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 would argue that your excellent post highlights why most RN's would be ill advised to switch to MD rather than maximize their education via an NP route. With regard to my own scenario I was 38 when I graduated with an RN and did not go back for my NP until I was around 45. I was able to complete the program "part time" in about six years while working an ICU job (and suffering from severe untreated ADHD). At the end of the day I get to see patients from my home office and earn upwards of 300K per year (albeit no benefits), but I could earn more if I charged no show, fees or pursued collections. Let me also say of the seven very dedicated students (from high school) who went in to college desiring to do medical school only ONE graduated and of the other three who "failed" in medical school three left with debts close to or over 100K with few marketable skills. At the very least if you are going "pre med" do so with a degree in something like Chemistry, or Biology rather than "pre med" as this at least offers the prospect of gainful employment if your ultimate plan is not successful. One of the people that I referenced above actually moved to Costa Rica and is in the process of renouncing their American citizenship due to the 100K plus in student loan debt (now in collections) and working as a dive tour guide.
I would argue that your excellent post highlights why most RN's would be ill advised to switch to MD rather than maximize their education via an NP route. With regard to my own scenario I was 38 when I graduated with an RN and did not go back for my NP until I was around 45. I was able to complete the program "part time" in about six years while working an ICU job (and suffering from severe untreated ADHD). At the end of the day I get to see patients from my home office and earn upwards of 300K per year (albeit no benefits), but I could earn more if I charged no show, fees or pursued collections. Let me also say of the seven very dedicated students (from high school) who went in to college desiring to do medical school only ONE graduated and of the other three who "failed" in medical school three left with debts close to or over 100K with few marketable skills. At the very least if you are going "pre med" do so with a degree in something like Chemistry, or Biology rather than "pre med" as this at least offers the prospect of gainful employment if your ultimate plan is not successful. One of the people that I referenced above actually moved to Costa Rica and is in the process of renouncing their American citizenship due to the 100K plus in student loan debt (now in collections) and working as a dive tour guide.
My post was only to provide insight and clarification with informed decision-making about pursing medical school, not to encourage someone to go in either direction. I am sorry to hear about your friends, but their situations do occur (I had peers in my class who did not complete med school). I forgot to mention in my other post that some people may not get the residencies in the specialties they want and have to settle for a less desirable specialty instead of not receiving any residency training. I would highly recommend for someone considering medical school to get an undergraduate degree in anything he/she wants (including nursing) and take the prereqs and a few additional med-school oriented science classes (keep in mind that the GPA needs to be acceptable). This way, if med school does not work out, he/she has a marketable profession to fall back on.
My post was only to provide insight and clarification with informed decision-making about pursing medical school, not to encourage someone to go in either direction. I am sorry to hear about your friends, but their situations do occur (I had peers in my class who did not complete med school). I forgot to mention in my other post that some people may not get the residencies in the specialties they want and have to settle for a less desirable specialty instead of not receiving any residency training. I would highly recommend for someone considering medical school to get an undergraduate degree in anything he/she wants (including nursing) and take the prereqs and a few additional med-school oriented science classes (keep in mind that the GPA needs to be acceptable). This way, if med school does not work out, he/she has a marketable profession to fall back on.
I think this article illustrates just how hard it is to get in to Medical school
https://www.savvypremed.com/blog/why-is-it-so-damn-hard-to-get-into-medical-school , let alone successfully matriculate. My son (aged 19) was homeschooled and scored a 1500 SAT score (around 97th percentile), and had never received anything less than an "A" before taking college level Anatomy. He is currently struggling to maintain a "B" in the course. This is "marginal" for his ambition to go to UCF nursing but would be tantamount to a major setback if he aspired to medical school. Here is a different analogy. In the entire eight years that I worked in ICU I probably worked with over 100 residents. Less than five were from the United States. Stated differently at many medical schools there is little (if any preference) given to US citizens. Thus, you are competing not just with the "best of the United States" but in many cases are competing with "the best in the world". Nursing schools by contrast are less daunting in admission standards. I go back to my original assertion that for most the decision to "go to medical school" should occur at about the same age that someone might aspire to "go to the Olympics" even high school is a "bit" late in the game to have the best chance at success.
Also, as to my assertion that I sometimes obtain results that "top notch" places fail to achieve with my clients. If it is true (and it is certainly anecdotal and equally possible that I fail to achieve equal results on other clients that could be obtained from a competent psychiatrist) it is because I attempt approaches like SAMe and Standardized Lavender extract, Omega three fatty acids, strength training, early morning light, and other integrative approaches which have reasonable evidence for efficacy in challenges like MDD, GAD and Bipolar (save SAMe which can precipitate mania in undiagnosed bipolar). Many if not most psychiatrists often do not strongly endorse these approaches in favor of more purely pharmacological approaches.
I think this article illustrates just how hard it is to get in to Medical school
https://www.savvypremed.com/blog/why-is-it-so-damn-hard-to-get-into-medical-school , let alone successfully matriculate. My son (aged 19) was homeschooled and scored a 1500 SAT score (around 97th percentile), and had never received anything less than an "A" before taking college level Anatomy. He is currently struggling to maintain a "B" in the course. This is "marginal" for his ambition to go to UCF nursing but would be tantamount to a major setback if he aspired to medical school. Here is a different analogy. In the entire eight years that I worked in ICU I probably worked with over 100 residents. Less than five were from the United States. Stated differently at many medical schools there is little (if any preference) given to US citizens. Thus, you are competing not just with the "best of the United States" but in many cases are competing with "the best in the world". Nursing schools by contrast are less daunting in admission standards. I go back to my original assertion that for most the decision to "go to medical school" should occur at about the same age that someone might aspire to "go to the Olympics" even high school is a "bit" late in the game to have the best chance at success.
Also, as to my assertion that I sometimes obtain results that "top notch" places fail to achieve with my clients. If it is true (and it is certainly anecdotal and equally possible that I fail to achieve equal results on other clients that could be obtained from a competent psychiatrist) it is because I attempt approaches like SAMe and Standardized Lavender extract, Omega three fatty acids, strength training, early morning light, and other integrative approaches which have reasonable evidence for efficacy in challenges like MDD, GAD and Bipolar (save SAMe which can precipitate mania in undiagnosed bipolar). Many if not most psychiatrists often do not strongly endorse these approaches in favor of more purely pharmacological approaches.
For a long time, there were more residency slots than residents (It is now just about at equilibrium with a projected surplus of residents in the mid 2020's). There were some residency disciplines that were highly competitive and would fill, but most residencies would not. I can see how an international graduate would have matched into one of these positions. Internal medicine was one of these residencies, but internal medicine is necessary for many fellowships (cardiology, GI, critical care, etc.). I mentioned previously that residency was the great equalizer. Once in post-graduate training, show what you are made of and write your ticket from there. Now, with medical school class sizes expanding, international graduates are having a more difficult time obtaining a residency.
Most medical school slots and residency slots do not have a preference for non-US international graduates because of all of the additional hurdles these programs have to go through for these candidates.
While medical school is difficult, it is not impossible. Many medical schools look at a variety of factors when offering a seat to someone and grades are just one of them. Looking at the article you wrote, the subject of the article may be having some difficulty due to the transition from homeschooling (lots of individual attention) to college (more self-directed learning).
I am glad your practice is doing well. Many psychiatrists are knowledgeable about CAM (This was part of our pre-clinical curriculum). I can speculate on reasons some may chose to use and and some do not. I have used various CAM treatments for some patients if appropriate, and have achieved varying levels of response.
Everyone's reason for going into medicine is different, so there is no right or wrong answer in regards to if/when to pursue it. If someone opts not to pursue medicine and go the PHMNP or Psych PA route, he/she can still have a great career, income and quality of life. I just encourage people to do their research and make the best decision for his/her circumstances and future goals.
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.
Hi Audrey,
I hope you find satisfaction and personal fulfillment in your academic endeavors. I know your future patients will be well taken care of.
I would argue that your excellent post highlights why most RN's would be ill advised to switch to MD rather than maximize their education via an NP route. With regard to my own scenario I was 38 when I graduated with an RN and did not go back for my NP until I was around 45. I was able to complete the program "part time" in about six years while working an ICU job (and suffering from severe untreated ADHD). At the end of the day I get to see patients from my home office and earn upwards of 300K per year (albeit no benefits), but I could earn more if I charged no show, fees or pursued collections. Let me also say of the seven very dedicated students (from high school) who went in to college desiring to do medical school only ONE graduated and of the other three who "failed" in medical school three left with debts close to or over 100K with few marketable skills. At the very least if you are going "pre med" do so with a degree in something like Chemistry, or Biology rather than "pre med" as this at least offers the prospect of gainful employment if your ultimate plan is not successful. One of the people that I referenced above actually moved to Costa Rica and is in the process of renouncing their American citizenship due to the 100K plus in student loan debt (now in collections) and working as a dive tour guide.
I appreciate your insight. That is the debate I am currently struggling with: to either just bust my butt in the NP field and optimize my own current knowledge and training and accept my decision/path or pursue medical school (and that adds another question of when). I know the latter would be more difficult. I honestly believe (and I feel you would agree) that just getting into medical school would be the most difficult. A PCT (patient care technician) at my hospital told me he applied to 30-40 medical schools with a 3.8 GPA, with I believe a 510 MCAT, and said he interviewed well in the group interviews, and still did not get in to any. That would be my biggest fear, honestly. I guess I would still have a career to fall back on, however.
So, I think now I am just devoting all my energy and time to studying in NP school, doing extra and trying to fill in any gaps I can. Thanks for your responses.
For a long time, there were more residency slots than residents (It is now just about at equilibrium with a projected surplus of residents in the mid 2020's). There were some residency disciplines that were highly competitive and would fill, but most residencies would not. I can see how an international graduate would have matched into one of these positions. Internal medicine was one of these residencies, but internal medicine is necessary for many fellowships (cardiology, GI, critical care, etc.). I mentioned previously that residency was the great equalizer. Once in post-graduate training, show what you are made of and write your ticket from there. Now, with medical school class sizes expanding, international graduates are having a more difficult time obtaining a residency.
Most medical school slots and residency slots do not have a preference for non-US international graduates because of all of the additional hurdles these programs have to go through for these candidates.
While medical school is difficult, it is not impossible. Many medical schools look at a variety of factors when offering a seat to someone and grades are just one of them. Looking at the article you wrote, the subject of the article may be having some difficulty due to the transition from homeschooling (lots of individual attention) to college (more self-directed learning).
I am glad your practice is doing well. Many psychiatrists are knowledgeable about CAM (This was part of our pre-clinical curriculum). I can speculate on reasons some may chose to use and and some do not. I have used various CAM treatments for some patients if appropriate, and have achieved varying levels of response.
Everyone's reason for going into medicine is different, so there is no right or wrong answer in regards to if/when to pursue it. If someone opts not to pursue medicine and go the PHMNP or Psych PA route, he/she can still have a great career, income and quality of life. I just encourage people to do their research and make the best decision for his/her circumstances and future goals.
Thank you so much for your explanation and guidance. Your response highlights why medicine seems more intricate and thorough due to the extensive education and training you explained. I feel I am not getting that with the program I chose.
As you mentioned not being able to work, I see so many NP students working full time as an RN and full time school. I do not understand how this is even allowed. I am part time in work and in school and am still cramming in all of the material we are presented in our 7 week courses while trying to do clinical. Working not only takes away potential study days, but it adds to mental and physical stress/demand that can be positively given toward learning and training.
I truly believe getting into medical school would be the most exhausting and largest barrier for me. Once in, I do not doubt my ability to learn the material (which it will help coming from NP), study it, and apply myself through a whole program. As I stated above, I know people who had great grades, MCAT scores, letters of recommendation, etc. that had a very difficult time getting in. I believe getting an acceptance letter is more out of one's control than it is excelling in medical school and finishing all the way through residency. That's just how I see it, though. I could be completely wrong, because I have not (obviously) gone through medical school. I know it is extremely tough.
Thank you again for your conversation. Good luck in your psychiatry career. It's nice to get perspective from the physician side.
Thank you so much for your explanation and guidance. Your response highlights why medicine seems more intricate and thorough due to the extensive education and training you explained. I feel I am not getting that with the program I chose.
As you mentioned not being able to work, I see so many NP students working full time as an RN and full time school. I do not understand how this is even allowed. I am part time in work and in school and am still cramming in all of the material we are presented in our 7 week courses while trying to do clinical. Working not only takes away potential study days, but it adds to mental and physical stress/demand that can be positively given toward learning and training.
I truly believe getting into medical school would be the most exhausting and largest barrier for me. Once in, I do not doubt my ability to learn the material (which it will help coming from NP), study it, and apply myself through a whole program. As I stated above, I know people who had great grades, MCAT scores, letters of recommendation, etc. that had a very difficult time getting in. I believe getting an acceptance letter is more out of one's control than it is excelling in medical school and finishing all the way through residency. That's just how I see it, though. I could be completely wrong, because I have not (obviously) gone through medical school. I know it is extremely tough.
Thank you again for your conversation. Good luck in your psychiatry career. It's nice to get perspective from the physician side.
I for one am grateful that I was able to go to NP school and work. Had this not been allowed I would not have been able to go back to school and many of the clients that I serve would still be looking for a provider.
I for one am grateful that I was able to go to NP school and work. Had this not been allowed I would not have been able to go back to school and many of the clients that I serve would still be looking for a provider.
Yes I understand that is the way many people are able to do it, yet many people are full time students full time nurses. I just don't see how you can learn the material while working 36-40 hours a week. Maybe during the fluff classes where learning that content is less pertinent to becoming a provider (which is about a year of classes in many NP programs). Just my viewpoint... I am sure some students can make it work just fine.
Yes I understand that is the way many people are able to do it, yet many people are full time students full time nurses. I just don't see how you can learn the material while working 36-40 hours a week. Maybe during the fluff classes where learning that content is less pertinent to becoming a provider (which is about a year of classes in many NP programs). Just my viewpoint... I am sure some students can make it work just fine.
Everyone is unique. In my case I completed the Masters program over five years instead of advised two or three. In addition, during the last two years I only worked 24 hours. Also, I read all of the text books cover to cover at least twice before taking the classes. Also, I read complementary texts such as Harrison's Guide to Internal Medicine and Kaplan and Sadock's Synopisis of Psychiatry and virtually every Lecturio.com video lecture, along with most of the material at Boards and Beyond before even starting the program. Thus, most of the course material was 'review" and yet still challenging given the extreme nature of my untreated ADHD and limited time. I say let people learn in the way most beneficial and conducive to their situation and goals.
myoglobin, ASN, BSN, MSN
1,453 Posts
I would argue that your excellent post highlights why most RN's would be ill advised to switch to MD rather than maximize their education via an NP route. With regard to my own scenario I was 38 when I graduated with an RN and did not go back for my NP until I was around 45. I was able to complete the program "part time" in about six years while working an ICU job (and suffering from severe untreated ADHD). At the end of the day I get to see patients from my home office and earn upwards of 300K per year (albeit no benefits), but I could earn more if I charged no show, fees or pursued collections. Let me also say of the seven very dedicated students (from high school) who went in to college desiring to do medical school only ONE graduated and of the other three who "failed" in medical school three left with debts close to or over 100K with few marketable skills. At the very least if you are going "pre med" do so with a degree in something like Chemistry, or Biology rather than "pre med" as this at least offers the prospect of gainful employment if your ultimate plan is not successful. One of the people that I referenced above actually moved to Costa Rica and is in the process of renouncing their American citizenship due to the 100K plus in student loan debt (now in collections) and working as a dive tour guide.