Have you taken many premed courses? If it was me, that would play a big role in the deciding. If you have and did well in them, why not finish them up before you graduate? Then you could keep your options way open.
Thank you all for your insights. You have given me some great points to consider. It does not sound like any of you are disappointed with your career choice, which is reassuring.
Family practice is my goal for many reasons such as variety of cases, cradle-to-grave care, et cetera. If I went the MD route, this is what I would chose to do (no intentions of being a subspecialist). FNP would also get me there. I posted to see if there were possibly compelling reasons not to chose FNP. I don't hear any so far other than difference in pay. I'm not motivated by money so this is not a consideration for me. And you're right, I can gain the extra scientific knowledge by reading on my own.
On other boards, I've read some disparaging remarks made by some med students and MDs about the knowledge base of NPs (or what they perceive to be a lack thereof). I've read things like "they don't know what they don't know", "they have just enough knowledge to be dangerous", and "I would only trust my family to be treated by a physician". Do any of you find your education to be looked down upon by other clinicians in real life? This doesn't bother me, I'm just curious.
People will say what they want to say and what makes them feel better, even when it is bashing another profession. Maybe some have had a few bad experiences but that should be judged on an individual basis. And just so you know these internet boards are not the real world.
I had only one bad experience during clinicals with being treated disparagingly due to my status as an NP student. It was in a clinic based in a teaching hospital with many residents rotating in and out, and I was kind of treated as a resident but I did not feel my knowledge base was the same as theirs. Part of the problem was there was so much turnover that the attendings did not remember from week to week who I was or what my role was, and they either assumed I was a resident or was trying to pass myself off as one. But that was only one negative experience. In every other site I was treated respectfully by the MD's who precepted me and they taught me as much as I was ready to learn.
Another thing, I tried to take USMLE practice tests and I could not pass them, but most med students couldn't pass them either without some focused preparation. That's why I say to get yourself some good textbooks and expand your knowledge base on your own.
I am in NP school now and I have one more year to go!!! Only one more year of studying, missing family events, and making hardly any money since I can only work part time. If I had chosen the MD route, there would be years to go before reaching this goal. Even though I could do more and make more $ as an MD or DO, I am happy with my choice. Then again, I am in my 30's and this is my second career. I may have chosen differently if I were younger and lacked a mortgage and family.
I went to med school and left during my 3rd year. I can't describe how miserable med school is and the lack of life you have with friends and family. The journey to becoming a doctor is long and tortuous. The cost is very high, into the hundreds of thousands in some cases (mine would have been over $400,000), and you can't always decide what type of doctor you want to become. I once figured out it would take me over 10 years at almost $4000 a month to pay back my loans. That, along with malpractice insurance, I would end up making about $30 or $40 thousand a year for nearly 10 years. The cost, quality of life, stress, depression, and no time for self, family and friends will take its toll on you. Stick with NP instead of MD, you will thank yourself in the long run. I left med school to become a NP, I'm now about to graduate with my BSN and will shortly be attending a NP program within the next two years. I'm so happy I made the switch! Best of luck with your decision! Remember, chase what you love to do, not what it pays you!
I am none of those but my suggestion if money is the issue, look towards the military because they will not only provide you with money, but probably better training than the civilian world can for MD
If you are looking for the more scientific route I would look into PA school, most are 24-28 months and depending on the state have the same if not more autonomy than an NP.
In my opinion MD route is a best option. Look at the VA jobs for nurse practitioners, pay scale is 56000 - 96000, whereas general physician (MD) salary range is 96000 - 375000. Same work but huge difference in pay scale. It is outrageous.
If you are young, and if you can afford to pay off loan, go to Caribbean and get a MD degree.
The pay scale there is VERY misleading, even if you just consider the money.
For the OP, I would still pick NP nine times out of ten. Much of the choice is personal though.
Future residents choose their own specialty and programs to apply, nobody can do it for them. But because the chance to get no match is real (less common for US MD grads and much more for everybody else), almost all of them include a few of less competitive places, like Family med programs situated in the middle of nowhere, in their "lists". If they match there, little can be done in terms of changing specialty as well as future career prospective.
I agree that NPs can be as "holistic" or not as they want, but at least they can try if they wish to do so. An MD cannot legally prescribe or even "legally" (i.e. documenting the fact) recommend anything which is not approved either by FDA, pharmaceutical industry or specialty guidelines. An MD who is licensed to practice family medicine can "learn" how to do lunch-break face lifts, Botox shots and such during a weekend "seminar" and then set up a "spa" and practice it all, and that's legally OK until something bad happens. The same MD cannot, legally, recommend melatonin pills for a senior patient suffering from insomnia, although in Europe it is an established practice. Here in the USA only habit-forming benzos and things like enzopiclone (Lunesta, $10/pill) are "approved as being safe and effective" for the purpose.
I had a good chance to go other way, and after some very hard and very long thinking chose NP way. My foreign diploma would eliminate the problem with school debts, but moneys won't buy me time off my life, time with my family, time for my patients, freedom of specialty choice and freedom of recommending alternative therapies when indicated. And I'm free to read the very same books doctors read - believe me, there is no rocket science in clinical medicine, and no special talents or qualifications are required to learn biochemistry or molecular biology.
What country are you in as in the USA this is totally false. We prescribe many drugs "off label" and can prescribe melatonin all day long if I want...for all the little good it does.
I've only been working as an FNP for about 6 months, but so far I'm quite satisfied with my decision.
Disadvantages: 1) a shorter time in training, and it seems like there is a lot that I don't know yet, but as one of the MDs pointed out, my experience in nursing counts for a lot. 2) no "status" of being an MD and honestly I just don't care. When (usually well-meaning) patients ask if I want to "go on" to become a doctor, I smile and shake my head and say "nooooo..." followed by some sort of statement highlighting that I'm happy with my position and I love what I do. Half my patients call me "doctor" anyway despite my repeated corrections. Most of the MDs in the group treat me with great respect or at least kindness, more like a peer.
3) Money - I don't know what the MDs make, but I don't think the rate is that much different than mine. I work in a county clinic, so I'm sure I could make more money somewhere else, but again, I don't really care - I love what I do and I'm making more than enough to pay my bills and build my savings. I also have a good benefits package, and got a nice holiday gift.
Other advantages:
1) I work for a supportive and education-focused medical group that values their PAs and NPs and is invested in our success. 2) everyone in the group seems to share a desire to provide quality care to the medically under served. 3) the hours aren't bad at all: I work 9 half-day clinics per week, but if I decide to start a family I think they would be flexible and let me cut back. I also have the option of working after-hours urgent care (not ready for that yet) No weekends or bank holidays. I'm never on call (while the MDs in the group rotate). The medical director constantly urges me to take more vacations and not spend too much time in the office at the end of the day. 4) Did I mention I love what I do? Family practice is interesting, challenging, fun and while I don't look forward to going to work every day, the good days are definitely more than the bad.
So, if I could do it all over again, I would still choose NP.
No doubt. If I were a young, early 20s, college kid again I'd apply to medical school or pharmacy school (maybe both) and go with whatever took me. Back in then pharmacy school was like hitting a gold mine. The Pharm.D. was a new thing back then too with a lot of schools still doing a five year B.S. In hindsight, med school would've been better for me. I hate OB/Gyn and couldn't care less about peds or surg, but hey any experience is a good experience (theoretically).
UTVOL3
281 Posts
Have you taken many premed courses? If it was me, that would play a big role in the deciding. If you have and did well in them, why not finish them up before you graduate? Then you could keep your options way open.