NP vs PA

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Hi , I'm a 19 year old VN student going to the 3 month of school now. My ultímate goal is to the an MD , however That is kind of imposible due to my financial status. I live on my own in McAllen Texas and my parents live at Mexico, so everything i do is on my own. As I said I want to become an MD but due to the money I find that option out of my league but one of my main reason to become an MD is to be the boss , not to be bossing around or anything like that but to help other by having the full experience of the medical experience. I thrive on the moral

Concept of respect and honestly that is one of the reason I want to be an MD. However , not everything is possible so i want to know what is better : an NP or PA? Better in the sense that I can get the full experience in a hospital, that I can be practicing in a hospital without being under someone that much? I need all the pros and cons. Thank you!

Specializes in Critical Care Transport.

Larry I think you misinterpreted what elkpark was trying to say. Yes, a nursing license and BSN are required to begin an NP program. However, that doesn't mean each candidate applying has professional experience working as an RN. For example, someone who holds a business degree decides to enter the nursing field can apply for a dirent entry MSN program with an NP focus. 12 months into the program and the BSN and RN license can be obtained and then the NP education begins. Another 18-24 months and the student graduates with an MSN and eligible for certification exams. So, yes, a nursing background is required, but by no means does it have to be extensive. This is similar to the PA education model as others enter with unrelated degrees. There is still a requirement for direct patient care which continues to be forgotten or overseen when posting on this subject.

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Specializes in Critical Care; Recovery.
This isn't true. There are scads of the so-called "direct entry" NP programs for people who already have a BA/BS in another discipline, but no nursing background or experience, and graduate them two or three years later as an NP. There are plenty of people with an undergrad degree in history, or anything else (when I was in grad school, some of the direct-entry students at the school had undergrad degrees in French literature), and a few prerequisite courses, who are getting into and completing direct-entry NP programs, exactly the same as the PA programs. These programs are incredibly popular (just look around this site). You can no longer assume that NPs had a nursing license or any nursing experience before becoming NPs.

I was responding to this PP who said "you can no longer assume that NPs had a nursing license" "before becoming NPs. I 'm arguing that completing a rigorous accelerated nursing program and passing the NCLEX is an accomplishment within itself. If there direct entry nursing programs that do not require a "nursing license" prior to direct entry, I am not aware of them and would like a citation to prove this.

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Specializes in Critical Care; Recovery.

Also my assumption is that most people will work as a nurse for the 2 or more years it takes to complete these direct entry programs, unless the have some serious financial support.

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I was responding to this PP who said "you can no longer assume that NPs had a nursing license" "before becoming NPs. I 'm arguing that completing a rigorous accelerated nursing program and passing the NCLEX is an accomplishment within itself. If there direct entry nursing programs that do not require a "nursing license" prior to direct entry, I am not aware of them and would like a citation to prove this.

The program I attended (as a traditional, experienced-RN student) has a direct-entry track as well as a traditional track. The direct entry students do 12 mos (one calendar year) of basic nursing education and then join the traditional students in the two years of the MSN specialty classes. The program does NOT award a BSN at any point in the process. The direct-entry students do not sit the NCLEX (are not eligible to sit the NCLEX) until the end of their second year (the first year of the MSN specialty track), so they aren't even able to pursue employment as an RN until the final year of the program. And, when I was there, none of the direct-entry students I knew were working as RNs, even after they were licensed. They had no intention of ever working as RNs (we had conversations about this, and I heard this frequently); they specifically went to a direct-entry program because they were (only) interested in advanced practice nursing.

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Specializes in Critical Care; Recovery.
The program I attended (as a traditional, experienced-RN student) has a direct-entry track as well as a traditional track. The direct entry students do 12 mos (one calendar year) of basic nursing education and then join the traditional students in the two years of the MSN specialty classes. The program does NOT award a BSN at any point in the process. The direct-entry students do not sit the NCLEX (are not eligible to sit the NCLEX) until the end of their second year (the first year of the MSN specialty track), so they aren't even able to pursue employment as an RN until the final year of the program. And, when I was there, none of the direct-entry students I knew were working as RNs, even after they were licensed. They had no intention of ever working as RNs (we had conversations about this, and I heard this frequently); they specifically went to a direct-entry program because they were (only) interested in advanced practice nursing.

Fair enough. What program did you attend?

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Hello CalderonLuis,

Although I am not an NP or a PA and thus cannot comment on the actual job description, I did look into both program routes. I hope you find this information helpful.

All PA schools require a bachelor's degree and most require at least 6-12mo of hands on clinical experience (500 hrs+, some schools 2000-5000 hrs). The pre-med counselor at my school said that generally they value EMT more than CNA experience, but I'm sure it depends on the school and the application overall. PA programs that I've looked into range from 2-3 years.

Now onto NPs. As others have mentioned, there are direct entry programs for those who have a non-nursing bachelors. The first part of the program (usually a bit over a year) will allow you to sit for the NCLEX exam. Some programs give a BSN while others simply an RN license. Then students go onto the Masters portion of the program. Columbia and a university in Seattle, WA (the name of which escapes me at the moment) have 2 year programs (total).

There are also direct entry programs for students who do not have a bachelors at all, but are RNs. I do not know how long these programs are, but I don't imagine they're more than 2-3 years. There are fewer schools that offer such programs, but they're out there!

So, potentially you could get your VN license and work as a VN while completing Associates in nursing, and then work while you attend a direct entry program for RNs. That may be the fastest route.

As for autonomy, there are 18 states that allow NPs to practice independently after working a certain number of hours.

https://www.aanp.org/legislation-regulation/state-legislation-regulation/state-practice-environment

There are people who become doctors after working as NPs or PAs, but of course most people do the traditional med school rote: bachelors and then med school. I'm sure that if you talk to several NPs and PAs, most would say they were happy with their decision and are glad they did not go to med school. There is a PA in my town that owns a practice and employs an MD. There are NPs that have their own practices, too (with and without MDs).

Remember that this is a nursing forum, so you may get different responses than you would on a different site.

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After reading your question, I believe you still have the choice and chance to become an MD. First of all, have you taken any college courses that can be used for an undergraduate degree such as biology, English, etc? You are young which is in your favor and there are many pathways to becoming a physician if that is your goal. I would suggest speaking with NPs and PAs both ( without telling the other you are considering both professions). Ask people ( MDs, PAs, and NPs) if they are happy and satisfied with their career choice. Best of luck!

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Specializes in Cardiac (adult), CC, Peds, MH/Substance.

A few things:

MD PhD program was mentioned. If you have a 4.0 GPA from a decent undergrad school, that may be an option. Those programs are extremely competitive; the ones I looked at make med schools look easy to get into.

If that's not an option for you, you may consider federal programs to pay for med school. Military branches have programs that will pay for med school, as does U.S. Public Health Service Home . Do some googling.

If you're choosing between NP and PA, it depends on your background. If you get a BSN at some point, NP is the obvious choice. It'll be faster and more appropriate for your experience. If you work as an LPN while getting "some other" BS degree, IE biology or microbiology, then the PA route may be faster/easier (most likely will be). If you work in primary care, the job is "basically" the same. Some will tell you that NPs have more ability to do different things, but I think unless you're trying to go out on your own (and only in certain states could you), that either PA or NP would be satisfying. Consider also that for NP or PA, you may only see your medical oversight (DO/MD) once a week or month in certain jobs, and that they're basically signing paperwork after the fact because they trust you, not looking over your shoulder.

I'd recommend talking to some current NPs and PAs in your state/locale, and get their experiences.

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Specializes in Cardiac (adult), CC, Peds, MH/Substance.

I just noticed that you're in Texas. Check out TWU's RN to MSN program. There are two routes: Route one, you are an RN, and apply to their RN to MSN program. Route two, you are an RN with an undergraduate degree in anything which is not nursing. Both routes are faster than doing an LVN program, then an LVN-RN bridge program, then an RN-BSN program, then an MSN program. While TWU is located in the Dallas area, you can do the classroom portion online. There are plenty of online LVN-ADN/BSN RN programs that are accomplished in a whole lot of different ways. I think based on my research so far, that an LVN-ADN bridge program, then RN-MSN program would be the fastest. Keep in mind to look at the requirements though. There are a bunch of LVN-RN programs in South Texas. I'm not sure about RN-MSN(NP) programs, but TWU definitely has one.

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Specializes in Family Practice.

It is what the title implies Physician assistant. Nurse practitioner is no assistant to anyone but herself. Yes, as a NP you will corroborate with MDs and refer clients that will be beyond your scope but NPs can treat write prescriptions without a signature from the MD at least in California.

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Specializes in Cardiac (adult), CC, Peds, MH/Substance.

In Texas, it depends on the medication. For example, if it requires triplicate, NPs can't write for it. Most things they can though. Both NPs and PAs in Texas are required to have a supervising position, but what "supervising" means varies with direct proportionality to how much trust there is between the NP/PA and the MD/DO. Most of the NPs/PAs I know just do their thing without anyone telling them what to do very often.

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