My I'm going to medical school

Horseshoe, BSN, RN · Oct 13, 2015

Usually if a college is advertising its program, its probably not going to make you a whole lot of money and/or provide good job prospects. Sort of like buying a car, the easier it is to buy, the bigger the shaft they are breaking off in you.
I mean who really thinks that something as easy to accomplish as a masters in nursing will continue to pay as much as it does? Nursing school isn't overly difficult to finish/get into, neither are the masters or bachelors. Engineering, medicine, other math, and those professions that have a barrier to entry will continue to pay well into the future. There is more than likely a direct correlation between the level of offense somebody takes to this post and the severity of a hit his or her career will take in regards to the flood of oncoming masters prepared nurses. It seems to more successful ones of the bunch take this a little more lightly. Don't be blinded by self-bias, the flood is coming my friends, and you do not want to drown in the sub-70000 salary tidal wave that is coming to wash away your dreams of a home, car, and whatnot.
btw, while i was reading this 15 adds popped up on this website saying I can change the world with an DNP. So obviously as soon as that diploma hits my hand hunger, HIV, obesity, and all those other world problems will be cured. Unless of course by changing the world they mean feeding the investors in these online for profits a daily steak dinner for the rest of eternity, guaranteeing them and their loved ones a new BENZ, and adding on a new garage to their already huge mansions.
All you people who spend ridiculous amounts of loan money on these rip off schools are a bunch of suckers. Even a car salesman for land rover would have pity on your soul.
Americans and their dreams... its what investors feed off of, and many of you have fallen right into that trap.
How does this relate to the above post? Theres only one for profit medical school in the country, and probably 500 nursing ones. Just a rough estimate regarding the number of for profit nursing schools, but anyway, don't think for one second the credentialing bodies aren't getting a big chunk of change from this. The AMA is probably just as greedy, but at least they don't feed off of their own kind. But again, nurses are know to eat their young, both at work, and in the financial markets.

You know, in spite of your poor delivery, I do think you make some very good points here. I hope you realize, however, that even MDs are being sucked into the *&^#hole that is now the US healthcare system. Doctors no longer bring in the big bucks they once did, for all the "barrier to entry" that remains in the field. The hassles with insurance providers for substantially reduced reimbursement, the huge debt, etc., no longer compensate so well for the long years of education and the continued time, effort, long hours, etc., required to stay afloat in this profession.

I would damn sure do things differently, knowing what I now know. My husband has a Bachelor's degree in finance from a second tier university. He put himself through school selling trophies to little league teams, so he graduated with no debt. He makes seven figures annually and doesn't lose a huge portion of his income to malpractice insurance premiums, loan payments, etc., and doesn't have to spend inordinate amounts of his time trying to be appropriately compensated for his hard work by greedy insurance providers or clients who lack the means to pay for his services. My DH could reasonably laugh at all of the brilliant but idealistic pre-meds who believe that being a doctor will provide the same high standard of living as it once did simply because admission standards remain incredibly high and the education is as rigorous as ever. He could point out the irony of a pre-med scoffing at nurses about their "American dreams," or could chuckle about the naivete of a future doctor labeling "people who spend ridiculous amounts of loan money" on these schools as "a bunch of suckers." He could, but he's nicer than I am, so I am doing it instead.

I think anyone who enters health care with an eye towards making a bunch of money has been had. And that includes you, OP.

PG2018 · Oct 13, 2015

Doctors see patients just for the money?

Why the heck do you see patients!?

I see them for money because my family and I developed this bad habit - we like to eat. Geez, you think if most of us won a big lotto that we'd keep working?

WKShadowNP, DNP, APRN · Oct 13, 2015

I know my ROI will be less than ideal financially, but I also know what I can afford and what I will settle for, largely due to advice given here .

I look at loans as an investment. I may pay more in the long run but I'm gaining a career. I can live with that.

Horseshoe, BSN, RN · Oct 13, 2015

Geez, you think if most of us won a big lotto that we'd keep working?

I would! I have this determination to have an active license all the way into my 80s. I worked too hard for that damn thing.

Of course, I don't work very much any more, but I'm still out there! I'll be that PRN nurse who still shows up from time to time when she's old and still thinks everyone believes her hair is really brown because she "has really good genes."

tbaughm · Oct 13, 2015

Yah and writing a post like you are the bullying quarterback from the movie The Waterboy doesn't detract at all from posting credibility. :no:

allnurses Guide · Oct 13, 2015

I intially read the post and thought "I don't like what he's saying" but as I though about it I think I really just didn't like the way it was said. So here are my thoughts about some of the major points you made. Maybe some others will realize that they agree with the content.

Never before besides law and maybe the MBA have I ever seen such a large amount of specific programs pop up. Every school in america seems to have a masters level nursing program in their academia. This includes the notorious for-profit schools that everybody excluding people who hold degrees from these institutions seem to loathe.

Didn't you post in another thread about going into law next?

The nature of the statement though is correct. NP programs are increasing exponentially, although I think it seems like there are more than there really are (about 370 in the US), though this doubles the number of medical schools. The number of NP graduates per year has more than doubled in the past 10 years.

Our credentialing bodies, by allowing all of these poorly regulated programs to pop up

They don't seem to be doing enough, I agree. The should have never allowed programs to detacth themselves from providing preceptors. This, IMHO, is the biggest problem right now. If it was corrected, the non-quality programs would wane as preceptors began to associate with only quality programs.

job availability will decrease severely in the next few years.

This issue is one of the double-edged swords of APN vs physician. Physicians have controlled entry to practice to keep demand and wages high for a long time. To that end they have created a primary care deficit which has opened the doors for APN independent practice. APN programs are churning out graduates to fill this deficit and as they do so, access to care improves while NP demand/wages also fall. If we keep the primary care deficit high enough to maintain higher wages, are we aren't any better at improving access to care than physicians are/were.

Low barrier to entry. This is where the nail gets hit on the head. Essentially, to keep enrollment high, higher level nursing programs (excluding a few from higher end schools) have DROPPED their admission standards, in fear that somebody will go to another program instead of their own. NO GRE, NO GPA, NO EXPERIENCE, NO INTERVIEW. I mean come on people, really??? Your so money hungry you will lower your admission standards just to get more applicants and provide more seats. At least in the medical world, schools keep it competitive, for which is mostly to make their school look better.

I went to a quality school with a quality reputation for several decades. When I applied the admission rate was less than for two local medical schools. It was very selective which allowed the program to be rigorous which allowed production of quality providers. That program remains selective, but there are now 4 other local programs that have significantly less admission standards. Unfortunately I know that there are quality programs that deny student and actually refer them to these less selective programs. That concerns me.

It's not that a student with a weaker admission application can't be a great NP, they can, it does mean that the less selective programs surround that individual with a weaker curriculum and weaker colleagues and reduces their chances of reaching their potential, at least initially.

Role confusion. This is not prevalent everywhere, but even with all these nurses pushing for education of the np model to patientsâ€ a large amount of people still don't know what we are. PAGING DOCTOR NURSE, DOCTOR NURSE. I mean how ridiculous does that sound. DOCTOR NURSE??? while the DOCTOR NURSE complication may be DNP and PHD specific, there is much confusion to a nurse wearing a while coat, prescribing medication, etc (not anything wrong with it but it is confusing to patients)

Role confusion runs rampant around APNs, sadly most of it comes from other nurses. I don't agree with you here that patients are confused. Most patients want quality care from a provider that listens to them. They could care less whether that person is a MD or a DO, a physician or a NP, an RN or a CNA. Most patients would rather call the person taking care of them a "doctor" or a "nurse" regardless of degree.

This white coat and doctorate education issue isn't between physicians and nurses because pharmacy and therapy have doctorates and white coats too. (Actually attendings in my hospital wear suits not white coats). There is quite a bit of research about this out there.

Weaksause curriculum. I am sure there are very difficult schools out there that provide the MSN needed to obtain the overly sought nurse prackkâ€ status, but many of these online programs at for-profit universities have really dumbed the requirements. I know of many schools that require no closed book tests, being the only one you take is your majorly feared BOARD EXAM, which was so notoriously easy i don't see how anybody can fail it.

There are absolutely programs with weak curriculum that teach to an exam (the boards). Its a shame.

I have been involved with teaching both in-person and online, and to be honest, I have no problem with open-book exams, provided they are appropriately challenging (which I am not sure they are) and/or done with a time constraint. The reason I feel this way is that it teaches novice NPs to use resources in practice, which I think is very important to providing quality care.

The boards were beefed up over the past few years but they remain a minimum competency exam. I am actually astonished that the fail-rate is 15-20% between the different exams. On that note, the pass rate for the USMLE is 95-97% nationally.

But anywayâ€¦. it is too easy, to short, and does not always prepare people for the level of knowledge required to do his or her job.

I agree that education does always prepare novice providers for their role. I think this is true of nursing and medicine. Medicine has a way of handling that: residency. Nursing has a way of handling that: collaborative practice requirements. Novice providers in both disciples are exposed to the role under supervision.

If anybody else wants to follow me through a more difficult and rewarding pathway than advance practice nursing can provide, you will reap the rewards of the hard labor you shall put forth, if not, enjoy the last few years of excellent salary guarantee (excluding excellent providers, which most people think they are but they are not even close) and wallow in your despair once your fighting for jobs that pay a couple grand more than RN positions.

Hope you are planning on a specialty and you make the residency cut for it, because I am not sure most primary-setting physicians are so happy with their lives either. Most PCPs make 10-20% more than NPs after $400k in debt, taking night and weekend call, and getting paid less than minimum wage for 3-5 years during residency. And in the end, they deal with the same administrative red tape crap that NPs deal with, and most work for a large healthcare system that sees them as a productivity number. Unless you are an orthopedic surgeon, dermatologist, or other high-paid specialty, the grass might not be greener.

If you goal is $500K+/year there are easier ways with less hoops to jump through than nursing or medicine.

Actually, I think that's part of this NP-rush. Nurses at the bedside are pretty well paid compared to other jobs but the work sucks so people want to take the next step up to a provider where again they are well paid compared to other jobs but that work also sucks. I always tell perspective NPs that the only really good reason for wanting to be an NP is to provide quality cost effective care. If you don't love the role then you won't love the job.

I happen to be one of those that loves the role and the job, I just hope that the opening floodgates don't mean the outcome studies start being effected, because once that happens, the future is going to take a nosedive. I mean that the future of independent practice, I think regardless of how bad NP outcomes were, physicians will be happy to hire them, as they still create revenue.

Barnstormin' PMHNP · Oct 13, 2015

BostonFNP, very well said, as usual.

Horseshoe, BSN, RN · Oct 13, 2015

Hope you are planning on a specialty and you make the residency cut for it, because I am not sure most primary-setting physicians are so happy with their lives either. Most PCPs make 10-20% more than NPs after $400k in debt, taking night and weekend call, and getting paid less than minimum wage for 3-5 years during residency. And in the end, they deal with the same administrative red tape crap that NPs deal with, and most work for a large healthcare system that sees them as a productivity number. Unless you are an orthopedic surgeon, dermatologist, or other high-paid specialty, the grass might not be greener.
If you goal is $500K+/year there are easier ways with less hoops to jump through than nursing or medicine.

Even some of the specialties are complaining that they are having a lot more trouble being reimbursed.

And you are correct that the best paid specialties are now CUT THROAT competitive. You have to be the absolute cream to get those residencies. Very very few MDs are going to have the standard of living which once used to be common among physicians. Most docs I know have told me that they would never encourage their kids to go into medicine.

My DH does work very hard indeed for his money, but it's a cake walk compared to what would be required of a doc to make the same compensation. Most will never be able to, and it has nothing to do with brains, competency, or what they can contribute in terms of affecting patients' lives.

Everyone needs to put food on the table, and there is NOTHING wrong with wanting to make a very good salary, but I think people who go into medicine thinking they are going to make boatloads of money but don't at least have some level of passion for the profession are going to be quite disillusioned. There is no longer utopia in the field of American healthcare, not that there ever really was. Things have not gotten better and I do think the OP is right about a lot of what he wrote.

sauce · Oct 13, 2015

i know the OP in real life and no he is not going to do it for the money. We both went to the same school and pretty much chose the medical field out of interest and hes still interested in the medical field. We have had conversations about doing other things but I mean like everybody knows if you want to make the big bucks without regard to what you are doing, the best bet would be financial engineering and/or computer science related stuff. The demand for people who can do calculus based calculations on computers and actually understand that stuff will always be in higher demand than everything else since not everybody wants to stick it out to understand the complex math we have discovered in the past 200 or so years.

but if somebody wants to work in the medical field, being a physician is usually the best bet, either that or a particle physicist that controls dosing on chemo and such. They can make six figures easily with less schooling. If you can work your way through all the calculus based physics and stuff.

I forgot to mention sales, many of the car dealer people around my parts make well into six figs without a college degree. Of course its only the top salesman, but if you are as money hungry as they are it can be done without too much problem.

but back on topic, I thought about going back to school like the OP but just do not want to put the time into it. Would it be worth it in the long run? Yes. People here seem to have some inaccurate skew of what some specialties make. ER in rural areas is one of the highest paying specialties, for which the physician providers make around four times that of one of the pa or np in the same setting.

Doctors keep their salaries on the hush hush, and make much more than proclaimed oftentimes on the internet. Not counting the ability to form medically related business (owning a nursing home is very profitable if you understaff it and blame bedsores on hospital admissions) but again you have to be ruthless in many cases.

Anyway, nurse practitioner school was a cake walk and like dranger says if you disagree you probably have very poor study habits. Pretty sure my undergraduate chemistry class was harder than anything experienced in my asn bsn and/or msn program, and we went to a BM school with a decent rep. Most nurses are not cut out to be nurse practitioners since the level of commitment is much higher.

One of the lower paid ER docs i know makes 350k per year, sleeps most of the shift, and got like 5 20k bonuses during one year. Not amazing money but if you love the medical field you wont get that in another other position.

Nursing will always be just nursing and those who try to make it something it is not probably should have done something else. You can't turn every career path into a phd level profession. When you try it just makes you look silly.

End rant.

Horseshoe, BSN, RN · Oct 13, 2015

i know the OP in real life and no he is not going to do it for the money. We both went to the same school and pretty much chose the medical field out of interest and hes still interested in the medical field. We have had conversations about doing other things but I mean like everybody knows if you want to make the big bucks without regard to what you are doing, the best bet would be financial engineering and/or computer science related stuff.

Investment banking, commercial real estate development/investment also come to mind.

allnurses Guide · Oct 13, 2015

Look at some of the salaries, I know I was surprised: https://www.aamc.org/services/first/first_factsheets/399572/compensation.html

For primary setting providers it's $160-180k as a starting salary. That's more than NPs by a significant amount, however, the average work week is 54 hours and most have more than $300K in loans to repay.

On the other side, their potential is much higher.

Horseshoe, BSN, RN · Oct 13, 2015

Look at some of the salaries, I know I was surprised: https://www.aamc.org/services/first/first_factsheets/399572/compensation.html
For primary setting providers it's $160-180k as a starting salary. That's more than NPs by a significant amount, however, the average work week is 54 hours and most have more than $300K in loans to repay.
On the other side, their potential is much higher.

It's certainly better than your average Joe can make for some specialties. However, they don't make that kind of money right out of med school. The amount of education and post med school education required to get there is mind boggling, not to mention expensive. I believe these docs earn every penny they make, but there is blood on every one of them. And they spend years paying off their loans and paying for malpractice insurance is a major hit. One needs to consider salary hand in hand with loan repayment and malpractice premiums. Those two things alone will eat up a disheartening amount of that paycheck, and we aren't even talking about federal and state income taxes. That a major OUCH for a profession which requires so much of them.