Before becoming an RN, I was debating MD vs. PA vs. RN and eventually get my masters degree. I decided to go the RN route because at the time, nursing seemed like it had a lot of opportunities and it is a highly respected and flexible field. 8 or so months after working as an RN, I jumped the gun and joined on an online NP Program for FNP. Just two years later, I am realizing what a mistake that was.
The first year I was so busy with fluff assignments and truly just doing my best while also gaining nursing experience (I have worked full time through most of the program, just went down to part time a few months ago). I did not realize the lack of depth I was receiving and what they weren't teaching me. The past few months, I have realized how insufficient NP education is (not sure how it took me this long to wake up, I guess just not having time to think about it because I was still busting my butt with the readings). Nonetheless, this has put me into a mental spiral if this is what I even want to do now. I've taken it upon myself to basically do the bare minimum for the fluff work and spend extra time on patho, pharm, sciences, etc. and do med school style questions (using Osmosis, Human Dx, anki flash cards). I'm a pretty good self-learner and I know my limitations and what I am weak on. But I feel like I am just in too deep and there's too much to learn out there. I'm around 8 months from graduating, starting OB and peds clinical next semester and at this point I'd feel it idiotic not to just finish.
But how ridiculous would it be to go to med school after I graduate? I am burning to really, really, learn the details on medicine in a proper fashion. Ideally, I'd love to find a great doc to work with who will know my limitations, be willing to teach me and utilize me as his/her extender of care, but I know that isn't always promised and I don't want to end up working without physician supervision and see cases I was never taught in NP school. But I also am like, why the hell didn't I realize this a year ago and just quit the program then? I think I was just so excited to become a provider.
I'm 26 years old. I know if I did do med school I'd be in a hell of a lot of debt and pretty poor for awhile, and I do want to have a family with my fiance, so that would definitely take the back burner. I also know it will be extremely difficult from the application process to residency. He also is applying to med schools now. Any advice or anything would be appreciated. I already know what I did was a mistake, so no need for lectures.
I know people who started medical school in their late 20s/early 30s. It is totally doable.
Your desires are valid and totally understandable. The MD community, in my opinion, is much stronger and I hear way more stories about strong MD mentors vs strong NP/RN mentors.
There is no point in being miserable, underchallenged, and unhappy at your job. If you know you'd rather be an MD than an NP, then go for it.
Yeah, I will just have to give it my all through the rest of my NP education and starting the NP profession and see how it goes and how I fit into the role. I agree that in terms of medical science and raw material, MD offers a much more challenging, rigorous coursework and clinical education. Thank you for your insight!
Specializes in Pediatrics, Pediatric Float, PICU, NICU.
16 hours ago, adammRN said:
I feel like this forum is surreal. In the real world, I don't encounter nurses with the types of thoughts and hate and shade you do on here about the profession trying to increase standards and requirements.
This is awkward, considering the only one showing "thoughts and hate and shade" in this thread is you when you thought a reply was directed at you when it wasn't ? but I'm glad you've had a more positive experience in the real world, that's a plus.
OP (and anyone else who this may apply to) there isn't a wrong answer at all. You are young enough that if med school is truly what you want, then go for it. It wouldn't hurt to go the old fashioned route and write out a list of pros and cons to both options. I think the biggest "con" regarding med school is the length of time it will take and of course the financial cost of it. Good luck either way!
This is awkward, considering the only one showing "thoughts and hate and shade" in this thread is you when you thought a reply was directed at you when it wasn't ? but I'm glad you've had a more positive experience in the real world, that's a plus.
OP (and anyone else who this may apply to) there isn't a wrong answer at all. You are young enough that if med school is truly what you want, then go for it. It wouldn't hurt to go the old fashioned route and write out a list of pros and cons to both options. I think the biggest "con" regarding med school is the length of time it will take and of course the financial cost of it. Good luck either way!
Yeah, I hope people didn't take my post as shade toward the NP community. If anything I'm putting shade on myself for jumping so soon into school after only a short time as a nurse, and toward the lack of NP school standardization and how easy some programs are compared to most PA schools and med school. And just because a program isn't as rigorous, doesn't mean it won't graduate great NPs, and vice versus. I kinda wish they would have turned me away and said I needed more nursing experience. At the time I was just ecstatic to get in.
A pros and cons list is a great idea and I can't believe I didn't think of that. Thank you for your encouragement and reply!
Keep in mind that if you go the medical school route you may want to consider a few other points:
a. Most of the pre-req's require pre req's. Thus, many of the Physics, and some of the Chemistry options require that you have taken Calculus first. If you did not do this then you may be looking at "more time".
b. It is sometimes not enough to "do well" on the MCAT and get "good grades". Often you will need to be 95% percentile plus if you want to get in medical school and obtain a decent residency this also means doing well on USMLE levels I, and II (and eventually III). You could go to one of the off shore schools like Grenada (still competitive, but a bit less so) but the price will in many cases almost double verses a state school.
There is nobody online who can make this decision for you, unfortunately. None of us know you, and even if we DID— you are the one with insight into what you really want to do.
I spent about ten years thinking “Do I want to do the med school thing? I don’t know. I’ll take the pre reqs...” And eventually just looked at my life and decided, No. As much as I would have loved to be an MD, I am just not going to make the sacrifices it would require. So I’m starting my PMHNP in January, and I will be content. That’s the fork I chose, ultimately.
Many people choose the other fork. Many people who take either path are happy, and many who took either fork will tell you “I should have done it the other way.” There is no right answer here— there’s only figuring out what you really want to do (and if it’s reasonable and feasible). But whatever you decide, do it and don’t look back. There’s no perfect path, so choose and then rest in your decision.
Specializes in ACNP-BC, Adult Critical Care, Cardiology.
There are so many paths and variables involved in choosing between a career as a physician and an NP. Ultimately, it's a personal decision. However, I have a few stray observations based on the posts thus far:
1. OP is in an FNP program presumably with a goal to work in Primary Care. Earning potential is not widely different with a comparative Family Practice trained physician. Training is less for NP's which can be an advantage. However, OP's concern of the inadequate training may be remedied by additional training including a Primary Care NP fellowship which exists.
2. Many posters are PMHNP or are in a PMHNP program. That makes sense that the role is primarily the same and there is some wisdom in picking the NP route in that case especially with the existence of independent practice states.
3. I am an Adult ACNP and my practice environment is vastly diverse and geared toward specialty practice from ICU to Hospital Medicine to Cardiology, etc. Hospital based practice will always rely on physician leadership to some extent regardless of independent practice laws for NP's. The pay gap for NP vs physician will also be wide with physicians winning that battle for good reason because these are commonly multiple boarded physicians with lucrative specialties. However, it did take them years of training to get to that point.
The trend in hospital based practice even in academic medical centers is collaborative practice between physicians and NP's even with residents and other physician trainees around. Residents are temporary "workers" and are not always invested in their rotations for various reasons. NP's will always have a presence in the hospital setting and bring consistency to a medical practice. Perhaps this could be a role the OP could explore given that she is more interested in a collaborative practice, mentor-mentee relationship.
RN married to MD here. Skip all the posts listing how difficult medical school is and how many years of your life will be involved etc etc. Those years will pass either way, and will be small compared to the years left in your career once you're done training. My husband started medical school at 28, at 36 he has finished residency. It sounds old, but this is the career he wanted and knows the slog has been worth it. Additionally, though nobody would say medical school is easy, approaching it as a "second career" student means you will likely be better able to manage the school load while still maintaining a work-life balance.
There's absolutely no need to debate the relative merits of NP school bs MD school + years of residency in the specialty of choice. Anyone being honest with themselves can understand why one of those models results in a better trained clinician; you yourself already recognize this. A final note that hasn't been mentioned: though in appearance the work of NPs and MDs in many specialties looks very similar (outpatient primary care, general internal medicine) in other specialties it certainly does not: surgical specialties, radiology, etc. If these areas truly interest you, there is no comparable NP path.
I think your mind is made up....go to medical school.
There are so many paths and variables involved in choosing between a career as a physician and an NP. Ultimately, it's a personal decision. However, I have a few stray observations based on the posts thus far:
1. OP is in an FNP program presumably with a goal to work in Primary Care. Earning potential is not widely different with a comparative Family Practice trained physician. Training is less for NP's which can be an advantage. However, OP's concern of the inadequate training may be remedied by additional training including a Primary Care NP fellowship which exists.
2. Many posters are PMHNP or are in a PMHNP program. That makes sense that the role is primarily the same and there is some wisdom in picking the NP route in that case especially with the existence of independent practice states.
3. I am an Adult ACNP and my practice environment is vastly diverse and geared toward specialty practice from ICU to Hospital Medicine to Cardiology, etc. Hospital based practice will always rely on physician leadership to some extent regardless of independent practice laws for NP's. The pay gap for NP vs physician will also be wide with physicians winning that battle for good reason because these are commonly multiple boarded physicians with lucrative specialties. However, it did take them years of training to get to that point.
The trend in hospital based practice even in academic medical centers is collaborative practice between physicians and NP's even with residents and other physician trainees around. Residents are temporary "workers" and are not always invested in their rotations for various reasons. NP's will always have a presence in the hospital setting and bring consistency to a medical practice. Perhaps this could be a role the OP could explore given that she is more interested in a collaborative practice, mentor-mentee relationship.
I believe that the point about the fellowship residency such as the one's offered through https://thriveap.com/blog/nurse-practitioner-residencies-the-ultimate-guide (formerly Midlevel U) is an excellent point. Indeed, there is no reason that you could not "stack" several of these together for up to an additional two years of clinical experience (they would be very glad to have you in most places since they pay you below market wages in these programs). However, this would allow you to add as much additional clinical experience as you felt was right for your situation. I do believe that the "extra decade" involved for most to go back and do the medical school route is significant. For most that is well over a million dollars in lost income (not including interest if it were invested) or a great deal of orphanages that you could open in Nepal (as a former friend did on a school teachers income) if you were more charity minded. Of course the more medical school pre requisites that you have already completed and the younger you are the more the "medical school" route makes sense. In general my "over/under" cut off would be around 25 IF someone had at least completed Calculus. Otherwise, you are looking at doing a calculus track before you can do some of the pre-requisites such as Physics (most medical schools want you to take the sections using calculus rather than algebra).
RN married to MD here. Skip all the posts listing how difficult medical school is and how many years of your life will be involved etc etc. Those years will pass either way...
This is pretty laughable, coming from someone that didn't do either...
At this point, I have studied along side many medical students and met many MD/DO. While there might not be a comparison in the training, the time is important and more time does not necessarily make you a better provider. No one will get their time back and it is not practical for everyone to do as there are other things to consider.
Since you know about being a provider, please explain why nutrition is omitted from medical school curriculum but also how taking organic Chemistry, calculus and physics helps provide good patient outcomes or is necessary to do the job of say a psychiatrist?
The only real truth is you can always be a good provider no matter which route you choose and other things in life are more important than your job or title.
This is pretty laughable, coming from someone that didn't do either...
At this point, I have studied along side many medical students and met many MD/DO. While there might not be a comparison in the training, the time is important and more time does not necessarily make you a better provider. No one will get their time back and it is not practical for everyone to do as there are other things to consider.
Since you know about being a provider, please explain why nutrition is omitted from medical school curriculum but also how taking organic Chemistry, calculus and physics helps provide good patient outcomes or is necessary to do the job of say a psychiatrist?
The only real truth is you can always be a good provider no matter which route you choose and other things in life are more important than your job or title.
Agreed. Even though I "only" have an MSN I have had clients tell me that I have obtained results after "top" national psychiatrists at places like the Mayo clinic could not. It certainly wasn't because I had more Physics or Calculus. If these results were better it is more likely because I always emphasize nutrition whether it is a DASH diet for hypertension, or a Mediterranean diet for depression along with integrated CBT and CAM products like SAM(e), Standardized Lavender extract, L-Theanine, Omega three fatty acids, CBT(I) (to get to optimal sleep, if sleep isn't good nothing else will be) along with ordering basic labs to look for things like thyroid issues, or anemia. My focus is on being the best provider that I can be with the education that I had access to and at the same time looking to improve my educational "knowledge" base with the best evidence based resources available.
FamNP123
23 Posts
Yeah, I will just have to give it my all through the rest of my NP education and starting the NP profession and see how it goes and how I fit into the role. I agree that in terms of medical science and raw material, MD offers a much more challenging, rigorous coursework and clinical education. Thank you for your insight!