RN to MD or CRNA

inthepipeline, LPN · Jul 14, 2015

I actually spoke with a nurse who went to med school after being a nurse for 8 years. Working as a nurse made him realize he wanted to be a doc. He had no regrets about becoming a nurse, just that he wanted to take on the doc role. I strongly recommend shadowing an ICU nurse, ICU NP/PA, CRNA, and MD anesthesiologist. Also, shadow a PICU nurse, peds NP/PA, and pediatrician. Ask the nearest CRNA program if you can shadow a SRNA and a med student. Also, work as a nurse for a couple years or more even after your obligation is up as actually being in the clinical enviroment and having that job and responsbility will help you see what you like. Also being a CRNA and MD are radically different, it sounds like you're just kind of reading and hearing about them, but don't really know truly what the roles are about. That's ok, I was and in many ways still am the same way, we all started like that. Just be honest with yourself and why you want a specific role. Yes, CRNA has money, autonomy, and respect, but do you actually like critical care, physiology, clinical pharmacology, the OR, and anesthesia? Do you mind your patients largely being asleep, following them for a short period? What draws you to peds? How does a peds nurse, peds midlevel, and peds MD/DO approach the same case? What do they do the same differently each day? Write down your answers, see how they evolve over the years, notice what questions you learn to ask and what the answers mean to you as you aquire more experience and knowledge. Do not be in a rush. Also, I worked with a doc who worked the first 2 years of med school, I've heard of it happening, but it is rare and not manageable for the overwhelming majority of people. Same with CRNA school. Good luck! If you do the pre med requirements they will help for CRNA school too, they won't hurt one bit so go for them! Also, one thing that really helped me was learning the difference of when I'm just interested in something superficially vs I'm interested in doing something day in day out. Think of something you thought you'd love before starting nursing school, but did not love once you saw day in day out reality of it once you got exposed to it. Apply that to being an MD or CRNA.

JPINFV · Jul 14, 2015

Questions I have:
1. Can medical school be done while working a full-time job?

While I'm sure there's a rare person who has worked full time during the first and second years, the answer is largely "no" and definitely not during the 3rd and 4th years. While lecture attendance is variable from "everyone is required to go to lecture" to "most people watch at home and spend "lecture time" as self directed study," everyone understands the information they're responsible for. Furthermore, during rotations (3rd and 4th year), it's hardly unheard of to spend 60-80+ hours a week at the hospital (especially surgery and inpatient medicine rotations... outpatient rotations tend to be kinder hour wise). I routinely had 30 hour shifts as a student during surgery and medicine rotations. This doesn't include time outside of the hospital studying for Step 2 (a large factor in residency applications), shelf exams (standardized tests in what ever field you're rotating in that normally is a part of your grade), and traveling for interviews for residency during 4th year.

Oh, and no attending or resident is going to care that the 3rd year med student has to go to work. You're job is medical school, and if you decide not to show up, no one is going to think twice about failing you from your rotation.

2. I am not confident that I am smart enough to finish medical school. Is this a feeling that the majority of people have going into medical school?

If you're smart enough to get into a US medical school (MD or DO), then the actual fail out rate is under 10%. You've got an excellent chance at making it out in 4 years like everyone else, and those that don't generally only end up repeating a year. Very few people actually fail out. Now the Caribbean schools are a whole other situation.

3. I want to utilize the opportunity to go to med school for free. Is being a CRNA more beneficial (opportunites, advancement in career, pay, etc...) than becoming an MD?

Unless you want to go into primary care in an under served area or want to go to the military, then there's no such thing as a "free" medical education. Also calling those options "free" understates the downside of those options when looking at them only because it makes medical school "free."

4. What are the pros/cons of becoming an MD vs. a DO.

DOs get a little extra training in muscular skeletal issues using a historical set of treatments that range from deranged (cranial, Chapmans points, etc) to evidence based (osteopathic manipulative medicine for low back pain is equivalent to traditional medical treatments). Some fields will be easier to get into, some a little harder, but it's largely a push. Additionally, at this time there are separate residency programs only open to DOs, while DOs are allowed into MD residences (granted some bias and discrimination still occurs), however the residency systems are currently being merged into a single unified system.

By and large, unless the extra training really interests you, the general consensus in terms of schooling is MD > DO >>>> foreign.

Now outside of school and residency, no one cares and the options after residency is essentially the same.

5. Does Med school work like an undergraduate program where you can go at your own pace? or is it fixed and you have to structure your schedule around the programs set schedule?

No. Even the schools like LECOM that have a more independent study option ("directed study program") still requires their independent study students to be on campus for certain courses and laboratories. That also doesn't apply to 3rd and 4th year.

Additionally, all residencies start sometime near the end of June to July 1st with July 1st being the traditional start time. Furthermore, that doesn't include orientation that normally begins a week or two before the official start date. You're still paid for orientation, but it's not really the "start date" that most people think of when it comes to starting residency.

JPINFV · Jul 14, 2015

In your nursing program, did you have to do the pre med requirements (biology, chem,physics)? Or did you have to go back and do them before you went to med school?

Also, a lot of nursing programs use either a "chemistry for health care professions" or a shorter summary course (the technical name eludes me at the moment for this type of course) instead of the general chemistry for science majors type course. You need to take the chemistry (and physics and biology courses) designed for science majors, or you'll likely not get credit when it comes to apply for med school.

adventure_rn, MSN, NP · Jul 14, 2015

Maybe I'm misunderstanding, but CRNA and Pediatrician are radically different roles. May I ask why you've chosen those two? At the risk of sounding cynical, the only things that they seem to have in common are high salary and prestige. I definitely second the people suggesting that you shadow MDs, CRNAs, NPs, etc. to help decipher which roles you would actually enjoy. I went to school with a ton of kids who are currently in med school and are just now realizing that they hate it; however, they've invested so much time and money into the process that they feel as though they can't leave. That sounds miserable to me.

Assuming you have a Bachelor's Degree, the process to become an MD will take you at least 10 years (2 for prerequisites, 1 to apply to school after completing your prerequisites, 4 of med school, at least 3 of residency). This is also assuming that you Bachelor's was completed as a traditional four year degree program, not an ADN-to-BSN online type of degree--I am almost certain that med schools wouldn't accept an applicant with a Bachelor's degree earned online, though CRNA might (I really can't comment on that).

I believe that CRNA degrees now take 3 years to complete, since they are transitioning from masters degrees to doctoral. To qualify for CRNA school, you will need a minimum of at least one year working in ICU (not sure if the job you're about to start is in an ICU), so you'd have to delay your application process until you can complete that requirement.

A couple of additional points/questions...

If you've got scholarships for either program, why would you need to work full time? You could probably take your pre-reqs while working full time, but even that might be a stretch (if you want to do well enough in them to get into med school). I think it would be entirely unrealistic to work full time and try to do MD or CRNA; even working PRN might be a stretch, which brings me to my next point...

Both med school and CNRA school are hard. Much harder than nursing school. The med school pre-reqs are hard--college-level organic chemistry, biochem, calculus, and physics are really stinking hard (I should know, I've taken them). Whichever path you choose, MD or CRNA, you've got to be committed to study your butt off full-time for multiple years in a row.

In addition, both med school and CRNA school are hard to get into. You basically have to have a 3.7, be at the top of your game, have great test scores (in the case of medicine), and have a compelling reason for wanting to attend (which you demonstrate in your essays and interviews). Another PP suggested that you could "knock out" your med school pre-reqs at a community college while working full-time; I think that most med schools wouldn't even consider accepting community college courses (unlike many nursing programs).

I'm sorry to be so brash, but it sounds like you haven't given a lot of thought to why you'd want to be in those roles, nor have you done much research into even the most basic requirements for applying. Not sure how much we can help you here until you do those things.

adventure_rn, MSN, NP · Jul 14, 2015

Also, a lot of nursing programs use either a "chemistry for health care professions" or a shorter summary course (the technical name eludes me at the moment for this type of course) instead of the general chemistry for science majors type course. You need to take the chemistry (and physics and biology courses) designed for science majors, or you'll likely not get credit when it comes to apply for med school.

Yes! Also, if I'm not mistaken, most med schools require that you've taken all pre-reqs within 5 years of starting the program. So depending on when you apply, you might even have to retake some of your pre-reqs that you've already completed for nursing (i.e. intro bio).

JPINFV · Jul 14, 2015

Oh, the type of course I was thinking of was a survey course. So a survey course of chemistry that includes general, biochem, and organic chemistry counts for nothing in the med school game.

guest769224 · Jul 21, 2016

Plus the marketplace for CRNAs is getting smaller

I realize this post is now a year old, however, I'd appreciate if you elaborated. Are you sure it is getting smaller? What makes you say that? I am under the impression job opportunities are increasing, and with a nation-wide focus on healthcare organizations cutting costs, some MDA's are being phased out by CRNA's, especially in rural areas. It appears to be a growing market.

guest769224 · Jul 21, 2016

when the schools start pumping out massive amounts of CRNA's dropping income from about $175k a year to maybe $75k.
CRNA's are worth a bundle now, but I suspect over the next decade they will be worth less and less because schools pump up output on specialties if the demand seems to be there. They always overshoot and create too many. Over time I suspect the MD will be more lucrative. Do some research on the slope of the rise of CRNA candidate output in the country and then decide. Please share your results with us.

While conducting that kind of research would be interesting, I disagree that salaries for CRNA's will plummet that drastically. There is little evidence of this yet occurring. A national shift exists of APRN's gaining more recognition, traction and independence, yielding more job opportunities (Such as the VA proposition). Are you aware that MD/DO graduate output has also risen? There are for-profit MD schools, just like in nursing. CRNA has a promising future, as does MD/DO. As for NP, that is debatable.