Question about NP/DNP

Specialties Doctoral

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So if I become an NP before 2015 before they change everything, will I still be able to get Post-Masters certifications in other areas? Or does that mean that if you become, let's say, an ANP and decide that you want to be an ACNP, does that mean that you would have to get a DNP since you "missed the boat"?

I am just afraid that if I decide on a certain area then I will be stuck with it, unless I decide that I want to a lot more time and money to get the DNP.

Specializes in ER; CCT.
Hmm I am not sure if you understood my question.

You know how they are changing it to where you have to have a DNP to practice as a nurse practitioner in 2015? I am asking if you graduate before then, but after 2015 decide that you want to change your specialty (ex: going from an ANP to an ACNP) would you have to get a DNP in order to do this? Since right now you can get Post MS certificates in more than one specialty.

Right now you can be a certain type of NP and then get a post MS cert in a different field. After the big change in 2015, you won't be able to get post MS certifications from what I understand. You would have to get a DNP degree.

It will be curious for sure to watch the transition for MSN/NP programs that currently allow a maximum of 5 years for program completion (all programs that I know about).

To prevent students from getting caught in the middle of the change (ie: students completing a MSN who would not be board eligible) these programs would have to shut the doors of the MSN/NP route no later than 2009-2010 or change policy to require a shorter program completion--No?

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It will be curious for sure to watch the transition for MSN/NP programs that currently allow a maximum of 5 years for program completion (all programs that I know about).

To prevent students from getting caught in the middle of the change (ie: students completing a MSN who would not be board eligible) these programs would have to shut the doors of the MSN/NP route no later than 2009-2010 or change policy to require a shorter program completion--No?

Or just ignore it. There is no requirement for a program to move to the DNP. There are many programs that will not be able to move to the DNP. It will probably be similar to the MSN "requirement". It was issued in the mid 80's but more than 1/3 of the programs were still non masters in the mid 90's. There was no real change until the Medicare rule changes in 1997. Even then there were 1-2 non masters programs as late as 2006.

There are essentially four entities that can mandate the DNP. Medicare or other insurance companies. The state BONs. The certifying organizations (all of the organizations in a specific specialty have to change or its meaningless). Or the program accrediting organizations. So far there is no evidence that this is happening. Expect to see a push for this - probably from NONPF. The coming healthcare revamp is the most likely tool.

David Carpenter, PA-C

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Or just ignore it. There is no requirement for a program to move to the DNP. There are many programs that will not be able to move to the DNP. It will probably be similar to the MSN "requirement". It was issued in the mid 80's but more than 1/3 of the programs were still non masters in the mid 90's. There was no real change until the Medicare rule changes in 1997. Even then there were 1-2 non masters programs as late as 2006.

There are essentially four entities that can mandate the DNP. Medicare or other insurance companies. The state BONs. The certifying organizations (all of the organizations in a specific specialty have to change or its meaningless). Or the program accrediting organizations. So far there is no evidence that this is happening. Expect to see a push for this - probably from NONPF. The coming healthcare revamp is the most likely tool.

David Carpenter, PA-C

With the requirement for DNP will the PA programs follow course?

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With the requirement for DNP will the PA programs follow course?

I doubt it. If PA's are smart, they will stay master's.

I've been saying this over and over again. We're shooting ourselves in the foot with the DNP. DNP is longer to complete than a PA but there's no benefit in terms of scope or pay. The DNP does not give us an edge when it comes to finding jobs. If you're an MD, who would you rather hire? A PA who is asking for 70k or a DNP asking for 100k but they both do the same job?

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With the requirement for DNP will the PA programs follow course?

Not if we have anything to say about it. There is actually AAPA policy against the doctorate as an entry level degree and there was discussion about coming out against any doctoral PA degree.

The primary difference is that PA education is competency based. Every PA learns generally the same things no matter what the degree. This is why if you go to a certificate program a number of programs will give you credit for that work toward a Masters. This has been looked at a number of ways and there is no difference between a certificate/Associates, bachelors or Masters PA. If anything the certificate programs require more prior healthcare experience.

The other factor that argues against this is that certificate and associates programs (bachelors to some extent) provide a disproportionate share of PAs to under served and rural health care areas. Studies that have been done show that the best way to provide rural health care providers is to recruit and train them in rural areas (actually one study in the sixties identified the PAs wives being from a rural area as the most important factor:rolleyes:). Most rural areas are not capable of supporting doctoral level education. PA education does not lend itself to distance learning in my opinion. This leaves programs based out of whatever educational institution is available and has community support.

David Carpenter, PA-C

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Specializes in OB,ER,PEDS,Mediation,FacultyED.

PA's: With all due respect to PA's, I am of the knowledge that the DNP is a doctoral graduate degree in Nursing. PhD, or MEd may be the terminal degrees for PA's at this time?... please to inform if you find information to correct AND/OR add to my current data; I do welcome and appreciate all information to assess ANY issue, & choices,to fullest. THANK YOU! Present information in my personal data base:

Doctoral Programs in Nursing

Highest academic preparation in Professional Nursing is the doctoral degree. Doctoral programs focus on preparation either for original research (PhD) or for data-based improved practice outcomes (DNP).

DNP guidlines indicate the following generic [bASIC] requirements

to include, but not limited to--

--Graduation from an MSN program with national nursing accreditation

--Acceptable GRE scores, including writing test

--Evidence of current advanced nursing practice certification and

currently practicing in an advanced practice role

--Current advanced practice nursing recognition in good standing

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Specializes in Critical Care, Emergency, Education, Informatics.

Angel;

Those comments had nothing to do with PA's getting a DNP. It was about PA's developing their own equivalent.

PA's: With all due respect to PA's, I am of the knowledge that the DNP is a doctoral graduate degree in Nursing. PhD, or MEd may be the terminal degrees for PA's at this time?... please to inform if you find information to correct AND/OR add to my current data; I do welcome and appreciate all information to assess ANY issue, & choices,to fullest. THANK YOU! Present information in my personal data base:

Doctoral Programs in Nursing

Highest academic preparation in Professional Nursing is the doctoral degree. Doctoral programs focus on preparation either for original research (PhD) or for data-based improved practice outcomes (DNP).

DNP guidlines indicate the following generic [bASIC] requirements

to include, but not limited to--

--Graduation from an MSN program with national nursing accreditation

--Acceptable GRE scores, including writing test

--Evidence of current advanced nursing practice certification and

currently practicing in an advanced practice role

--Current advanced practice nursing recognition in good standing

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Specializes in OB,ER,PEDS,Mediation,FacultyED.

thank you Craig, for clarification. I do embrace PA's dedication to advanced practices and respectful of career path choices as well. Would like to be kept informed of future options, for all: please do inform when further informtion/developments occurr in PA arena. This thread has served well to open my door to explore, much appreciated!

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Not if we have anything to say about it. There is actually AAPA policy against the doctorate as an entry level degree and there was discussion about coming out against any doctoral PA degree.

The primary difference is that PA education is competency based. Every PA learns generally the same things no matter what the degree. This is why if you go to a certificate program a number of programs will give you credit for that work toward a Masters. This has been looked at a number of ways and there is no difference between a certificate/Associates, bachelors or Masters PA. If anything the certificate programs require more prior healthcare experience.

The other factor that argues against this is that certificate and associates programs (bachelors to some extent) provide a disproportionate share of PAs to under served and rural health care areas. Studies that have been done show that the best way to provide rural health care providers is to recruit and train them in rural areas (actually one study in the sixties identified the PAs wives being from a rural area as the most important factor:rolleyes:). Most rural areas are not capable of supporting doctoral level education. PA education does not lend itself to distance learning in my opinion. This leaves programs based out of whatever educational institution is available and has community support.

David Carpenter, PA-C

Did the AAPA also oppose the BS? master's degree? I thought I read the a disproportionate share of PAs opt to do speciality versus rural primary?

Interesting in that you say there is no difference between a certificate/Associates, bachelors or Masters PA. If this is true why ? Are there studies that support the "null"

I still see PAs following the NP route, like it or not you will see some form of clinical doctorate for the PA with in the next 2 years. I have been around for each educational leap, 1st the NPs jump, soon afterwards the PAs jump.

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Did the AAPA also oppose the BS? master's degree? I thought I read the a disproportionate share of PAs opt to do speciality versus rural primary?

The AAPA's official position "endorses the baccalaureate degree as the current minimum degree for physician assistants and encourages all physician assistants to possess a minimum of a baccalaureate degree."

The use of endorses here is important as opposed to mandate. There is further policy that PA education occurs at the Masters level. However a number of attempts to mandate the masters for PA education have been summarily dismissed. APAP (the association of PA progragms) states the following:

1. The Association of Physician Assistant Programs (APAP) recognizes that PA education in accredited programs is conducted at the graduate level and recommends that PA programs grant students a credential* reflective of this level of curriculum.

2. The credential granted should reflect the institutional mission and needs of the local and regional communities served by the program, and maintain the academic integrity of the curriculum and the competency of students. After careful study or reaffirmation of its mission, a program may determine that offering an alternative credential (non-master's degree) may better serve its institutional mission and the needs of the community."

Their statement is essentially the status quo. They want the masters but recognize that some programs/communities cannot grant a masters degree.

As far as specialty movement. The number of PAs in primary care remained static while the percentage of PAs in primary care is falling. The numbers and percentages of PAs in specialty care is increasing. Depending on the numbers primary care will probably cease to be the largest percentage somewhere around 2010. One study shows that programs changing from bachelors to masters had an increase in the percentage of students going into primary care. Another study however, showed that non-masters programs had a larger percentage of students going into primary care (even when including a surgical non-masters program). Masters programs also decrease the number of under-represented minorities (although this effect is uncertain).

Interesting in that you say there is no difference between a certificate/Associates, bachelors or Masters PA. If this is true why ? Are there studies that support the "null"

There are a number of studies. The only real metric we have is pass rates on the PANCE and graduation rates. These are identical. There are other studies that look at the first year salary and they are generally identical. This should not be a suprise. The way that PA education is structured means that an certificate program and a masters programs students are taught the same material according to the educational blueprint. Generally the change from a bachelors to a masters program has been adding a research class and a paper (at least in my program and others I have examined).

I still see PAs following the NP route, like it or not you will see some form of clinical doctorate for the PA with in the next 2 years. I have been around for each educational leap, 1st the NPs jump, soon afterwards the PAs jump.

We haven't jumped yet. While the majority of PA education is at the masters level there are still certificate, bachelors and associates programs being created. There have been associates programs created in the last four years. There are a couple of issues that make it different than the NP front. One is that there is no group calling for a doctorate. There is in fact no group currently calling for the masters to be required. There is in fact a large group that are firmly opposed to any sort of degree requirement. The four main arbiters of PA policy (AAPA, APAP, ARC-PA and NCCPA) are in agreement here. There is some push to make the masters mandatory from some of the masters programs but there are enough non-masters programs to oppose this. A summary can be found here:

http://www.aapa.org/clinissues/DegreeIssue1999.html#ref

and here from AAPA:

http://www.paeaonline.org/0500docs/Webpaper051800.pdf

The other issue that PA programs and the PA profession will have to consider with the degree issue is opportunity cost. On the average (yes I know that there are exceptions) PA students are not competitive for medical school they are extremely competitive for DO school. The top 20-30% of PA students would probably be competitive for many medical schools. Looking at the prerequisites there is only 1-2 classes needed for medical school. If the PA profession goes to a clinical doctorate presumably most students would shift to medical school leaving less competitive students for PA school.

The one current PA doctorate (Baylor) is two years of full time work (40+ hours per week). It consists of six months of didactic, six months of EM research and 12 months of clinical rotations in EM, anesthesia, toxicology, EMS and other areas. Adding this to the typical PA program would make the program the same time frame as medical school. At that point it does not make sense to go to PA school.

Given nursing's prediliction to try to make the masters mandatory for PAs (Ohio and Missouri) the masters may eventually be mandatory. However, it will be over the resistance of PAs that understand the difference between clinical competence and a degree.

David Carpenter, PA-C

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