CNM vs. Med School

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Hey all.

I'm 2 years away from finishing up my BSN. My original plan was to apply to CNM programs who don't require experience in my last semester of nursing school as I have no desire to work as a nurse.

Problem is, the med school bug is in me again. I keep thinking that I shouldn't settle for being a CNM while I'm so young(19, 21 at BSN graduation.) I can realistically take another year or two of prerequisites and apply to med school when I'm 23. The thing that bothers me the most about midwifery is the handing over of the cases to the physician when things start getting complicated. I would never forgive myself for not being able to go through with the patient.

Basically, my questions are as follows:

1. At what point do you decide to involve the physician?

2. How respected are you by physicians/ patients?

3. If any of you have done it, how doable is it to take 1 pre-med course each semester along with a full time nursing school schedule?

I am truly at a loss. Any insight will be

appreciated!

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If you really want to be a physician, go to medical school -- you won't be happy in nursing.

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Specializes in Reproductive & Public Health.

I think it is important to remember that being a CNM is not "settling." Or at least, it shouldn't be. Midwives are not mini-OBs. They are two distinct (yet collaborating) professions.

When you involve a physician will depend on your practice. I did my last semester of CNM school at a collaborative practice, where the midwives managed EVERYONE, from the waterbirths to the IDDM with severe pre-eclampsia. Our physicians were colleagues, not supervisors, and were with us every step of the way (by phone or in person) for any patient that required it. We followed every patient through to the end, no matter the complications or if the actual delivery was conducted by the physician (and for the record, the actual birth is just one part of the whole experience of labor/delivery/postpartum). We first assisted at c/sections.

In contrast, I have also worked in practices without physicians, and any patients requiring collaboration were transferred out of our care completely.

I too struggled with the decision to go for my MD vs CNM. In the end, what settled me is my love for public health, and the realization that my love of midwifery was based in a strong passion for public health, not a passion for being in the OR all day (not that I don't love me some surgery, because I DO!). What sealed the deal is that I have two special needs children, and I was not willing to take on the grueling schedule of med school and residency. And let me tell you, I am SO GLAD that the buck does not stop with me. There is real comfort in knowing that there is someone to turn to when the sh*t hits the fan.

I guess my point is, only YOU can know which path is right for you. I did not settle for being a CNM- I chose it freely. You have to choose the path the is right for you.

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True, settled wasn't the best choice of word. But Cayenne, how would you compare your career to that of your fellow OB/GYNs?

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Specializes in Reproductive & Public Health.
True, settled wasn't the best choice of word. But Cayenne, how would you compare your career to that of your fellow OB/GYNs?

Significantly less money, for one- and that is definitely a consideration. But on the flip side, you have significantly less student loans, and having an RN license makes it easier to make ends meet while in school. The hours in OB are rough, whether you are a midwife or doctor. There is tons of room for advancement in each profession, and plenty of different practice environments to choose from~I am a new graduate nurse midwife, and I had offers from a free standing birth center, a CNM/MD group practice, and from Planned Parenthood (of course, job options vary widely by location).

I have always had very positive, professional relationships with physicians- very much a "team" mindset. Of course, there are cranky OBs (just like in any job), but most are great.

Some facilities and practices are more midwife-friendly than others. Certainly there are places where midwives are not able to practice autonomously, or where physicians are less than welcoming. But I like to think that is the exception rather than the rule.

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Arghhhh the decision is so hard. My options right now are:

1. Either finish up my BSN and go straight to CNM.

2. I can finish up BSN and then do all the pre- med courses.

3. I can drop out of the nursing program and pursue a conventional biology pre- med degree.

Right now I'm leaning towards option number 2, as it allows me to have a backup plan in case med school doesn't work out, albeit taking 2 years longer.

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Significantly less money, for one- and that is definitely a consideration. But on the flip side, you have significantly less student loans, and having an RN license makes it easier to make ends meet while in school. The hours in OB are rough, whether you are a midwife or doctor. There is tons of room for advancement in each profession, and plenty of different practice environments to choose from~I am a new graduate nurse midwife, and I had offers from a free standing birth center, a CNM/MD group practice, and from Planned Parenthood (of course, job options vary widely by location).

I have always had very positive, professional relationships with physicians- very much a "team" mindset. Of course, there are cranky OBs (just like in any job), but most are great.

Some facilities and practices are more midwife-friendly than others. Certainly there are places where midwives are not able to practice autonomously, or where physicians are less than welcoming. But I like to think that is the exception rather than the rule.

Cayenne, if u don't mind me asking, where did you complete your CNM?

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Dreamer, I'd say if your heart is in ob/gyn, then pursue it now. If you go the cnm route and have to transfer care to OB, you might be unhappy. Think about why you want to be an MD and why you want to be a CNM. Weigh the pros and cons, then decide. Good luck to you on your journey!

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Right now I'm leaning towards option number 2, as it allows me to have a backup plan in case med school doesn't work out, albeit taking 2 years longer.

Having your RN license will also be very useful to help pay your way through medical school.

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Having your RN license will also be very useful to help pay your way through medical school.

In general, no one works during medical school and no one is going to be sympathetic during rotations about a student's job. Even for medical students, 60-80 hour weeks weren't uncommon during 3rd and 4th year.

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Specializes in Reproductive & Public Health.
Cayenne, if u don't mind me asking, where did you complete your CNM?

Baystate Midwifery Education Program in Massachusetts. LOVED IT.

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Baystate Midwifery Education Program in Massachusetts. LOVED IT.

So interesting! In case I do decide to follow up with midwifery, my school of choice would be the Midwifery Institute at PhilaU, which is associated with Baystate. Glad to hear you liked it.

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