CogNeuroGuy

I've been spending a while researching (e.g., 2+ years) what path I wanted to take to work as a primary provider in mental health. Some of you may have read some of my previous posts and know that I've worked as a psychometrist, I hold a M.S. in cognitive neuroscience and I was set to apply for Ph.D. program in counseling and clinical psychology. The reality of it was more childish than it being practical. I love working with patients, working in the neurology private practice conducting neuropsychological evaluations gave me so much satisfaction in life that despite having a terrible boss and coming into work dreading having to deal with her crazy ass (pun intended), the patients made it worth while. I just moved to the South Florida area so that my husband could attend the Pharm.D. program at Nova Southeastern University. I am $101,688 in debt, I still have some wiggle room for federal loans at the undergraduate level and I have roughly $43K left in graduate level federal loans (assuming I don't use any undergraduate level loans I have remaining). The market for what I currently do is not there, I work in customer service for $13.50 an hour (this is a set back). It's taken 7 years of my life to really tease apart what path will achieve my goals, and the goals are as follows: 1. Financial stability and growth 2. Market demand for my profession 3. Level of autonomy 4. Work/life balance 5. Amount of time in school Notice how work/life balance and amount of time in school are at the bottom of my list, they aren't significant factors, but they are factors none-the-less. I urge you to read my posting in the "poop" thread to read up on the path to becoming a psychologist, market demand for both psychologists and master's level therapists (i.e., LPC, LMHC, LCSW, etc.). Once you know the background on that, you will see why I have opted to do the following: 1. Spend 1 year completing 6 courses of pre-req courses at Broward College 2. Apply to and (hopefully) attend an accelerated BSN program at FIU or UM (possibly FAU, but they frustrate me with their additional math class requirement, they are like the thorn in my side with this). 3. Spend the next 15 months (give or take some) in the program and graduate 4. Spend a brief period of time working as a floor RN while I apply to MSN programs to become a psychiatric NP 5. Attend the NP program for 2 years and graduate. 6. At the age of 32, I will sit for my licensing exam and be fully functional I was actually at the Pitbull concert the other night in Miami and the woman behind me had a seizure. Irrespective of my knowledge of seizures from a neuropsychological standpoint, I knew the basics, I turned her on her side and let her ride it out while I flagged EMTs over. This was an amazing experience for me, so all of the other threads where people complain about doing this type of work or messing with poop, etc., I am sure I will grow to accept and adapt to it. I've sat in on neurosurgeries for my research as a grad student, so blood and other fluids are not that big of a deal (the poop will take time for me to get used to). I'm a native Texan (from Dallas). I've worked with many psychiatric NPs as well as family NPs. I love what they do, I love the lifestyle it provides them. I also like the nursing model when approaching a patient. I'm very much into the spending more time with the patient vs. what doctor might have time to allocate. I will probably wait until August of 2016 to start so that I can qualify as an in-state student for tuition purposes, but I see myself taking 2 courses a semester for 3 semesters then take the appropriate entrance exam. I'm a big guy, I'm diabetic and I have hypertension, insomnia and sleep apnea, so despite all of this, I still want to do it. I believe the "dues" I'm about to pay will be worth it.

Thanks for the info! I am in the process of contacting them. I have already reached out to FAU, but they told me to come to an information session. I have plans on calling up Nova tomorrow.

I have posted here in the past, roughly put: I have a B.A. in sociology and psychology and a M.S. in cognitive neuroscience. Collectively I have accumulated $93,212 in federal loans. This leaves me with roughly $14K to use in remaining undergraduate loans and roughly $45K is left to use aggregate-wise (undergrad + grad loans available). With that being said, I have considered becoming an RN with the goal of being a psychiatric NP. I just moved to Ft. Lauderdale and as such will wait one year to establish my residency for tuition purposes (I have already received my FL driver's license). I live close to Broward College and pretty sure I will go there to take my pre nursing courses (A&P 1/2, Micro, Chem, Nutrition). My biggest concern will be affording the actual BSN, I have no wish to get another associate's degree, I much prefer to complete the second bachelor's so I can move onto getting a second master's as soon as possible. Nova Southeastern University is the closest program to me, but they are very expensive, my husband attends the pharmacy program there I have considered FAU as well as UM. With this being said, do these programs typically provide some type of scholarship 99% of the time? It would really suck to go through the whole process of getting my pre-reqs finished, apply and get accepted only to find that I can't afford the BSN. Remember, I have $14K to work with in remaining UNDERGRAD loans...I think Nova is just a little over $14K . Any thoughts?

Really? I barely log onto here, and because I don't agree with your rationale, the only comeback you have is I am a troll. If that helps you sleep better, whatever.

I use the term midlevel provider because it is an accurate description of that provider status. It seems like you are getting pretty defensive about this. We simply are differing on a matter of opinion here, but I would say that your basis for NPs or other midlevels to be compensated at the same rate as doctors for providing equal services doesn't hold water. Whether you like it or not, those who went on to further education got one and is reflective in their pay, if that offends you, I'm not sure what to tell you other than, go and do it yourself. The training is more intense, more in depth and much longer. You may have great experience, which it sounds like, and like another poster said, you seem to be the exception to the rule, but since you are working within a science related field, we must rely on facts, and the facts are laid out very plainly. I myself often toss back and fort deciding if I should go onto medical school or nursing school. I'm not going to sugar coat the differences between the two providers, I will rationalize why one path was better for me vs. the other. Unlike other employment markets like business where having a credential doesn't matter in terms of getting paid a good salary (which I worked in mortgage for a long time myself), medicine and academia does. As a research scientist, I too performed all of the testing, the literature reviewing, the actual writing of morificecripts, data analysis and reporting of my findings. These are all things a Ph.D. scientist can do, but if you look at any major medical university and look at the research scientist jobs, you will see they pay differently at the master's level vs. the Ph.D. despite the fact that you are doing more work than the Ph.D. scientist. In business, I was working with people, getting paid the same salary for doing the same job that people with MBAs had, and at the time I only had a bachelor's degree. Again, business is a fine example of how one could take on roles that higher ups do and lack the credential and get paid nearly the same, and in some cases more than those who took the time to invest in their education. Medicine on the other hand operates like academia, your credential places you within a certain bracket of pay. There is a reason why you don't see a lot of medical schools accepting the bulk of their applicants, otherwise you would see a huge influx of medical doctors (this goes beyond the shortage of internship sites). Overall, the services and knowledge of a physician provides to their patients is going to be more in depth and representative of the longer education and often times experience they provide vs. a NP. You may have had some crap experiences in which you seemed like the more knowledgeable provider, but again we are talking about variance, and insignificant variance at that.

My intent for using that was the imply that I typically view progressive actions in society favorably (e.g. gay marriage, equal pay for women, pro choice, etc.)...that was the point.

This sounds wonderful! I too was looking at geographical fluctuations in rates as well as the nice map that shows states where NPs can practice independently. I just moved to Miami from Dallas. In Dallas, NPs are paid very very well ($90K+ starting). In the south Florida area, I have noticed a huge lack in psychiatric NPs. Needless to say, I don't see us staying here past the time it takes for my husband to complete his Pharm.D. In the meantime, I have switched my DL to Florida and will wait until next August to take pre-nursing courses at the local college around us so I can apply for a second bachelor's in nursing. I know my goal, I love working with patients, I like the private practice I work in now and is something I would love to continue doing, but with better pay.

Hi there TheOldGuy, I definitely empathize with your point of view and I wanted to shed some light on a comparison that is similar to what psychologists do vs. midlevel social workers, mental health therapists are doing. At the moment, for one to provide mental health care to someone that is non nursing or medically related training, the standard is either the master's degree (social work, rehabilitation, school, community, mental health counseling) or the doctorate (Psy.D., Ph.D. in clinical, school or counseling psychology). Between these degrees, these practitioners learn approaches in talk therapy, psychologists are highly trained in psychometrics and advanced clinical training in talk therapies. Right now, many midlevel clinicians are able to provide the same counseling services as psychologists do, and for many insurance companies, the reimbursement rates are not all that different. However, now you are having some master's level clinicians providing psychological assessments, and frankly have nowhere near the training if at all compared to psychologists. To put this in perspective, the average LMHC/LPC or LCSW will have a 4 year undergrad, a 2 year master's (some take longer due to personal needs, but not due to curriculum differences) and a 1 year post-master's practicum to accumulate the 3000 hours they need to apply for license to practice independently. The average psychologist will have a 4 year undergrad, a 5 year doctorate (Psy.D./Ph.D.) and a 1-2 year post-doctorate fellowship/residency. At face value, the sheer length of training is already greater for psychologists, let alone the amount of coursework and dissertation work they complete vs. midlevels. The average physician will have a 4 year undergrad, a 4 year DO/MD and for psychiatry, 4 years of residency training. The schools some people have referred to that don't require a bachelor's degree are So, since we deal in evidence (e.g. significance), these are very rare exceptions to the overall labor force of practicing physicians. NPs on the other hand, have a BSN (4 years) and a MSN (2 years), again, if someone is taking longer than 2 years, that is due to personal needs and not due to difference in curriculum. According to the state of Florida, that is all that is required to apply for the ARNP license. By these calculations, NPs mathematically have less education than a physician, let alone the rigor of the coursework completed in medical school, for which I have personally experienced as I took several courses in neuroanatomy, etc. during my master's jointly with the neighboring medical school. I am a very liberal guy, I am pro choice, a gay married male, Democrat, etc. But in this case, I fail to see a feasible excuse other than "we do the same job."

I too am in the same boat with the person you quoted. I did my undergrad in sociology and psychology and have a master's in cognitive neuroscience, publishing and gaining clinical experience in clinical neuropsychology only to find an extreme saturation of practitioners, an overall lack in public demand for what psychologists SPECIFICALLY offer (e.g. psychometric testing). Many insurance companies will not cover the costs for these assessments, some companies are now pushing to only allow medical doctors or some mid level people to be the only ones who will be reimbursed for testing (despite the fact they dont hold any formal experience in psychometrics, statistics, research ,etc.). NPs have a market demand over something >30% and psychologists have about a 12% market demand. Ph.D. programs in clinical psychology on average receive over 150 applicants a year and accept 3.78 and GREs >65% are considered and will almost always have a publication as a 2nd author or lower with a couple of conference presentations or some clinical exposure during undergrad (e.g. suicide hotlines, women's shelters, etc.). I currently work in a private neurology practice as a neuropsychometrist, and make decent money off of it, but the demand is extremely small. If for some reason I were to ever get fired, left, moved, etc., the ability for me to reasonably find a similar job is The NP route is something I have been scouting out for years, especially when I started my previous master's degree. Everything I listed about NP market viability and stability is much better than the current goal of becoming a psychologist. At the end of the day, my intent is to treat people's psychiatric illness, and recently it has been working with patients with CNS damage, degeneration, etc. I could go the MSW route, but the pay would be terrible, the market viability is 10% better than psychologists but nowhere near NP standards. From the research I have conducted, I know there are good opportunities for me to take on further education during the MSN program or afterwards to gain more therapy skills often seen and learned within MSW or LMHC programs.

I am moving to Fort Lauderdale this week and will be looking at getting my CNA so I can start working ASAP. My husband and I are moving there for him to start pharmacy school. Does anyone recommend a specific school to get trained/licensed as a CNA around the Ft. Lauderdale area?

Great advice. I suppose I should look into how long the CNA process could take. :)

While I appreciate your input, I am not arguing, I am simply letting you know the available facts. At the moment, if I were to apply to any second degree bachelor's program (e.g. TWU, FAU, FIU, etc.) these programs will grant you federal aid (e.g. loans) that fall under your designated program (since I would be applying for a second bachelor's, they would pull from my available undergraduate loans I haven't used). As a graduate student, you don't use loans from the undergraduate category, they pull it from the graduate category. So, I only spent $45K for undergrad, I still have $15-16K I could use towards funding a second bachelor's. If I were to wait 3 years for us to move back to Texas to attend TWU, I could afford the tuition alone with this amount. Secondly, the "cap" you are referring to is $130K, this combines the total amount one gets from undergraduate + graduate loans. If one attends professional school (e.g. law, medical, dental, pharmacy, etc.) that cap is bumped up to $224K. Again, I have available funds, the question here is where would I go to complete a second BSN. In terms of education, I don't think you fully appreciate the extent of employment vs. suitable employment vs. debt ratio when it comes to completing a Ph.D./Psy.D. to become a psychologist. Ph.D. programs in clinical or counseling psychology have an acceptance rate somewhere between 3-7%. Most programs will have 150+ applicants in a year. Aside from this, to be competitive for admissions, one should have a 3.7+ and a GRE of 1100+ (old scale). On top of this, one needs to have research experience, simply applying straight out of undergrad without posters or publications will put you at the bottom of the list, even for bottom 20% programs. Psy.D. programs accept larger classes, and depending on the school, they have an acceptance rate between 20-45%. However, rather than having your degree paid for like the Ph.D. in clinical or counseling psychology, one has to pay for the degree itself. Current Psy.D. tuition nationwide ranges between $150-250K for the whole program...this is just tuition, this doesn't count how much one will need to take out in loans to pay bills, etc (because you won't be working in the doctoral program, not until your 4th or 5th year, and at that rate, you might be making $20K a year). The research I have done on acceptance rates in the respective second/alternative BSN programs are somewhere between 30-75%. For NP master's programs (since the current trend is to migrate NPs to the DNP eventually and master's level trained NPs are grandfathered), one can alleviate even taking the GRE for admissions if one has a prior master's in some NP programs, such as Yale's (which I have). I am not downplaying the NP route at all, its the exact opposite, I feel that I would be better suited to provide mental healthcare via the NP route vs. being a psychologist. Again, taking into consideration the employment vs. suitable employment vs. debt ratio, the NP route would be the most optimal track to go. Considering starting salaries in psychiatric NP range from $75-90K (depending on location) with an employment rate 30% greater than for a Ph.D./Psy.D. psychologist, there is a reason why the NP/PA profession is lucrative. I have several psychologist friends who are going back for a PA or NP just to have an increase in their salary due to the fact that they would make more as a PA or NP than as a current psychologist. It seems like you took my comments personally, and you shouldn't. I am laying out the available facts. I am unaware of how long the DNP would take, but considering one is still able to attend a master's program to become a NP to practice and hold a NP license and be paid at a NP rate vs. a psychologist who HAS to have a Ph.D. to obtain a license (the term Psychologist is a legally protected title only reserved for those who have received a Ph.D. in clinical, school or counseling psychology). Again, I do appreciate your advice, I was simply providing you with an answer to some of the "introspective" questions you presented for my journey.

Thanks for the feedback. I am very familiar with the differences between those who approach treatment of patients via a medical model vs. a holistic model, I even looked into going the PA route. I have been researching this for the past 2 years as I completed my master's. I will be able to get financial aid, so I am not worried about that. In terms of employment with what I currently have, it's very difficult. Even when one tries to apply my education to a business background, it seems like they know you are fudging your education, and that's exactly the responses I get from some people I network with. Besides that, I don't want to be in a business environment, otherwise I would have gone into a business-oriented background 7 years ago. I went the route I did to potentially become a psychologist. That is probably one of the most competitive occupations to get into, and many people don't realize that. They don't realize that psychologists are working for the same pay and insurance benefits that master's level practitioners bill for, it is a real problem. Many of my mentors were lucky enough to get out of private practice to work for a hospital or to teach as a professor, but then again, getting those jobs are even more competitive. When the national average for employment of psychologists is 14% and declining, things are not looking pretty. Insurance companies can't find the clinical utility in offering reimbursement for psychological assessments because they are very expensive and time consuming. Due to some of these reasons, this is why you will see an average psychologist who spent 4 years of undergrad, 5 years of doctoral training plus 2 more years of post-doctoral training just to get licensed only making $65-70K for the first 5-10 years of practice. I used to work in a private practice and worked with NPs and really enjoyed seeing them work, especially the pay they got for a third of the education a psychologist must go through. I will be working in private practice when I move to Florida as well as some at The Cleveland Clinic doing neuropsychological assessments. Both will be part time opportunities. This alone wont be sufficient in being exposed to what nurses go through. I would highly doubt one day would provide me even with the most valid scope in what nurses deal with on a daily basis.

I posted many months ago that I have been considering going the RN route. Briefly about me; I completed my undergraduate degree in sociology and psychology from the University of North Texas and then I completed my master's degree in cognitive neuroscience at The University of Texas at Dallas. I have research experience and publications in clinical neuropsychology. With all of this being said, I am moving to Ft. Lauderdale on July 31st because my husband will be attending pharmacy school at Nova Southeastern University. I have worked many jobs in corporate America and can tell you that I do not want to spend my life working in a cubical. I would like to use my knowledge in brain and behavioral science to do something with myself and thus the idea of nursing came to mind. If I went the RN route, my goal would be to become a nurse practitioner in neurology or psychiatry. I have zero experience in the applied health profession area. My only experience with patients was as a graduate student researching at UT Southwestern Medical Center in which I rounded with a neurologist 3 times a week for 6 hours a day. I saw patients, she allowed me to assist in cranial nerve checks, speaking to patients about neuropsychological assessment results and also enrolling them into some of the research studies we had going on there for Alzheimer's. What could I do in terms of work when I make the move to Ft. Lauderdale that will allow me to gain experience interacting with patients, etc? I know many suggest the M.A. route, but that would require paying for and attending a M.A. program to gain a license, this won't provide immediate employment for me. When we move there, we will be strapped for cash, I will need work. Since being a M.A. is not my goal, I would like to get something that allows me to work in the healthcare environment while I can subsequently knock out any pre-requisite courses I need for a BSN program.

I am not a nurse, I already have an A.A., B.A. and will be graduating with my M.S. in cognitive neuroscience this May. My original plan was to go into a Ph.D. for clinical psychology, I volunteered, got experience doing research, even published some articles in some prominent journals and published many posters for national and international conferences. I realized after I worked in neurology rounding with a doctor in there that I loved seeing patients, not sitting in a room for 4-7 hours doing neuropsychological assessments. My undergrad is virtually useless (sociology/psychology), so is my master's, unless I go and do research in psychology or neuroscience. The point to my synopsis above is that I tried it out, I have spent $96K in student loans to get three college degrees that by themseleves are useless to me for job prospects. Sure, I can snag an office job (which I have done lots of mortgage and recruiting and retail jobs). Before all of this, I was a professional classical musician, I played for 15 years, professionally for 4; teaching and performing. Music is/was my passion, but the market for classical musicians is even worse for paid research assistants. To address your concern directly, I really do empathize with what you are feeling, it's frustrating, scary and depressing. Seriously, after spending weeks reading many of the posts here on allnurses.com and Student Doctor Network, you will find that most people in those forums are predicting doomsday scenarios; pharmacists complain of saturation, student loan debt, no jobs in 4 years and actually having office politics! Dentists are complaining of student loan debt and market saturation, veterinarian students are complaining about no jobs and low pay. Nurses are complaining about the environment, no nursing shortage anymore = fewer job prospects and pay issues. The point is...these are pretty difficult fields to get into, the pay is significantly better and you will see more professional longevity within these fields compared to other fields that maybe only require a generic bachelor's degree. I look at all of these issues, and I tell myself; "I suppose we should have all just become janitors then." I think you should get in there, and try it out. I have been looking at doing the BSN myself with the ultimate goal of getting the MSN in psychiatric NP. I have no big plans to want to be in a high-capacity atmosphere, but if I had to do it, I would do it just enough to get into the environment I would want to be in. From the responses I have read, there are many paths to take to practice as a RN, you don't have to be in some unit like you see on TV, you do have choices which is good. I certainly know that I want to be an independent practitioner, so the NP route is my ultimate goal, not bedside. Goodluck!