forpath

That Oceania place is a joke! You don't necessarily have to take the MCAT, there's not a single class on "Healthcare as a Team" or "Advanced Medical Theory" and you can't attend online. What gives?

No reciprocity that I know of. And according to many posts on here, there shouldn't be, as you do completely different things as an NP than you would as an MD. You see, NPs practice nursing, MDs practice medicine. Even when you do the same thing for the patient. It would be hard to argue that credit is due for learning/practicing nursing in an MD curriculum, when that is one of the main tenets of promotion of advanced nursing degrees-that they are an alternative to medicine. Unfortunately, you will have to slog through medical education starting from scratch. It will take you 10 years of training to get back to what you are doing now (4 years med school, 3 years internal medicine residency, 3 years hem/onc fellowship). Assuming you get accepted right away. And you'll be ~150K in the hole.

excellent points. it is not a licensing exam, as it is voluntary. i would presume, however, that there is something more that a dnp learns with respect to clinical practice than is learned in fp school. otherwise, there would be no need for a dnp. if one wanted to achieve a doctorate level in nursing, one could pursue a phd, especially as you have stated that there are people looking to the dnps to provide more research. in addition, there must be more that is learned (or supposed to be learned) as half of the experienced nps who took the exam failed it. if it tested only the stuff they learned as nps (both during school and on the job), one would presume all would have passed. keep in mind that this test was, as you stated, designed for these nurses based on their program of study. and as it was the first test offered, one would think that mundinger would have motivation to see the test was fairly constructed. i just have a hard time rectifying the results with respect to clinical capacity. if the dnp is going to be offered, there has to be a standardized assessment of their knowledge. every doctorate level has it, and they should be no different. as i said before, there has to be a metric by which you compare all practitioners, at least on paper, and this metric, in my opinion, should be a knowledge based test. if you cannot pass, you cannot practice. the trouble, however, lies with the fact that there is probably very little difference between what an np does everyday and what a dnp does everyday. you probably cannot stop a licensed np from practicing when he/she cannot pass the dnp exam. so this all goes back to what a lot of people have said, why even have the dnp when there is a phd and an nd already developed? which raises a good question. did nds have licensing exams different from nps?

so would you go so far as to say that the same would be true of any licensing exam, that they are not worthwhile? why take medical boards, the nclex, the bar exam, sit for phd comps, etc? and how do you ensure that every student is getting an equal educational experience if you do not have a standard metric by which you compare them all? if all 50 nurses passed the exam with flying colors, would you still say the test was not worthwhile or would you say "see? dnps are the bomb."? i think it would be a mistake for the test to go away, as it would damage the image of the profession. "we took the test, half of us failed, so we're not taking that test anymore. it's too hard. but hey, bring us your children and other loved ones." and why would you say that it has no meaning to practicing dnps? it was supposed to measure minimal clinical competence of new dnps (who were experienced nps when they took the test, by the way) and mundinger said it was designed specifically for dnps. if one cannot prove minimal competence on paper (which is based on knowledge), then why should one be able to practice? in my opinion, the failures of this test are incompetent to practice until they pass, and even then they are suspect. how should we measure minimal competence of healthcare practitioners? wait until they kill a few and then let the free market take care of it?

They are already starting to take it... From the ABCC website, "The content of the exam is focused on evidence based clinical care. Clinical evidence is applied to practice by many direct care providers; its application is not limited to the medical discipline. The exam is not intended to test graduates from the diverse DNP models of education, but rather to test clinical competency in comprehensive care for the graduate whose doctoral education is focused on direct clinical care." As you all probably know, 45 experienced NPs with DNPs took the test recently...50% passed. Besides the fact that that is a mathematical impossibility, what do you all think of those results in light of the ABCC's description of what the test is supposed to measure? To me, this means that 50% are incompetent to practice as DNPs and should not be allowed to until they pass, just as MDs/DOs are not allowed to practice until they pass theirs. Some have criticized it as being a physician-aimed test, but Mundinger says the test that was administered was designed especially for APNs.

Has there ever been a study that shows that there are worse patient outcomes when a CNA dispenses meds compared to when a nurse does it? And why should the nursing profession feel entitled to influence another profession and say what is and what isn't within the other profession's scope of practice? In this case, the CNA profession. It just seems so arrogant and I know it is just because of money. When a CNA dispenses meds, she is practicing nurse assistancy, but when a nurse dispenses the same meds, it is nursing. They are completely different things. And so what if nurses had more pharmacology than CNAs in school? I can think of like 4 anecdotal experiences where a CNA is a genius and the nurse under whom she worked was a total idiot. Maybe one doesn't need to go through all the years of nursing school to do what a nurse does. Maybe one can do it all with a CNA in much less time, with fewer tests and less stress. In case you all cannot tell, I am being horribly sarcastic and irreverent. It just struck me as ironic that if one were to replace CNA and medication aid with "DNP" and nurse with "physician" in this discussion, many of you would be on the other side of the argument.

Who's encouraging him/her to go into medicine? It seemed like a good question to ask of someone who already has one doctoral degree. Clearly this person must have considered medicine as a possibility, and they had an answer as to why they wanted to go into advanced nursing instead of medicine...it is the path of less resistance. Not as long, not as many tests, not as much stress. How stressful med school would have been for the OP is unclear, as he/she feels that the 1st 2 years of chiro school are harder than med school. I found that comment to be interesting. I don't know too many physicians who flunked out of chiropractic school. Besides, based on a lot of comments on this board, the world obviously needs great physicians as well.

I imagine your reasons for pursuing an advanced nursing degree instead of going to med school are very similar to many others---Too long, too many tests, too much stress. Again, just curious--how do you know the first 1.5-2 years of chiro school are harder than med school? And if chiro school was so much harder, then it should be much easier going through med school. You may not even need to study.

Just curious...why not med school? And good luck no matter what you do. It's courageous to leave what one does every day.

As far as I know, a DNP is not eligible to take the USMLE and therefore can never pass it, unless he/she goes on to be enrolled in an accredited medical school.

Sure, if you can get congress to pay for it. And obviously, from an absolute perspective, you do not need nearly as much money to fund DNP residencies as you do medical ones. I do not think ceasing the federal funding of medical residencies if DNPs can not get funding is a viable option, especially in this economic climate. You would not be able to fund the training of a significant number of medical trainees, and then, talk about a physician shortage!!

For all the reasons I mentioned above, I completely agree with you. Unfortunately, it obviously has to be something the nursing community does on its own, including lobbying congress for additional funds for post-graduate training. There is simply no way a DNP could enter a medical residency.

So are you insinuating that DNPs should be admitted into medical residency programs?

I am by no means an expert on this particular test, but it was my understanding that the material for the DNP exam was taken from the Step 3 exam, and then altered by the nursing organization administering the exam so that it would be more applicable to what the DNP candidates were taught. So, I'm not sure it was a straight-forward "medical" test the DNP candidates took. Perhaps you feel anyone could become a great provider in primary care given enough time. Of course they could. How much time is enough? 1 year? 10 years? I presume many people, including myself, would likely prefer that they see someone who is, for the most part, beyond the steepest part of their learning curve before they entrust their care to them. But when you speak of specialties (cardiology, ENT, dermatology, pathology, etc), a residency, and for many of us, a fellowship is the only way to gain a minimal level of competence in that specialty before one has to take care of patients or provide pathologic or radiologic diagnoses. Many specialties cannot be covered in medical school (or DNP school) in sufficient detail and therefore post-graduate training is absolutely "precious". I would submit to you that all recent med school and DNP grads are minimally competent to practice medicine and nursing, respectively. The major difference is, MDs/DOs are forced to undergo additional rigorous training (~60-120 hours/week) in residency/fellowship and then take additional board exams before they are allowed to care for their own specialty patients, whereas DNPs can be simply released on the general populace without supervision in a number of states and with minimal supervision in many others. So yes, in the medical model, a residency does make or break a provider in terms of specialties. Anyway you look at it, there is a steep learning curve following graduation for both professionals, the difference is, in the medical model, there is someone who is intensely looking over the shoulder of the medical graduate. The same can simply not be said about the nursing model in a number of settings. Don't get me wrong, I also feel very strongly that a 3 year family practice residency is not nearly enough training to take care of the exceedingly broad needs of the patients in their panel. If one honestly feels that they know enough to competently practice psychiatry, pediatrics, OB/Gyn, dermatology, internal medicine (including its subspecialties, like endocrine, cards, etc) and some others after only 3 years of residency, then they are way smarter and more confident in their abilities than I am. And if one thinks they can do it after only 4 years of school (MD/DO or DNP), well, you get my point.

Although I am not the original poster, I was lurking on this thread. MDs/DOs are not eligible to take NCLEX (or even a watered-down version of it), and so there would be no statistics available to answer your question.