Direct Entry FNP Program vs MPH Cost

[wanderlust]

I was admitted to Yale's Direct Entry - GEPN program (FNP specialty). For the past 3 years I had been working towards applying to direct entry programs and am very excited to be admitted. However, the cost of the school is making anxious. Estimated costs for the first year is $100,000 and I was only offered $11,000 as a Scholarship. The last two years are approximately $50,000 each. I know if I accept, I will need to apply to Scholarships - nurse corps and HRSA being some of them. Not a guarantee, but I feel that my experiences make me a competitive applicant.

At the same time, I applied to a few MPH programs, more as a backup plan. I was accepted to UC Berkeley's Maternal, Child, and Adolescent Health. I am offered $15,000/year scholarship, which would cover tuition and then some. Free education!! That is very appealing to me. Also I already live in the Bay Area, so moving would not be a hurdle.

So now I am stuck! I want to hear people's thoughts on the cost of school. I do not want to be $100,000+ in debt, although I know people do it and it's possible to pay off. But it is very daunting. Thoughts and insights would be appreciated.

[reticularformation]

Hi, I recently turned down admission to one of UPenn's NP programs because I refused to shoulder the $90K+ tuition cost. I chose La Salle instead for $40k, and I will use my employer's reimbursement to cut that figure in half (even if it takes a little longer to finish that way). I'm going to be brutally honest about the thought process that led me to that decision - your mileage may vary.

With the median salary of FNP being $100k (even in California), think about the reality of paying off over $100k in loans. You most definitely will not start with a salary of $100k, but let's assume you do. Even at a modest federal tax rate of 12% (if you're married), you're netting $88k a year (before state taxes and social security deductions). Minus health insurance cost, minus 401K contributions, minus rent, utilities, car expenses, food, etc. Realistically, could you commit to paying back $2k/month? That will barely touch the interest accruing on those loans. The current grad loan rate is 6% and it starts mounting from day one. If you have to go into GradPlus (which you surely will, as regular grad loans are capped at $20,500), the interest rate is closer to 8%. That's a rough average of $7k a year in mounting interest, every year you remain in debt. That builds even while you're still in school, when you are not bringing in any income.

NP/MSN programs don't offer much financial assistance because they are in high demand (so they know people will take out loans to pay it). They are not academic degrees, there is no 'merit' in an MSN for the university. It is a purely pay-for-play degree that is selling like hotcakes. Do not expect much help from scholarship sources. The rare ones max out at $10k/yr.

Are there any other direct entry NP programs you can apply to? Prestige is much less important in the nursing world than in other fields, and being an NP does not require an Ivy League degree. Can you start working as an RN while you attend an MSN program? This could help the cost immensely (with a salary and tuition reimbursement), and you could gain bedside experience to boot.

Here are some loan repayment calculators that may help clarify what the actual cost of the degree will be:

https://www.nerdwallet.com/blog/loans/student-loans/student-loan-calculator/

https://www.credible.com/blog/calculators/student-loan-repayment-calculator/

In the end, what I kept thinking about was an NP I met with who graduated from UPenn and did her RN-MSN combined as a direct entry (total cost was around $130k). She was working and definitely making over $120k, but still in deep debt. She told me she had been paying $2k/month for five years and was only starting to touch her principle. She warned me that if I chose that path, I better be dedicated to being that specific type of NP, because my debt would prevent me from being able to do any other job. That scared me, because I want to remain flexible to pursue additional degrees and change specialties if I so desire. That amount of debt felt like shackles to me. And with so many other options for getting to the same destination, it seemed foolish to choose the most expensive option with little additional gain.

[wanderlust]

Thank you for your thoughtful response @reticularformation. You hit many great points. I am going to be a little sad missing out on an experience at Yale, but I need to keep the bigger picture in mind of graduating with as little debt as possible.