps, bear in mind that 3-4 years of np school (or i could even name at least one school that could cut that down to 2 years total) would still take much less time than 4 years med school + 5 years combo residency all for a very similar scope of practice and knowledge base (the most glaring exception being that family medicine could include catching babies whereas an fnp is only allowed to do pre- and post-natal care + well baby care, and i suppose "catch" in an emergency just like any rn). hope that answers you question without too much discouragement.