Advice on Psych NP vs. Psychiatry MD/DO

zoidberg, BSN, RN · Mar 13, 2012

no words anyone can tell you will replace shadowing. find some local md's and do's, np's working in psych, (or pa's, they provide insight as well) and be observant. be grateful, write a thank you note, and learn from real life observation.

Wabi Sabi, BSN, RN · Mar 22, 2012

If you have time, capability, and determination, I would say go to medical school and become a psychiatrist. Having a MD or DO behind your name opens many many doors and you will get to really be in charge of patient care. As a nurse, regardless of level, you are still a nurse and there's always limitations to what you are allowed to do.

newtinmpls, BSN, RN · Apr 28, 2012

I faced that same question; I had just finished my BSN by scholarship, no student loan dept, happy graduation, feeling on top of the world and could do anything. So I considered - should I just go for the MD or Psychiatrist?

I came to the conclusion that no, I liked the nursing approach. I looked around and there are enough states where the NP's have prescriptive privledges and independent practice, so I can find a place where I can practice as I like. I don't like the medical model of care; I like the multifaceted nursing approach (I summarize it as: Physical, Cognitive, Emotional, Spiritual and Social) in my opinion, the average medically trained practicioner (PA, MD, DO, Psychiatrist) will miss most of the patient.

Every month I've been in school (well more like every 2-3 weeks) in my BSN-DNP program, I've gotten forwarded e-mails from the student advisors, hoping to welcome new grads into rural positions and offering nice monies. So I'll have a place to go (many) and I'll probably be able to get repayment help on my loans.

The other side of this; go back to the 1800's, just before publication of the Flexner report. There were many types of "doctors", homeopaths and chiropractics and so on. The AMA was really successful in obliterating their competition, but nature abhors a vaccumm, and there is a place for doctoral level providers who are not allopathic-trained folks. Someday that will be me.

Diane

ImThatGuy, BSN, RN · May 2, 2012

The thing about going to medical school with the intent of becoming a psychiatrist is that you don't have to become a psychiatrist. You'll finish your first two years of medical sciences and then move into your clerkships and rotate through the major specialties and have some electives. That's your time to explore. I think medical school programs are set up so much better than nursing programs that I envy them and would rather be a doctor if the opportunity had been more available. If you finish medical school you'll have a MD or DO and can apply (although you'll do this while in school) to any residency program you like to specialize in whatever you like assuming of course you're accepted. In psychiatry, you're theoretically unlimited although you'd run into problems if you tried to start doing a lot, particularly billing insurance for a lot, outside of your board certified specialty. However, you're a licensed physician though. As a psych NP you're pretty much locked into that and potentially bound by a collaborative physician, and if you go to nursing school with the sole intent of moving immediately into advanced practice you're going to get flack from others who think you have to either pay your dues first or learn this "vast" array of nursing knowledge before you could ever be successful as a nurse practitioner.

HolyPeas · May 19, 2012

I'll be honest, it seems strange to me to go through all of nursing school to up and switch over to medical school. Why would you just go to med school in the first place? Not that I discourage it, but if its the title you are after why not just get a doctorate of nursing? Thats my plan....

Gena_g72 at yahoo · May 20, 2012

I really liked what you said about the NP with little experience at the end of your posting. I have so much stress related to my unability to decide between the two: should I become NP with only 3 years of RN experience (by the time i get my NP done) or, I'd rather become an MD with 3 years of residency experience? I am currently 38 and I am a new RN with no experience who got into a RN-BSN program. so if I continue streightforward, I will be NP in three years, but will only have 3 years of RN experience since i will work as an RN during my BSN and MSN studies. I think I will feel very uncomfortable being called an NP with only 3 yeras of RN experince. Based on the above rationale, sould it be a better idea to study 4 years in MD school + 3 years of residency and after 7 years I get an MD license. If I do this, I will be an MD in 7 years with 3 years of residency experince, and by that time I will be 46 y.o. (I am currently also accepted in a medical school oversees, that is accreditted in US).

Please, respond to my quesion, if you have any advice for me.

newtinmpls, BSN, RN · May 28, 2012

I am a new RN with no experience who got into a RN-BSN program. so if I continue streightforward, I will be NP in three years, but will only have 3 years of RN experience since i will work as an RN during my BSN and MSN studies. I think I will feel very uncomfortable being called an NP with only 3 yeras of RN experince. Based on the above rationale, sould it be a better idea to study 4 years in MD school + 3 years of residency and after 7 years I get an MD license. If I do this, I will be an MD in 7 years with 3 years of residency experince, and by that time I will be 46 y.o. (I am currently also accepted in a medical school oversees, that is accreditted in US).

If I understand this correctly, you went right into a RN-BSN program but did not start working as an RN till the very end of it? Now you contemplate an accelerated NP degree (which is how you would finish it in 3 years), and at that point you would be a DNP with 3 years of nursing experience (not counting clinicals, which are fairly huge).

Instead you could get into medical school, which you seem to be telling me would take 4 years (what about pre-med?) and then you would get three years of residency afterwards (instead of clinicals during - difference of approach). So 7 years from now you would be a medical doctor with 3 years of residency, but no independent experience.

If you went for a DNP, in 7 years you would be a doctoral level provider with 7 years of experience in Nursing. If you decided to practice in a state with favorable nurse practicioner laws, you would have similar independence of practice to a medical doctor and more experience.

But really none of this matters. If you "want" to be a "real doctor" and in your head that means it has to be a medical doctor, then that's what you need to do.

Dian