Please bare with me on this post, I'm considering going MD but time is of the essence and NPs here in Hawaii aren't really 100% autonomy (because the hospital/clinic you work at determines most of your restrictions) ALSO, I'd really like to have some insight from a current DNP or MS, NP. Someone who recently graduated and if you'd be able to share with me some of the curriculum. Also, I've been told by my counselor that I SHOULD NOT go straight from BSN to DNP without working first.....I really like the job of Doctors and have leadership skills that I'd really be able to implement in their roles, I just know that this is my calling, but I don't like the "synthetic" approach (what I refer to as "prescribing medicine for everything") I love DO! but there are no schools here, I need nurses insight on this from every aspect. To add, I want to apologize to anyone if my post is found offensive. Thank you in advanced.
NOTE: I've completed pre requisites for both nursing (at ADN and BSN levels) and med school.
EDIT!!!! - The pre requisites for BOTH the MD and NURSING PROGRAMS are NOT apart of my bachelors degrees. I only have ONE med school I'd be applying to, HERE in Hawaii and NO, you do NOT need a bachelors to apply but it IS recommended because most people do. I don't appreciate the HATE I'm seeing in some of these posts. For those of you who've responded to help me, thank you so much. It makes sense and I'd really like to get more insight on the NP profession. Additionally, how do you become certified in certain areas? Mental health, peds, etc?
if you get/got 30+ on mcat do med school as long as you don't mind putting in 8 years of 80 hour weeks. do schools you can get in with a 25, which id hope anybody can make that can click boxes. not really much difference between do/md except you can't match the top 3-4 most competitive specialties as DO.
if you don't want to dedicate 80 hours per week get a few years of nursing exp under your belt then go for NP but still realize the career afterwards is just as difficult as a doctors without as much pay but still a very good career option.
John Burns SOM, o-chem was EXTREMELY challenging. But I'm really leaning towards the DNP, but I'm wondering about the specialties as an NP. I like mental health. Do you know anything about certifications? Do RN certifications serve the same purpose if you are a DNP???
I can't tell that anyone has answered the question you are trying to ask about mental health and peds certifications. In order to sit for Psych-Mental Health NP certification, you must graduate from an accredited Psych-Mental Health NP (PMHNP) program. In other words, you cannot attend a Family Nurse Practitioner program and then be eligible to sit for PMHNP. Additionally, you must attend a Pediatric Primary Care NP program in order to sit for PPCNP. If you attend a FNP program, you are eligible to sit for FNP certification. Some programs offer dual certification. That would be a question to ask your recruiter. You can see certification eligibility info on both ANCC or AANP websites.
As far as maintaining RN certifications once you are a NP, that is a personal choice. You are no longer practicing as a RN, so they don't serve a lot of purpose. However, if you have Cardiac-Vascular certification as a RN, for example, and apply for a Cardiology NP position, it may give you some leverage as a job candidate. Just my two cents.
If I had to do it over again, I would probably go med school route. I loved org chem and physics, just couldn't fathom another 8-10 years of school and training at the time. I ended up working as a RN for 10 yrs before becoming a NP. The timing was all the same in the end.
I'm sorry my OP sounds confusing, I also think it's because most people are under the impression that you NEED a bachelors before you apply to medical school (the one I'm applying for doesn't) AND the fact that I'm stuck between NP and MD is reliant on my undergraduate degree.
Moving isn't an option for me. I'm really leaning more towards the NP route. It seems like there is more flexibility between specialties? Correct me if I'm wrong. However, it seems that if one wants to change specialties, it isn't easy. I'm interested in internal medicine and mental health. What are my options as an NP? The program here says it's focused on FNP but doesn't say much about other specialties...
So, to be an NP you need to either get a MSN or a DNP. You also need to have a certain specialty picked out, and the coursework that you take depends on which specialty that you pick. You will only be able to sit for the board exam of the specialty (or specialties) that you have completed the correct coursework for.
There is a mental health specialty that you allow you do to mental health care for all ages.
FNP allows you to do primary care for all ages; it would be like your family medicine practice - they see children and adults.
Then there is the "adult/gerontological nurse practitioner", and you can choose the primary care or the acute care track within that - one sees patients in a clinic/doctors office type setting, the other sees patients in the hospital.
FNP is probably the "broadest" specialty - but it is also the most common and so the job field is saturated in many places. Mental health seems to be the most in demand lately, from what I have read, and can pay very well, but there will also be fewer places to apply for jobs. So it really depends on what you want to do.
I can't tell that anyone has answered the question you are trying to ask about mental health and peds certifications. In order to sit for Psych-Mental Health NP certification, you must graduate from an accredited Psych-Mental Health NP (PMHNP) program. In other words, you cannot attend a Family Nurse Practitioner program and then be eligible to sit for PMHNP. Additionally, you must attend a Pediatric Primary Care NP program in order to sit for PPCNP. If you attend a FNP program, you are eligible to sit for FNP certification. Some programs offer dual certification. That would be a question to ask your recruiter. You can see certification eligibility info on both ANCC or AANP websites.
As far as maintaining RN certifications once you are a NP, that is a personal choice. You are no longer practicing as a RN, so they don't serve a lot of purpose. However, if you have Cardiac-Vascular certification as a RN, for example, and apply for a Cardiology NP position, it may give you some leverage as a job candidate. Just my two cents.
If I had to do it over again, I would probably go med school route. I loved org chem and physics, just couldn't fathom another 8-10 years of school and training at the time. I ended up working as a RN for 10 yrs before becoming a NP. The timing was all the same in the end.
Thanks for answering my question! So if someone wanted to switch specialties, they'd have to go through the whole 3 years again? I suppose most people don't switch. SHUCKS, I really like mental health but Hawaii program does not offer that. I know I offended some people here with my question and with further research after I guess there's some sort of hostility between MDs and NPs? Not sure if that's really true, I've never seen that here in Hawaii
So if someone wanted to switch specialties, they'd have to go through the whole 3 years again?
No, many schools have non-degree certificate programs for practitioners who are already an APRN in one specialty but are looking to add/switch to another. The ones at my school are 8-12 months long. There are also joint programs that train for two specialties simultaneously, like AGACNP and FNP.
If being a prescriber is your goal I would say go for MD or PA. I would not choose the nursing route. Especially if you have no interest working as a nurse. I absolutely loved nursing but there are things you have to deal with as a nurse that make the career difficult even if you absolutely love the job - some places have been fantastic, others were worse than some really seedy bars that I worked at in a former life (I have more shocking stories from the healthcare side than I have from the working in terrible bars side - which really says a lot).
The thing with the NP is that you really should have some nursing experience in a comparable area to the advanced practice specialty. Those in my program with 1 yr or less have had a lot harder time (meaning some have sadly been told to get more experience and try again) than those with 3-5 years in picking up the material. Which means putting time on the floor doing something you really might not like (nursing in general can be really stressful even if you enjoy it; it can be horrendous if you dislike it and soul killing if you dislike it and end up at a bad facility - I've worked nursing specialties I was not into and can attest to praying for a zombie apocalypse to end my misery, the money was not worth it).
The thing is that MD, NP, and PA are all comparable in terms of where the direction is going in terms of "holistic" care. My Psych program is done in conjunction with a school of medicine and I rotate with medical students and residents, have classes taught by faculty at the SOM and classes taught by faculty at the SON. Both schools are focused on health promotion, prevention and providing patient's with self care practices in order to manage their own mental health needs.
If being able to go back and fourth between specialties is a goal of yours, I'd say the degree that provides the most flexibility for that is PA. Followed by NP - you would have to pick up an additional certification and ensure you're able to get enough hours doing both to keep them active which can be a headache, but doable. MD is the most difficult because you would have to do an additional residency (but I do work with MD's that have both Family and Psychiatry Board certifications).
I'd say personally? I kind of wish that I had gone the PA route. Nursing, especially at advanced practice levels isn't very organized. There is huge variability between programs (entry requirements, content, delivery, clinical rotations), states (scope of practice), confusing rules (I'm in a PMHNP program I've been told by one NP professor that it is not within my scope of practice to prescribe medications to manage the metabolic syndrome that can come as a side effect of some of the medications I can prescribe, and another NP Professor that has said I should), different degrees (MSN NP, DNP - same scope of practice, same pay only difference is one is terminal and the other is not), different board oversight depending on state (some are governed by the same board as nurses, some have joint governance by the Board of medicine), and unclear chain of command (some places have a physician in charge of NP's others have a Nurse Manager).
The fact is that although you can have good and bad within all professions - you know that an MD/DO from one school and an MD/DO from another have comparable educations and had to pass the same steps and go through the same match/residency process as one another. Advanced practice nursing is still very convoluted and there is definitely going to be a surplus of providers at some point due to what is happening to the nursing profession as a whole (floor nursing isn't getting any easier), the economy (It's hard to outsource healthcare), Universities taking advantage of interest people have in advanced practice, and the APRN model doesn't have the imposed residency caps that the MD/DO model does (that limits providers so there isn't a swarm of MD's driving down salary).
Here's an example: one of the Psych ER's here has been trying to hire PMHNP's - they work the same hours, do the same evaluations and prescribing as the MD's; the MD's make $100/hr while they're trying to hire a PMHNP on for $36/hr. Just to put this in perspective - I can make more than that as an RN. Heck, I've had Server jobs where I had nights where I cleared more than that hourly in tips. And yet - people have been applying for that $36/hr PMHNP job.
If being a prescriber is your goal I would say go for MD or PA. I would not choose the nursing route. Especially if you have no interest working as a nurse. I absolutely loved nursing but there are things you have to deal with as a nurse that make the career difficult even if you absolutely love the job - some places have been fantastic, others were worse than some really seedy bars that I worked at in a former life (I have more shocking stories from the healthcare side than I have from the working in terrible bars side - which really says a lot).
The thing with the NP is that you really should have some nursing experience in a comparable area to the advanced practice specialty. Those in my program with 1 yr or less have had a lot harder time (meaning some have sadly been told to get more experience and try again) than those with 3-5 years in picking up the material. Which means putting time on the floor doing something you really might not like (nursing in general can be really stressful even if you enjoy it; it can be horrendous if you dislike it and soul killing if you dislike it and end up at a bad facility - I've worked nursing specialties I was not into and can attest to praying for a zombie apocalypse to end my misery, the money was not worth it).
The thing is that MD, NP, and PA are all comparable in terms of where the direction is going in terms of "holistic" care. My Psych program is done in conjunction with a school of medicine and I rotate with medical students and residents, have classes taught by faculty at the SOM and classes taught by faculty at the SON. Both schools are focused on health promotion, prevention and providing patient's with self care practices in order to manage their own mental health needs.
If being able to go back and fourth between specialties is a goal of yours, I'd say the degree that provides the most flexibility for that is PA. Followed by NP - you would have to pick up an additional certification and ensure you're able to get enough hours doing both to keep them active which can be a headache, but doable. MD is the most difficult because you would have to do an additional residency (but I do work with MD's that have both Family and Psychiatry Board certifications).
I'd say personally? I kind of wish that I had gone the PA route. Nursing, especially at advanced practice levels isn't very organized. There is huge variability between programs (entry requirements, content, delivery, clinical rotations), states (scope of practice), confusing rules (I'm in a PMHNP program I've been told by one NP professor that it is not within my scope of practice to prescribe medications to manage the metabolic syndrome that can come as a side effect of some of the medications I can prescribe, and another NP Professor that has said I should), different degrees (MSN NP, DNP - same scope of practice, same pay only difference is one is terminal and the other is not), different board oversight depending on state (some are governed by the same board as nurses, some have joint governance by the Board of medicine), and unclear chain of command (some places have a physician in charge of NP's others have a Nurse Manager).
The fact is that although you can have good and bad within all professions - you know that an MD/DO from one school and an MD/DO from another have comparable educations and had to pass the same steps and go through the same match/residency process as one another. Advanced practice nursing is still very convoluted and there is definitely going to be a surplus of providers at some point due to what is happening to the nursing profession as a whole (floor nursing isn't getting any easier), the economy (It's hard to outsource healthcare), Universities taking advantage of interest people have in advanced practice, and the APRN model doesn't have the imposed residency caps that the MD/DO model does (that limits providers so there isn't a swarm of MD's driving down salary).
Here's an example: one of the Psych ER's here has been trying to hire PMHNP's - they work the same hours, do the same evaluations and prescribing as the MD's; the MD's make $100/hr while they're trying to hire a PMHNP on for $36/hr. Just to put this in perspective - I can make more than that as an RN. Heck, I've had Server jobs where I had nights where I cleared more than that hourly in tips. And yet - people have been applying for that $36/hr PMHNP job.
Everything you've explained above helps me out SO MUCH! I would agree that the organization of the NP curriculum nationwide is flawed. The program you are in sounds WELL established and very organized. That sounds like a program that will prepare you well for what's ahead. Going the NP route scares me when it comes to job security. The fact that I would need to step out also scares me because I don't know if I'll have that same motivation later down the road and also, it might be harder to pick up the same scholarship that I have now. I'm wondering if I can finish the NP program but start as a regular floor nurse and then when I feel ready enough to take on more responsibility, apply for an NP role?
I think the general consesnsus (from your counselor and most rns) is that becoming an NP requires experience. Why? Because your program will not have the extensive training and residency that mds get. That is why you NEED acute care experience. Docs have 4 years med school, a year of internship, and at least another of residency to learn their craft. NPs get a more limited training PLUS the experience they bring. Thats mainly it.
I agree 100% and only wish the nursing schools would look past profits and consider the product they are churning out.
Everything you've explained above helps me out SO MUCH! I would agree that the organization of the NP curriculum nationwide is flawed. The program you are in sounds WELL established and very organized. That sounds like a program that will prepare you well for what's ahead. Going the NP route scares me when it comes to job security. The fact that I would need to step out also scares me because I don't know if I'll have that same motivation later down the road and also, it might be harder to pick up the same scholarship that I have now. I'm wondering if I can finish the NP program but start as a regular floor nurse and then when I feel ready enough to take on more responsibility, apply for an NP role?
well that will be the future, all the nurse practitioners will probably just end up being nursing pay level jobs. right now a PMHNP makes more than many engineering specialties (excluding software, petro, and a couple more) and is much easier to obtain.
people are flocking to PMHNP for the bucks, just like they do CRNA.
i don't think I've talked to a nurse that isn't currently/planning on getting their NP in the next year or two, and many back when I was working who were awful nurses are already graduated and flooding the market.
another year or two from now it is possible in many areas that unless from specific schools, MANY NP graduates will be caught without jobs, which is already happening, and it won't be worth a fart in the wind to get the degree.
So if you do choose NP follow what other people say and network your ass off and go to a good school.
even the PA market is getting saturated. Look at the increase in graduates. I feel bad for the ones spending 120k at the school I'm at to make 1/3 or 1/4 what ill make when I'm done with med school
or just be a travel nurse, the ones i rent my house to to make more than i did as an ER NP. They are just needed more.
Hell if i could go back id probably be an electrician and say fk all this education stuff, they often make more than 36 an hour, especially if your a good one.
rant over
TLDR- nobody gives two flying ***** about what degree you got its all market demand. Don't do what everybody else is doing, youll just end up fighting for scarce resources
well that will be the future, all the nurse practitioners will probably just end up being nursing pay level jobs. right now a PMHNP makes more than many engineering specialties (excluding software, petro, and a couple more) and is much easier to obtain.
people are flocking to PMHNP for the bucks, just like they do CRNA.
i don't think I've talked to a nurse that isn't currently/planning on getting their NP in the next year or two, and many back when I was working who were awful nurses are already graduated and flooding the market.
another year or two from now it is possible in many areas that unless from specific schools, MANY NP graduates will be caught without jobs, which is already happening, and it won't be worth a fart in the wind to get the degree.
So if you do choose NP follow what other people say and network your ass off and go to a good school.
even the PA market is getting saturated. Look at the increase in graduates. I feel bad for the ones spending 120k at the school I'm at to make 1/3 or 1/4 what ill make when I'm done with med school
or just be a travel nurse, the ones i rent my house to to make more than i did as an ER NP. They are just needed more.
Hell if i could go back id probably be an electrician and say fk all this education stuff, they often make more than 36 an hour, especially if your a good one.
rant over
TLDR- nobody gives two flying ***** about what degree you got its all market demand. Don't do what everybody else is doing, youll just end up fighting for scarce resources
What do you think about becoming an RN (BSN level) and doing that for a bit then transition to med school once I feel ready?? I know this is the longer route, but I suppose that if I step into the RN role, and like it, I might get comfortable and that'll be it. If I want more go MD...your thoughts?
if you want to go MD path skip nursing all together and take classes pertinent to MCAT and major in whatever you really want to major in. (a lot of schools show preference to non science majors for entry, but they are not always fond of nurses going back to get an MD degree oddly)
biology, chem, psychology, english, philosophy, etc are all good majors for pre med though. nursing not so much for some reason i do not understand but the admissions committees do i guess.
Aromatic
352 Posts
if you get/got 30+ on mcat do med school as long as you don't mind putting in 8 years of 80 hour weeks. do schools you can get in with a 25, which id hope anybody can make that can click boxes. not really much difference between do/md except you can't match the top 3-4 most competitive specialties as DO.
if you don't want to dedicate 80 hours per week get a few years of nursing exp under your belt then go for NP but still realize the career afterwards is just as difficult as a doctors without as much pay but still a very good career option.