viola900

the md i was talking to was talking about the basic education-the first 2 years in meidcal school in particular, but possibly also inlcuding the last 2 yrs, not residencies or practical experiences. i think it would be beneficial to have more practical experiences as well. his point was how much about every detail of science related to the muscle or the eye does a psychiatrist need to know-basically focusing knowledge on the providers area of specialty or area of practice fairly early in a persons training (assuming they know what area they want to go into).

i worked at landstuhl in germany as a civilian nurse and i was there during the navy rotation-all reserves (2008-2009). most people in germany who were deployed were there for at least 1 yr. they could volunteer for longer and some people, i think, had to do a second deployment. have a great deployment, hope you go somewhere cool--germany was really cool. and you can travel all over europe on your days off! hint..hint..

i mentioned in another post that i took the adult pmhnp test in 2007, i also took the new test when ancc was asking for volunteers to take the test so they could get preliminary data about the test. i took the tests about 9 months apart. for the real test for certification i only used the ancc study guide which was online and had a voice recording that was pretty useless, which was also under revision so they only had the old guide, but i just tried to memorize everything in it and everything i could think of related to the topics. i didn't study at all for the second test and we were never told scores. to me the tests were almost exactly the same. there was very little difference, so i wouldn't expect the new test to be any improvement or any more difficult than the last test. (many questions were literally the exact same questions as the old test) my best advice is to read the questions carefully and read questions multiple times, look at all the answers and see how they fit into the question. most of the questions are really badly written, poorly worded, and the most difficulty i had was trying to figure out exactly what they were asking. i felt if i could figure out the question i would know the answer most of the time. some questions were short and straight forward, go through those quickly, but anything with a full sentence or more--read them carefully. i felt pressured for time when taking the test and tried to move quickly bc i was afraid i would run out oftime, but i finished with probably 45 minutes remaining--so, there is time to read and think about the questions--so definitely do this. and yes, i passed first time.

i am a graduate of a direct entry program. i have a masters degree in counseling psychology and wanted to be able to do therapy and medication and so completed a direct entry pmhnp program. many of the students in my program were amazing. i would say half already had masters degrees in psychology or social work. some were newbies and had just graduated with a bach in another area. as far as i can tell all the people who graduated in my class (all pmhnp) are very good at what they do and have same scope of practice as a psychiatrist, are equally good at what they do as nurses who have been in the fiel "for years". if schools pick bright, interested students, the students can learn what is needed regardless of their background experience-this is true for nursing and medicine. i think it is unrealistic to criticize providers based on how long someone has been in the field, either prior to school or after school. people who go into any medical/nursing prgrams are able to learn the material and apply it. med students usually have no previous medical experience either (regarding direct entry students with no previous nursing experince). granted medical students get a lot more education in their programs, but a lot of people are questioning whether it is necessary. lots of people like medical training and the intensity of the training, but is it necessary? for most providers and areas of practice, its not.

back in the mid 1990's i was a premed student and the physician who ran the per med seminar class i took talked about the issue of how much training a person needs to be a medical provider (medical meaning: np, pa, and md). his sense was that medical schools and residency programs were over training/over educating for providing care. he talked about medical schools that were considering taking a more nursing model-eg: doing specialty training from the beginning of school and not doing as much general medical education. its funny that nursing is feeling they need to go more medical model-more general education, then moving into specialty training. he also suggested that medical schools were still using a 19th century model for education which was probably useful in the 19th century, but with highly specialized medicine and biology we now have, at some point it seems there may need to be a shift in the education of physicians-as there may be just too much knowledge to learn, and specialization- as a necessity dt the amount of information to learn- would occur earlier in training. maybe nursing and medicine are actually heading in the same direction, but they have different starting points? (eg: trying to figure out how much education and training are needed to have good providers) i didn't go to med school bc i would never be able to learn all that stuff physicians have to learn, however, i am a psych np and am completely capable of providing great care without having gone to medical school or getting a dnp. if i don't know something, i consult, could be md or np who has a good answer. but i also agree with other people, its each persons choice as to what they want to learn and how to use their education-if you want all that knowledge-go for it!

actually it is happening and the accrediting body has set the deadline. whether they will be able to follow through then, i don't know. when i was in school i would have liked a lot more clinical experience, and more in depth conversations/supervision about psychiatry. my classmates and i felt like we weren't ready to practice yet when we graduated. i think an additional year of more intentive practicum with supervision would be beneficial. but then i also got the same experience when i got my first job and was supervised by a psychiatrist. so, who knows, it will nbe interesting to see if any data is collected about masters v dnp providers and level of care. the program i went to converted to dnp the year after i graduated and they were promoting it as a systems and management focus, it seemed that the masters part of the program would remain the same, but be augmented with medical systems and management classes--eg: :how to be nurse leaders". i wouldn't be interested in that, but would have liked more in depth clinical experience. for a while i was looking into dnp schools, and seems different schools have different focuses-some are management oriented and others are more clinical, one was more research-to-practice oriented, so could be helpful to talk to the school to determine where their focus is. also, many of the programs are so new you could probably make up your own focus and work with faculty in your area of interest -would show you are a real leader:)

if you are enrolled in a program during 2015 you can finish the program and get licensed/certified, but cannot start new masters program after 2015 deadline.

one of my teachers was on the national committee to get dnp as entry level and my impression was that it is for ego, money, and prestige. she said nps would have more credibility, would hold more management positions, and would eventually get pay equal to that of mds. of note: she made no mention of better care for pts.

i went to ohsu pmhnp grad entry prgram and it was chaos. they admitted a bunch of students (i think 16 or more in my class) and then couldn't find practicum sites for everyone. there were some really fabulous instructors, but overall it was a very chaotic program. ohsu as converted their program to dnp, so if you go there it would be dnp (doctorate) as only option. in 2015 all np programs are supposed to convert to dnp (though i don't know how on schedule this is), since you're interested in academics, research, and teaching this would be a good option for you anyway.

i am pmhnp-adult only, i got a job in az for 86k within last few yrs, then in another city in az for 126k, and a third place offered 119k. i have friends who have been offered even higher pay in az. i have been applying in ca and most are around 85-100k. the most difficult part about getting my first job was that most places wanted at least 1 yr experience post grad school-though i think all the students who graduated from school with me had jobs soon after graduating, and as far as i know they are all still employed or have private practices. i think this is a very employable field. there are a lot of jobs, though not always exactly in the location where you want to be. also, you can do therapy and medication- no other masters level providers can do both. i have a counseling psychology masters, and started a psy d program (decided to change to pmhnp). i feel pmhnp gives me the most flexibility- can work in any setting (hospital, private practice, community), can bill most insurance (including medicare and medicaid), can bill for therapy or medication management, shortest time in school, and most independence in practice. i would definitely suggest pmhnp route vs counseling, sw, or psyd. pa's often aren't hired in psych, but there was 1 i worked with in the past. pa's also have to be supervised by md and nps in several states have completely independent practice. nursing school was a terrible experience for me, but i enjoy being an np and working with pts. recommendation for pmhnp during pmhnp program-i would ask to do a graduate internal medicine rotation-even if it is just a few weeks of observing. i end up having a lot of abnml labs coming back and i always refer to pcp for treatemnt and further assessment, but i feel like internal med is my weakest area (diabetes, heart/cardiovascular disease, thyroid disease are probably most relevant). there seems to be a big push in psychiatry for psychiatrists to be able to manage medical complications of mental illness or treatments- eg antipsychotic induced high chol, esp since many mentally ill only get care through psychiatry and have poor fup with pcp. eventually this may also be true for nps. a lot of programs don't focus on therapy training, so you might ask around if a sw, counselor, psychologist, or other types of providers will let you sit in on groups or other therapy training-even if all you do is observe it is very helpful experience to have.

the military psychologist program is not really active. the nine initial psychologists who started the program are no longer prescribing and never really worked in that role, even though reviews of the program showed the psychologists were highly trained and capable of prescribing. i don't think the program was ever expanded beyond the initial 9 people, even though they showed good results. specific states attempts to have psychologists be able to prescibe (including nm) are based on this program. the training the psychologists underwent in the military program was very similiar to pmhnp training, and about the same amount of time, same pre-reqs were required (eg: chemistry, physics, a and p etc.).

used ancc study guide and passed first attempt. lots of my classmates passed on first attempt as well.

if you are ancc certified as adult pmhnp you ca see adol age 13 and older. if you want to see younger children then you need the family certification. of course, state rules may be different.