NP vs. PA

I have often thought I would love to be an NP specializing in adult and geriatric health, since I've been a nurse for over 17 years now that has been 95% adult/geriatric. However, I have a friend who is currently studying to be a physician's assistant, although she has no nursing background. All I have right now is some classes towards my BSN...which one would be less time consuming and/or cost less to do?

Thanks and blessings, Michelle

Part of it depends on how you can relocate. Potentially as a PA student you could do one of the few remaining AS or cert programs. They tend to be inexpensive but very selective and demand large amounts of HCE (I would think 17 years would certainly qualifies). The other issue is the DNP by the time you get to looking at NP school. This would potentially add a year or more to your plans.

For a more traditional approach you could get your pre-reqs done in a year or two with a bachelors you could potentially be done with PA school in 3-4 years. BSN would take at least a year, plus 2-3 years for NP plus potentially 1-2 years for DNP.

As far as cost, with most PA schools you won't be working for two years. That adds to cost which you mostly have to take out in loans. On the other hand opportunity cost is a real cost.

For example the average nursing salary in MO (the OPs home state per the info button) is $51k.from here:

http://www.missouristate.edu/nursing/21882.htm

2 years for a BSN $11k

http://www.missouristate.edu/registrar/52654.htm

The FNP there would be around $11k and takes 2 years.

So total for FNP is around $22k

So for four years someone would make $220k -$22k or a total of $198k. Then that person would make an average of $70k per year.

PA would be one year or more of undergrad to get a bachelors. The cost of PA school is $17k. The cost of living is variable but lets say $18k per year. Total cost of education is going to be around $53k with no income so after three years you are at $51k - 53k so the total cost of this if three years is -$2k. Average PA salary is $88k from here:

http://www.aapa.org/images/stories/Data_2009/2009aapacensuswestnorthcentralreport.pdf

So at the end of four years the PA would be at $$86k.

Now there are a lot of assumptions here. For example this assumes that you can work full time through NP school. You can find posts on this both ways. Some people have no problem, some people have gone to part time or stopped working. It also makes assumptions on how long it would take to complete an NP program and how long it would take to get into a PA program. For example if it took three years to complete a PA program and six years to complete an NP program part time the earning results would look like this

PA six years: $262

NP six years part time: $134k.

Going straight into a PA program would net someone an extra $130k after six years.

On the other hand if it took three years to do a RN- NP program and four years to complete a Bachelors plus PA program it would look like this

PA four year: $49k

NP four year: $215k

So at the end of four years the NP would be $166k ahead.

For someone who has a bachelors PA school will almost always have less opportunity cost (assuming automatic admission to PA school). For someone with a bachelors in nursing NP will almost always have less opportunity cost. For someone with an RN but no BSN it will depend but generally will favor NP (the greater the difference between PA and RN salary the less the opportunity cost). Of course this also depends on the local RN job market among other things.

For the OP the best bet is probably a RN - MSN program. That will get the desired result the quickest. As has been discussed on this board multiple times, it also depends on the local market (ie if a particular provider is preferred) and what the local or regional job market is.

David Carpenter, PA-C