Pharmacist to PMHNP

Miss PsychNP · Feb 6, 2014

I am a 50 year-old male pharmacist (PharmD). I completed a BS in Biological Sciences from UC Davis in 1987. When I graduated in 1991 (from University of Southern California), the demand for pharmacists was very high due to a shortage; for that reason, I did not complete a pharmacy residency program. Over the next 13 years, I went to work in traditional areas of pharmacy. I consider myself a forward thinker and innovator, seeking to make new trails and follow my dreams. In 2003, the only way I saw this vision possible was to start my own pharmacy. Granted, I made this decision not knowing about the future existence of Medicare Part D (drug benefit).
I had the pharmacy for 10 years; it had to close due to personal health and financial business reasons. Unfortunately, part of these personal health issues resulted from working 60+ hours a week both practicing pharmacy and keeping the business afloat; thus, it interfered with my competent practice of pharmacy and thus led to its closing in November 2013. The board of pharmacy had to step in and take action. Soon after, my therapy team and I realized the situation was the problem, and not anything inherently wrong with me.
While going through my mental health treatment, I often thought about becoming a nurse practitioner if I could accomplish that without getting the RN degree first. I have always wanted to do more with my pharmacy degree since graduation, and only NOW (20 years later) has the need for increased scope of practice been recognized. With a surplus of pharmacists in the marketplace, the economical benefits (eg compensation) are diminishing. Yet, the current salary level of a PMHNP seems very comparable to PharmD.
I am looking for something different that will give more gratification that I am helping people and using my clinical skills and knowledge for patients' benefit. I had first-hand experience with the serious shortage of mental health prescribers in my area.
So in that vane, I am considering a career change to become a psychiatric mental health nurse practitioner. I am interested in accelerated programs available online for 'second career track?' folks.
What advice would you have for me?
Soul-searching Pharmacist

You would definitely be an asset...especially in psych. You can completed the second degree program. It sounds like you have the passion and definitely the drive to become a PMHNP. I would look into some schools that you are interested in attending and even talk to some of the PMHNPs that you have interaction with.

zenman · Feb 6, 2014

And yes, with one expensive private school I know that admit 50 students last year and the recent class size increase in local schools, the saturation is possible. if you search the web, you will find out that psychiatry residency slots have increased in the recent years as well.

I still disagree. Slots are up due to demand, but they are not being filled due to supply. Psychiatry is not one of the most competitive positions. Many slots are filled by foreign medical graduates. Many psychiatrists are at or near retirement age plus you have increase need due to aging baby boomers. You also will have increase in demand due to expanded insurance coverage. If you like rural areas you'll be in even more demand. My state would like to double the number of psychiatrists but it would cost millions to do so. One hospital here has 6 psychiatrists and wants 14 fulltime ones. Some commnity mentalhealth centers don't even have a psychiatrist. One that I worked with in NM has a director in Virginia who works via Telehealth. Of the 105 counties here, 100 are federally designated as mental health professional shortage areas. At my workplace we need NPs and psychiatrists bad. We have a huge population we can't serve due to lack of staff and have started telehealth from Hawall to try to ease the load. If you do child and adolescent you'll really be in demand. I only do adults and got 3 job calls yesterday. I don't think you have a bleak job outlook.

zmansc, ASN, RN · Feb 6, 2014

I'm not sure that the PA path would be that much shorter after doing a deeper analysis of the two paths. Most PA schools required the pre-reqs to be completed in the past 5-7 yrs when I looked into them. In that case the OP would have to repeat all of the pre-reqs, which might be easy for the OP, but would still take significant time and bring the time for each path to a much closer point.

I have no clue about psych and how PAs are used vs PMHNPs, so I can't help with how the two careers would be different.

harmonizer · Feb 7, 2014

I still disagree with zenman. Psychiatry is a profession that you can work far beyond the retirement age. I know psychiatrists who are still working in their 70s so retirement age is quite irrelevant. Psychiatry slots have been more competitive in the recent years. I have met some medical student grads who were worried about not matching in psychiatry. The demand for psychiatrists either has been or will be alleviated by the prevalence of psych NPs. Sometimes statistics about the shortage of physicians did not take into account the existing psych NP in the areas. When the news talks about they will need such and such numbers of physicians by an arbitrary year, they do not take into account the existence of non-physician providers (NPs). Maybe rural NM or NM is the exception. Most desirable places to live might be doing just fine. I can feel that demand has been relieved. The advertisement for the position I resigned from was taken down within a few weeks. Also they just eliminated one telepsych provider and they successfully demand that they want face-to-face services. Like zenman, I temporarily get calls for job but they are from random states in the country and not local. It is not like you can just relocate easily.

Despite the above, I still encourage OP to enter the profession because of his fantastic background as PharmD. I wish one day NP program will have a very in-depth pharmacology courses like in current pharmd program.

zenman · Feb 7, 2014

I still disagree with zenman. Psychiatry is a profession that you can work far beyond the retirement age. I know psychiatrists who are still working in their 70s so retirement age is quite irrelevant. Psychiatry slots have been more competitive in the recent years. I have met some medical student grads who were worried about not matching in psychiatry. The demand for psychiatrists either has been or will be alleviated by the prevalence of psych NPs. Sometimes statistics about the shortage of physicians did not take into account the existing psych NP in the areas. When the news talks about they will need such and such numbers of physicians by an arbitrary year, they do not take into account the existence of non-physician providers (NPs). Maybe rural NM or NM is the exception. Most desirable places to live might be doing just fine. I can feel that demand has been relieved. The advertisement for the position I resigned from was taken down within a few weeks. Also they just eliminated one telepsych provider and they successfully demand that they want face-to-face services. Like zenman, I temporarily get calls for job but they are from random states in the country and not local. It is not like you can just relocate easily.
Despite the above, I still encourage OP to enter the profession because of his fantastic background as PharmD. I wish one day NP program will have a very in-depth pharmacology courses like in current pharmd program.

Yes, retirement age is not as relevant in psych but dropping out due to frustration with current medical environment is. I'm not in NM; I'm in Kansas. However, I certainly would not call NM a less desirable place to live, especially since they are going on 21 yrs of NP independence. My info is from nationally via our hospital recruiter as well as from forums.

Pick any state and check it out.

http://health.usnews.com/health-news/news/articles/2012/03/30/fewer-us-med-students-choose-psychiatry-report

dgmrph · Feb 8, 2014

Harmonizer -

Are you saying enter as an NP, or as is possible now, as a PA? Some schools would require me to redo A&P as I have been out of school too long for their matriculation requirements. So the year possibly saved as a PA otherwise is now taken up (mostly) with pre-req work. Then, what determines the advantage comes down merely to 1)independence factor, and 2) salary (about 10% difference from what I've read over last couple days). For me, neither are strong to lean me one way or the other (eg. its a toss-up of a decision!)....The ultimate key will be choosing the RIGHT school!

harmonizer · Feb 9, 2014

To answer your question above , dgmrph.

If you are absolutely certain that you want to do psych only, then PMHNP is the preferred route. It is more specialized and recognized in mental health fields in certain states. You will get much more clinical hours for psych in NP program. If you think that you want to branch out and do other things too (surgery, ER, primacy care), my suggestion is to go for PA route. You can also go back for post-graduate certification in FNP after but it will take more time and courses. I don't think there is significant salary difference. In general, for PA route, maybe you can work for more high paying specialty --ER, surgery etc..etc.. but if you just want to do psych, PMHNP route is better.