I know this has been discussed on other threads, but I am looking for advice for me personally..
I am an RN in my late 20s who has practiced only in psych. To give you some background, I did some brief work in inpatient psych, most of my work in community & crisis stabilization (small, step-down, unlocked psych unit w/less acute patients) settings, and currently work as a psych case manager in a hospital.
I started out pre-med at a private college, took a year off due to medical illness, and transferred to a local community college, where I obtained my ADN/RN. I didn't enjoy med/surg clinicals and for many reasons was disenchanted with my nursing program, so I applied to transfer to a 4-year school and entered with a major in biology the fall after finishing nursing school & taking my boards. I ended up working during winter break as a psych nurse, switching my major to psychology, graduating with a BA in psych in 2009, and taking a full time psych nursing job after graduation; this is what I've been doing ever since.
Trust me, this is an abbreviated version...
This summer I started working at a large teaching hospital w/a teaching service/group of psychiatry fellows and residents, and have started to think about med school again. I have also thought about NP school (as it would be cheaper, an easier transition, and require a lot less courses-- I have taken some of the prereqs for med school but most are at least 5 yrs old and I haven't taken physics or orgo, which I would enjoy the least), but have been thinking of med school for a few reasons:
1. I like the idea of the deeper & broader training that med students get through med school & residency. I am leaning towards psychiatry (that's another discussion, as I'm not 100% sure...) and feel that my lack of background in med surg would put me at a disadvantage, as psych pts are so medically complex these days. With med school, I'd get a solid background in basic medicine. Also there is more clinical training through residency, as NP residencies aren't widely offered.
2. Med school allows for rotations-- I have always wanted to work in the ED and am not 100% sure I want to do psych forever (vs. medicine or ED) so this would give me a chance to rotate through all specialties
3. An MD opens more doors in the sense of positions of authority at teaching hospitals, like the one I am at.
4. I hate to say it (*prepares for flaming*) but there is more "prestige" associated with the MD and I have always wanted some of that, although I don't like to admit it..
5. Although I like the holistic part of the nursing model, I really didn't enjoy the nursing theory portions of nursing school. And I hate nursing diagnoses (*prepares for more flaming*).
6. I hear a lot about NPs not making any more than RNs despite more education, which is disheartening
There are also a lot of reasons why an NP would make more sense:
1. It would build on my RN degree and would not require a crazy amount of prereqs
2. It is generally a shorter, less expensive route, and I'd be more likely to get scholarships
(I assume, as there is less competition than for med school) -- I am ~$30k in debt from undergrad , along w/some credit card debt. Avg. med school debt is ~200k. PLUS I would have to take ~2yrs of prereqs, which would put me *another* $25-50k in debt if I went to a post bacc program with a solid advising/linkage program... I would make more $$ In the long run with an MD, although that's not the top priority
3. For me, it would be easier to get in (range of positions in psych nursing, including leadership and being @ a well known hospital)
4. Less stress (from what I have read) than med school-- less intensive basic science courses, less volume of information, less competitive classmates, etc
5. I feel like I would be taking a step backward in my career to have to devote most of my time to studying/memorizing chem, orgo, physics--- which, I'm sorry to say, I don't believe have a *direct* application to psychiatry (yes, it is good foundation material, but you know what I mean..)
I am wondering if anyone has advice/thoughts.. I know I obviously have to make my own decision, but I wanted to solicit feedback from the experienced and accomplished folks in here who have been (or are) in a similar position.
Another issue I'm considering is whether or not to eventually try to get an entry level RN position in the ED or med surg to try out those specialties before I commit to an NP program, if I go that route ... but I've probably said enough already!! I'll start a separate thread for that... ; )
Thanks in advance--