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PMHNP Vs. Psychiatry MD

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My question is for Psych NPs. If you could do it again would you go the NP route or go through med school and become a psychiatrist? I have an undergrad in psych and a nursing degree so the most obvious path would be PMHNP. However, with the bar being so low for getting into NP school I fear that this area will easily become over saturated as so many other areas have become. I would also think that having an MD opens more doors. Do you feel like you have ample opportunities or do you feel like you'd have more in you were a psychiatrist? Thanks for you input!

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TheSquire has 9 years experience as a DNP, EMT-B, APN, NP and specializes in Urgent Care NP, Emergency Nursing, Camp Nursing.

1,248 Posts; 14,351 Profile Views

Not a PMHNP, but: how old are you?  Are you willing to devote 7+ years of your life towards med school and residency?

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5 Posts; 110 Profile Views

I'm in my 30's, so not ideal. But if taking the long and more difficult path of med school leads to greater job satisfaction, more opportunities, and a higher income, then yes, I'm willing to do it. I don't want to go through NP school (the path of least resistance) only to deal with over-saturation and frustration, and regretting my choice later on. 

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FullGlass has 2 years experience as a BSN, MSN, NP and specializes in Adult and Geriatric Primary Care.

8 Followers; 2 Articles; 1,065 Posts; 10,201 Profile Views

There is an acute shortage of mental health providers in many parts of the US.  I'm in California and pretty much the entire Western US needs mental health providers.

30s is not too old for med school.  One of my friends started med school in his mid 30s and is now a doctor.

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Neo Soldier has 5 years experience as a BSN, RN.

1 Follower; 360 Posts; 4,818 Profile Views

You could get a doctorate and have a DNP. If you're willing to devote 8+ years to become an MD, I guess you could go for it. I don't know your situation and I can't say how realistic it is to tell you to start med school. 

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babyNP. has 12 years experience as a APRN and specializes in NICU.

2 Followers; 1,842 Posts; 28,150 Profile Views

I would encourage you to go to NP school rather than MD school unless you really have your heart set on MD school. The debt load for MDs is staggering (think upwards of a quarter of a million dollars) and there is an acute shortage of all psych providers so I don't think you'll see a saturation. Bonus if you can work an independent practice state- of which there are more and more every few years.

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FullGlass has 2 years experience as a BSN, MSN, NP and specializes in Adult and Geriatric Primary Care.

8 Followers; 2 Articles; 1,065 Posts; 10,201 Profile Views

If you really want to be a doctor, then go for it.  I started nursing school at age 53 and became an NP at 57.  Honestly, if I had been younger, I would have gone to med school.  I would say 45 years old or younger, I would have gone to med school.

One of the good things about psych is that it's easy and cheap to have an office - no special equipment and no staff needed.  In a large city, an established psychiatrist can easily make $400K to $600K per year.  Even working for a clinic, a shrink should be making at least $300K.

As a doctor, you don't have to worry about whether the state is independent practice or not.  

As for student debt, there are Scholarships available and there are also loan repayment programs.  Some employers also offer loan repayment.  Check out the NHSC and many states have equivalent scholarships and loan repayment.  The VA offers loan repayment.  Another option is join the military and have them pay for med school.

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umbdude has 3 years experience as a BSN, RN and specializes in Psych/Mental Health.

2 Followers; 994 Posts; 14,547 Profile Views

Same here...I would have chosen to apply MD or DO schools if I were in my early-to-mid 30s without any hesitation. It's not even for those "hard science" courses, but for that 4-year residency. It's true that med school is stressful, but psychiatry residency is known to provide good work/life balance and residents get paid fairly well. 

Psychiatrists do make very good money and they have enormous power at wherever they work. That is generally not the case for PMHNPs.

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beachbabe86 has 20 years experience and specializes in Oceanfront Living.

75 Posts; 303 Profile Views

please look at going to med school.  I have 2 daughters that have gone that route.  There are so many Scholarships available.  Both my daughters graduated debt free.

Best of luck to you! 

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149 Posts; 351 Profile Views

On 2/14/2020 at 4:29 PM, umbdude said:

Same here...I would have chosen to apply MD or DO schools if I were in my early-to-mid 30s without any hesitation. It's not even for those "hard science" courses, but for that 4-year residency. It's true that med school is stressful, but psychiatry residency is known to provide good work/life balance and residents get paid fairly well. 

Psychiatrists do make very good money and they have enormous power at wherever they work. That is generally not the case for PMHNPs.

One of my friends is a psych resident and probably works 30hr a week minus on IM Ward months 

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2 Followers; 180 Posts; 3,686 Profile Views

This whole "oversaturated" argument is becoming tired IMHO...

For the love of Goddess, nurses, if you want to get into the field of nursing and specialize with your advanced practice degree because you are passionate about it, DO IT!

Stop using the excuse that the market is saturated and therefore you can't or won't do what you love. I never hear physicians saying this, and I'll argue that in certain parts of the country, therr are oversaturated pediatricians, psychiatrists, etc...

Look, if you follow the trends as it relates to APRNs, phmhnp has hardly ever been considered a saturated field.

I'll get off my soap box now. It just seems like every other post now is using this oversaturated market arguement convince themselves or others not to pursue what they want.

Pursue what you love and doors will open for you. It's really that simple.

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adammRN has 11 years experience and specializes in DNP/PMHNP student.

278 Posts; 5,250 Profile Views

I am almost done with my DNP w/ sublet of PMHNP. 100% fact is that this market is far from over-saturated. There is insane need in a big cities. Almost all the psych providers know each other by name and they have back loads of patients. We have epidemic levels of mental health problems in the US. 

This coupled with the fact that some states allow complete independence, and IOWA for ex reimbursing 100% of MD rates for Fed insurance sells it. I think in the future this will get better and more states will convert to independent practice.  We just need to compile evidence our outcomes are just as good as MD. 

If I were younger and had to do it over I would have done MD, if I knew I was gonna spend 8 years in college and I entered the service, which has HPSP Scholarship. It would have been a no brainer. However, PMHNP is a great deal, esp when if you want to work as hard as a doctor you can and if you get PRN work on the side you can do 200k. I am in an independent practice with an NP and she grossed 300+k last year minus business expenses. With PLLC partners she would prob take home more. 

Edited by adammRN

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