NP vs PA Education

pro-student · Oct 5, 2018

NP education is much more variable than PA programs but, as you pointed out, there is much less focus on the sciences. That being said, your education is largely what you make of it. One can readily go through PA school and forget a fair amount of what they learned after they take exams. One can go to NP school and invest extra time and effort on areas like pathophys and pharm. Some NP programs have excellent courses in pathophys and pharm include involving physicians and pharmacists in these courses. Even if your school doesn't, there are no shortage of resources you can consult to bolster you own learning if you are unsatisfied with level of coverage in your program. Any reputable NP program with do a decent job preparing you to practice but you, as the student, are honestly the biggest variable especially in terms of how much you put into you education. I hope that help, Best of luck with your choice!

Rocknurse, MSN, APRN, NP · Oct 5, 2018

It's not so much an NP vs PA debate but more the school you decide to attend. I chose to go to a well respected bricks and mortar acute program and the education I'm getting is absolutely stellar. This semester we've had nothing but intensive disease management which requires me to learn in-depth pathophysiology. For example, this semester so far we've heavily concentrated on shock, both the pathophysiology of it and the management of it, vasopressors, ventilator management, learning to read x-rays proficiently and the mechanism of delivery of oxygen to the tissues. There's been zero fluff this semester and I'm loving it. We also have several classes shared with the medical students. I have absolute faith in the content I'm learning and have been able to apply it in my clinicals in the ICU. Pick a really good program and you'll get everything you need.

trackhead, APRN · Oct 5, 2018

Good to here, thx.

Jules A, MSN · Oct 5, 2018

This semester we've had nothing but intensive disease management which requires me to learn in-depth pathophysiology. For example, this semester so far we've heavily concentrated on shock, both the pathophysiology of it and the management of it, vasopressors, ventilator management, learning to read x-rays proficiently and the mechanism of delivery of oxygen to the tissues. There's been zero fluff this semester and I'm loving it.

Seriously jealous and while I have no experience with ACNP programs the highly regarded state universities I attended for my PMH-NP and FNP were both light. If I were doing it to work in any other specialty than psych I would have more faith in the PA curriculum.

OP I'm always curious when someone has already made up their mind, has been accepted and lists all the reasons why they have to be a NP would then post what usually ends up as a controversial thread?

lwsoccjs · Oct 6, 2018

Seriously jealous and while I have no experience with ACNP programs the highly regarded state universities I attended for my PMH-NP and FNP were both light. If I were doing it to work in any other specialty than psych I would have more faith in the PA curriculum.
OP I'm always curious when someone has already made up their mind, has been accepted and lists all the reasons why they have to be a NP would then post what usually ends up as a controversial thread?

I suppose to stir the pot lol. Or having second thoughts even though it has been stated that the decision is already made. Or lastly to hopefully sleep better at night, from possibly hearing an echo chamber concerning ones decision. Either way I do not believe the "study harder" to make up for the lack of NP curriculum is acceptable. Good luck with your decision.

Dodongo, APRN, NP · Oct 7, 2018

Either way I do not believe the "study harder" to make up for the lack of NP curriculum is acceptable.

I hate when people say this. "NP education sucks - oh well - it's up to you to teach yourself! NBD!" WTF. That's unacceptable. Because for every 1 student that does read more and do more clinical hours, there's 20 or more that don't and they come out as a crappy, know nothing loser that makes us all look bad. Choose a good school. And become politically active to try and raise the bar for NP education. We need to close down the for profit schools.

trackhead, APRN · Oct 7, 2018

I have a kid in school, no PA school locally, and I don't want to pull my kid from his school and relocated.

I'm not stirring a pot. I have worked with a bunch of awesome NP's over the years in the ED.

Just curious......

Advanced Practice Columnist / Guide · Oct 7, 2018

I didn't attend an FNP program but like you, I had significant experience as an RN at the bedside working in Med-Surg, ICU, and ED. When I was attending my Adult ACNP program, many of the courses were presented as if students already knew the basics. Of all the courses, Pathophysiology was the only course that took me back to the science basics on a cellular level.

Pharmacology was presented with the assumption that we already know the pharmacodynamics of the medications as acute care nurses administering these everyday in the hospitalized patients we take care of. The added layer of training is in assessing the evidence supporting the efficacy of certain agents for specific conditions and approved national and organizational guidelines on their use. Advanced health assessment focused more on differential diagnosis and interpretation of diagnostic tests and procedures not just doing a physical exam.

The whole year of clinicals is where the "real world" NP training happens. This is where you should be careful not to fall into the trap of finding your own clinical placements, being paired with a novice NP, or being assigned to a less than ideal practice setting where your learning will not be sufficient. Like other posters have pointed out, NP training can be variable and some schools are allowed to operate with less than a bare minimum of resources to offer the kind of exposure that will prepare you as future NP.

I think you have to be clear what your goals and expectations are with NP training. NP's have a compartmentalized model of training - you won't get a generalist education because you have to pick a specialty area of NP education. You have decided on the FNP knowing that each of the NP tracks have their own limitations. That's a fact. You won't expect exposure to Psych, ICU, acutely sick kids in this program. You won't have much, if any in-patient rotations at all.

That said, you can't expect to reasonably come out being able to work anywhere you want like a PA does. Both PA's and NP's come out of school as novices but PA's have the advantage of the generalist training.

Jules A, MSN · Oct 8, 2018

So my question for those of you who had similar backgrounds with a lot of prior experience as an RN, did you feel your FNP program prepared you for your job role? I realize it takes time to achieve, which is no different than when I was a new medic or RN. Just curious how the transition was for those with a fair bit of prior RN experience.
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I felt more prepared for my psych np because that was where my experience was heavy as a RN but still felt shortchanged by my well respected brick and mortar state university. In addition to the value I place on RN experience my clinical experiences were excellent possibly because they were done where I wanted to work and I selected physicians I knew and respected. Fortunately they allowed us to line up our own clinicals because their preceptors who were largely alum with 2 seconds worth of NP experience didn't impress me.

stephadler82, BSN · Jun 30, 2020

On 10/5/2018 at 7:15 AM, Rocknurse said:
It's not so much an NP vs PA debate but more the school you decide to attend. I chose to go to a well respected bricks and mortar acute program and the education I'm getting is absolutely stellar. This semester we've had nothing but intensive disease management which requires me to learn in-depth pathophysiology. For example, this semester so far we've heavily concentrated on shock, both the pathophysiology of it and the management of it, vasopressors, ventilator management, learning to read x-rays proficiently and the mechanism of delivery of oxygen to the tissues. There's been zero fluff this semester and I'm loving it. We also have several classes shared with the medical students. I have absolute faith in the content I'm learning and have been able to apply it in my clinicals in the ICU. Pick a really good program and you'll get everything you need.

WOW!! What program are you in?