Too early to start planning for becoming NP?

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I got acceptance notice from an ADN program that begins in Jan. and am excited but already my ambitions (and my previous traumatic experiences of not preparing well enough in advance) are making me already obsess a bit over how to best position myself for the next steps and education paths toward a more autonomous position as an NP or maybe a PA. I know I am putting the cart way before the horse here, but I do feel the march of time going by as I am older than normal for this kind of thing I guess (32y.o). I also don't have much of a social life or anything currently and moved to a total new state without knowing anyone so I am pretty much totally invested in my future career and schooling right now. Any advice? I am looking forward to the time when there are actual in person classes and forming a network with people in the profession so I can just get to learning actual practical things and not having my mind racing to the end all the time...But to the point, are there things I should be preparing for now, and if so, what are they?

Specializes in Stepdown . Telemetry.

Just an FYI to the OP: to get in to med school you will need an undergraduate degree. It’s not just prerequisites. apparently there are a handful of programs that accept students with 90 or so credits. But they are almost all 8 year programs. The 4 years of medical school then 2 of residency: add at least 2 more for you undergraduate completion. 

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On 11/1/2020 at 6:50 PM, MDBoy said:

part of me thinks, hey, 4 more years of school before a residency then maybe 3-5 more, I mean time is gonna go by anyway, I might as well pursue something really challenging and full of depth and rewarding while I am living, no? But the other part of me thinks that I should just stick with my current plan of getting ADN then starting work as nurse while I get my RN-BSN and get employer to pay for it and then do same for MSN NP or PA. Just not sure what will bring me more satisfaction in long run, What do you guys think?

Ultimately, only you know what will really fulfill you. I don't think 32 years old is too late to start medical school (yes, I said that), especially if that's something you really, really, really, really want. There is nothing worse than spending time and effort and money on something that you feel lukewarm about, only to discover at the end of 10 years you wished you had done something else. 

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Specializes in Nursing.

I don't know.Part of me wants to enjoy the journey and not just strive toward the end goal which I think is what I would tend to do more with the MD/DO path, although maybe not... I would be excited for the MCAT and essay and application portion of the process I think....honestly just to see what my caliber is. But honestly I am thinking joining the work force sooner might be more fulfilling, or so it seems to me right now. The idea of having a quicker foray into the actual patient care experience and learning while I work is more exciting and more how I think I would actually gain my ability to give a solid delivery of good practical care rather than theory (which I am a natural at conceptualizing but it doesn't necessarily translate to practice.) Also I think learning thise "MD" topics is something I do more on my own time as catered to my interests and whims of the day, something that sems more suited to becoming an NP/PA and seeing were my interests lead... And if I want to go further after becoming a PA or something, it wouldn't be that hard theoretically right? Anyone want to steer me away from this mindset?

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Specializes in Nursing.

I have almost 86 credit hours currently. All I need is maybe two perhaps 3 more semesters of classes to get enough for MD school prereq sciences, and take the MCAT. It would potentially take longer to be a PA, but I would have more ability to see where my passions lie in medicine as I go, and would pay substantially less depending on how I plan it. Or maybe do RN-BSN then apply for med school as a working RN?

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Specializes in Nursing.
On 11/2/2020 at 8:25 PM, adammRN said:

Yes. I am very happy. NPs can be completely autonomous, have great mentors and own their own business. That was my main goal. More than money or work location, I just wanted to be on my own. Being a nurse was very difficult, as nurses can be really catty and divisive as you see on this forum often. The PMHNP role in the west is nearly identical to that of the psychiatrist. I have talked with and worked with several now. Yes, there are some caveats especially in IP states. But my mentor owns her own practice (NP) and talks to her collaborating once a month or when needed.

If I were in your shoes, didn't have a degree or BSN/RN yet - it sounds like you really like learning and aren't jaded to school or care much about the extra time or money - I would go to medical school and do the HPSP military scholarship. Nursing will be for a long time faster and less rigorous and more restricted overall. 

I think I could potentially be very able to contribute positively back to people in need doing Psych NP, what worries me is that it seems like a lot of sitting in offices and being stuck in that, where I find more appeal in larger places that are abuzz with energy like maybe a trauma ctr at a larger city or something where you need to be constantly thinking and looking for what's next to come, ya know. Although I am not sure, I love talking and helping ppl so maybe I'd like psych NP more! IDK this is the hard part in planning tbh...

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You could do the PA route and then do a fast track to MD. That exists.

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Specializes in Nursing.

Where exactly does that program exist?

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18 hours ago, MDBoy said:

Where exactly does that program exist?

An Internet search shows me that there are accelerated MD programs, e.g., NYU, just like there are accelerated RN programs. It looks like Lake Erie College of Osteopathic Medicine has an accelerated PA to DO program. 

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Specializes in ICU, trauma, neuro.

Here is my case for NP:

1. Unless you want to do something specific like surgery (which requires even more school and residency and is even more competitive) NP's have completely IP practice in more than 20 states. PA's in most states are always tied to an MD.

2. You have the power to expand your own education. I probably spend at least 10 hours per week reading journal articles, case studies, and doing continuing education. Frankly, the "intensity" of my learning is probably even more efficient than it was in NP school where it was so "goal directed" at passing exams and completing assignments rather than figuring out the most evidence based and or effective models for treating clients.

3. In some ways medical school may limit your perspectives. For someone like myself who is heavily invested in CAM, herbal and lifestyle interventions along with mind/body spiritual perspectives (I am not a materialist and believe that we have a spiritual basis that underlies and physiology) my perspective would be heavily suppressed in medical school and if I did not "self repress" my perspectives, I likely would not do very well.

4. As an NP (PMHNP) I charge as much as I like with patients and can spend as much time as I desire limited only by my schedule and my need to earn a certain amount of money to pay my bills. Now if I can do this at 51, with 160K in student loans, 40K in credit card debt, and no medical insurance (and still like my job most of the time and enjoy my life) then certainly someone much younger should be able to accomplish this to an exponential degree.  

To me MD is a route which is usually the route best left to someone who knows this is what they want to do no later than early high school. It is literally so competitive that you need awesome grades from your freshman year of college integrated with great MCAT scores, and USMLE scores along with high residency performance evaluations if you aspire to high levels of success. Even with all of that you can in most cases count on not being IP until your early 30's (really best case). Contrast that with my son who is 19 and will soon be starting his BSN program. There is no reason (if he aspires) that he could not be where I am at now by age 25 earning 250K or more per year working for himself with literally no student loan debt (he has a full ride academic scholarship).  The difference between earning 250K at 25 and 30 is at least several million dollars in income and indeed someone could conceivably retire by their mid 30's (although even if I won a billion I would work at something until I died or became too feeble as it is I plan to work until I'm at least 72 which by then should make me almost old enough to run for President).

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Specializes in Nursing.
On 11/14/2020 at 12:09 PM, myoglobin said:

Here is my case for NP:

1. Unless you want to do something specific like surgery (which requires even more school and residency and is even more competitive) NP's have completely IP practice in more than 20 states. PA's in most states are always tied to an MD.

2. You have the power to expand your own education. I probably spend at least 10 hours per week reading journal articles, case studies, and doing continuing education. Frankly, the "intensity" of my learning is probably even more efficient than it was in NP school where it was so "goal directed" at passing exams and completing assignments rather than figuring out the most evidence based and or effective models for treating clients.

3. In some ways medical school may limit your perspectives. For someone like myself who is heavily invested in CAM, herbal and lifestyle interventions along with mind/body spiritual perspectives (I am not a materialist and believe that we have a spiritual basis that underlies and physiology) my perspective would be heavily suppressed in medical school and if I did not "self repress" my perspectives, I likely would not do very well.

4. As an NP (PMHNP) I charge as much as I like with patients and can spend as much time as I desire limited only by my schedule and my need to earn a certain amount of money to pay my bills. Now if I can do this at 51, with 160K in student loans, 40K in credit card debt, and no medical insurance (and still like my job most of the time and enjoy my life) then certainly someone much younger should be able to accomplish this to an exponential degree.  

To me MD is a route which is usually the route best left to someone who knows this is what they want to do no later than early high school. It is literally so competitive that you need awesome grades from your freshman year of college integrated with great MCAT scores, and USMLE scores along with high residency performance evaluations if you aspire to high levels of success. Even with all of that you can in most cases count on not being IP until your early 30's (really best case). Contrast that with my son who is 19 and will soon be starting his BSN program. There is no reason (if he aspires) that he could not be where I am at now by age 25 earning 250K or more per year working for himself with literally no student loan debt (he has a full ride academic scholarship).  The difference between earning 250K at 25 and 30 is at least several million dollars in income and indeed someone could conceivably retire by their mid 30's (although even if I won a billion I would work at something until I died or became too feeble as it is I plan to work until I'm at least 72 which by then should make me almost old enough to run for President).

Wow thank you so much for this analysis. I was under impression that NP's jobs were more "office"-y and PA was more hands on doing procedures and things but this is something to reconsider... Of course my mom is an NP, so maybe I just kinda wanted to rebel against her! But this was a fantastic read, thanks!!

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Specializes in Nursing.

So just to clarify, as a PMHNP, I could open my own practice? How soon after graduating would that be possible if so? A  Psych NP/PA route has been an idea I've been toying with lately....

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Specializes in ICU, trauma, neuro.

Technically, from day one in over 20 states. In reality you would need resources and it would take about three to six months to get credentialed if you want to accept insurance. Although, not my own practice I work 1099 for a company where I earn 70% (and pay a $600 per month fee) and set my own hours, schedule, standards ect.  Even in non IP states so long as you have a willing MD willing to provide "supervision" (usually for a fee of 10-15%) you could open a practice. Thus, in almost every state with some like New York being more restrictive than others (some states limit the number of NP's that can be supervised to as few as four other place no limit at all. Some require office visits every so often, others pose no such restriction).

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