NP to physician

[UnsureNPStudent]

I posted here a few years ago, be re-visiting since I still can't get going to med school out of my head... Sorry if this is long winded.

I'm turning 30 this fall. I currently am a nurse practitioner, have been working as one for the past 7 months. About 2/3 way through my NP program I realized I really wish I had pursued medical school, but kept with my program and even did a one year "residency" to help me feel better prepared.

Every day I go into work wishing I wasn't a midlevel, wishing I had just done the whole thing of going to medical school. The problem is my husband is a second year med student and we want to start having kids in the next year or two. I just don't see how time, financial (we would live off his residency salary plus a military stipend) or location wise we would be able to manage it, especially since wherever we go for residency won't be near any family to help raise our children.

I have a strong desire to be a mom, but I also have this huge itch to go to medical school. There are parts of being an NP that I love but overall my job is pretty crappy. I get paid 84k currently to do the job of a physician (I do have a physician I can go to almost anytime with any questions), and the liability/stress of a physician with far less training. If I were to pursue med school I'd have to quit this job for prerequisites and MCAT prep because I put in around 50+ hours a week and have not much spare time. I'd likely go back to working as a nurse as it would be a way less mental toll on me and only 36hrs/week.

The good thing is, is my husband is in military so I could use his GI bill to pay for 3 years of my schooling, which he has brought up himself. He's very supportive. He will only have 2 trimesters of med school debt as the military is paying almost all his student loans.

The only way it could realistically work is if I got into school near wherever he gets into residency, which would make it even that much more difficult to pursue. I don't see us doing long distance for 3+ years, and definitely not with a child.

Or do I just suck it up and be an NP and maybe pursue when kids are a lot older?

Any tips are appreciated.

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[MusicDOc124]

A couple of points:

I have a strong desire to be a mom, but I also have this huge itch to go to medical school.

Whenever I talk to pre-meds, med students, or people in general regardless of their field - I ask them what they see their life looking like in 5, 10 years, etc. Society puts a little too much emphasis on jobs/careers than what I like to see, and it leads people to sacrifice things they actually want. Who wants to work? relatively few. Who wants to have a family, travel, have no stress, etc? most people. Work backwards in the sense of looking at what your goals truly are in life and where you want to be, and see which path gets you there in the timeframe you want, or at least which does it best. If MD/DO gets you there sooner or something, go for it. If it causes delays or is too costly (literal cost + opportunity cost), then I recommend re-evaluating goals given where you are in life currently to make the decision by asking yourself what's more important - changing careers to something in the same broader field or not living apart form your spouse, making a family, and having a little more flexibility in your life during this window of time whereas going MD/DO may give different flexibilities later (post school and residency).

I get paid 84k currently to do the job of a physician (I do have a physician I can go to almost anytime with any questions), and the liability/stress of a physician with far less training.

It's not the job of a physician. It may feel that way at times, but it's not. And while only you can speak to the stress you feel, the liability is not the same.

The problem is my husband is a second year med student and we want to start having kids in the next year or two. I just don't see how time, financial (we would live off his residency salary plus a military stipend)

The good thing is, is my husband is in military so I could use his GI bill to pay for 3 years of my schooling, which he has brought up himself. He's very supportive. He will only have 2 trimesters of med school debt as the military is paying almost all his student loans.

I presume your husband is using HPSP since you mention he's receiving a stipend. Did your husband serve at all before using that program? If not, he doesn't have the GI Bill yet. To receive the full GI Bill entitlement, it requires 36 months of active service when not in a period of pay-back (i.e. HPSP, ROTC, service academies). Thus he would need to finish med school and residency and complete his required serviced from the HPSP scholarship first before continuing to service for an additional few years to earn the GI Bill. And the kicker here is for him (or anyone) to sign the GI Bill over to family, there must be at least 4 years left on contract, which means another service period on top of that.

 

[operaman]

Just a few thoughts:

1) what kind of physician do you want to be? Especially if you’re already an NP, make sure the outcome of med school is worth it. Last thing you want is to endure 7 years of medical training only to end up with basically the same job you have now. So if you’re thinking of a field that’s off limits to you as an NP, then maybe it’s worth it.

2) sounds like you have a crummy job - 50 hrs a week and 84k - that’s pretty abysmal compared to my NP friends. Most of my NP friends are working more like 36h a week and doing it for nearly double the salary you’re getting. Hopefully you’ll have more options as you gain experience, and you might feel different about med school if you had a nice cushy well paid gig right now.

3) what field is your husband planning to pursue? This may factor in heavily in a couple ways. A very busy and prolonged residency may complicate your own training especially if you decide to have kids. His expected salary may also be a big factor in your own cost:benefit analysis. If it’s low, your contribution may have a big impact; if he’s bringing in 7-figures in a high tax state, your additional income may literally get cut in half by the tax man anyhow. The military service will delay this a bit, but still worth considering as it will play into your broader financial plan as a family. Run some hypothetical realistic numbers and see what your various choices mean in terms of net worth and retirement and other goals you may have.

No easy answers I’m afraid. I can imagine scenarios where you go to med school to do something you’d never do as an NP, make a ton of money and enable you both to retire much earlier with a higher net worth. Maybe that’s worth some sacrifices elsewhere. But I can also imagine a situation where you might sacrifice a lot of time and energy to end up in a modestly compensated field doing similar work to what you do now and actually retiring later with less.

 

[VelmaBoots]

I’ve posted on other threads but I’ll share some of my story and maybe it will help you. You’ve gotten some good advise regarding timing of going back to school given your desire to have children and your husband’s current schooling.

As a kid, my dream was to be an MD - I wanted to be a surgeon. I got married, had kids, and then eventually when to RN school. Now I’m an NP. When I went to NP school I had 3 young children and no hope of going to med school at the time - it’s why I choose NP instead. However, Immediately after graduating NP school I started thinking (again) about med school. I live in a state where I can practice independently (eventually) but I don’t feel that NP training is thorough enough that I would ever be comfortable practicing independently as an NP. I’m currently at my 2nd job (in 7 years) and I love my subspecialty (but I hate being an NP).

I work nephrology and want to be a nephrologist; So I’m going to med school this summer. I did a DIY post bacc and studied for MCAT while I worked full time as an NP. It wasn’t easy but I did it and it can be done if you find the right job with enough flexibility. My kids are a little older now too so that helped.

If you really want to be a doctor, I think you should pursue it. The timing of school first or kids first is definitely something to consider but either should be doable at your age.

I’ll tell you from personal experience … 25 years later and I still have the same desire to go to med school that I had when I was 18. Going the NP route did not quench my thirst for knowledge like I thought it would. So, now I’m 43 and embarking on a 3rd career. I feel that I would have been disappointed in myself and in my life if I hadn’t pursued this. It’s 1 life to live and in another decade I’ll be in my 50s regardless of how I choose to spend the time. I decided to use these next several years to go to medical school. So when I’m 50, I’ll be a doctor instead of only wishing I was.

Good luck in your decision.

 

[VelmaBoots]

Also … I work roughly 40 hrs / week for about $100K. I can’t imagine any amount of money would make up for the lack of autonomy and lack of knowledge I have as an NP. Unless maybe I was making $200K lol but honestly I’d probably still go this route.

 

[PB2464]

As a late starting physician that put off having kids for this "dream", it's one of my biggest regrets now that I have a family. Start a family and don't look back. It's the key to happiness.
Yes, having the financial stability is nice, but that's not your issue whatsoever.

 

[RangerBob]

I'd like to echo the above.

Your goals and priorities change dramatically once you have kids. They also change dramatically as you get older. We, as a society, don't put much emphasis on finding a spouse/raising a family compared to finding a job/livelihood, when spouse/family are much more likely to bring you the majority of your happiness than a job.

In hindsight I wish my wife and I started a family earlier. As a stereotypical male, I kept telling her I wanted us to be more financially secure before we had kids. We weren't really that old when we started trying (or rather, not trying to prevent) getting pregnant, and it actually took a few years for it to happen for us.

While I really enjoy my job, I think I could be happy at a lot of other jobs if they allowed me to live where I am (near family) while still being enough to support the ones I love.

Trying to start a family and medical school at the same time is difficult to start with. I saw it done and most commonly the med student had a very supportive spouse--one male student had a stay-at-home mom as they had three kids, and one of our female students had a husband who was able to work remotely and was more part-time, so he had plenty of time to take care of their son. They both had local family support as well.

If your husband is going to be a resident, he's really not going to be able to be that level of supportive. If you go to medical school, you're going to need someone else while he's a resident--whether it's a family member, or paid help, to take care of the kids on exam days, so you can go to lectures, study, watch the kid if they're sick and daycare falls through, etc. And most the work/coordination of all of that would likely fall on you since as a med student, you usually have more free time/are more flexible than a resident (exception being M3 perhaps).

With a high-earning spouse (at least he will be someday), you can do whatever you want. Work or not work. Part time or full time. Stay at home or whatever. You can do what my wife does and work an unrelated minimum wage job in addition to being a stay at home mom. She doesn't think twice about not putting her Cal degree and master's to use. You could even work as an NP with/for your husband. Having a (future) high-earning spouse really frees you up to a lot of things. 10 kids? Not an issue. Full-time childcare? Also doable.

So there are a lot of logistics to think about, but really it comes down to what does your heart really want, and what does it want most.

Going to medical school is a wonderful dream, and it was my biggest dream when I was in college. But now medicine comes after my wife an son. And frankly it also comes after my garden, but no one will pay me to work in my own garden.

 

[VelmaBoots]

It seems that we all have different opinions on this and obviously the ultimate decision is up to OP and her spouse. Some women want kids PLUS their own career. An “unrelated minimum wage job” doesn’t sound like a fulfilling option for someone who continues to have the “itch to go to medical school”, despite being an RN and NP already? 🤔
If my husband or I won the lottery tomorrow, I’d still go to med school. It’s not about money. It’s about filling the desire to have the knowledge and right/ability to practice and to be able to help those around us. Of course, I come from the advantage of having already had kids earlier in life. Maybe priorities change with age for some people but for me, it DID NOT. And, there are plenty of non-trads going back to med school who must have felt the same!

 

[RangerBob]

It seems that we all have different opinions on this and obviously the ultimate decision is up to OP and her spouse. Some women want kids PLUS their own career. An “unrelated minimum wage job” doesn’t sound like a fulfilling option for someone who continues to have the “itch to go to medical school”, despite being an RN and NP already? 🤔
If my husband or I won the lottery tomorrow, I’d still go to med school. It’s not about money. It’s about filling the desire to have the knowledge and right/ability to practice and to be able to help those around us. Of course, I come from the advantage of having already had kids earlier in life. Maybe priorities change with age for some people but for me, it DID NOT. And, there are plenty of non-trads going back to med school who must have felt the same!

I agree. We're all here to help the OP make her decision. The trouble is we (and possibly her) have no idea how having kids will change the equation for her. We're all colored by our own experiences and biases, but hopefully a diverse set of opinions will help the OP make her decision.

Ultimately I think she's going to have to pursue one dream at the partial/entire expense of the other.

1) Go for MD (or DO), don't have kids
2) Go for MD, have kids before/during med school, but likely rely significantly on friends/family/hired help for their early years
3) Have kids now, don't get MD
4) Have kids, wait to get MD until they're a bit older

Option 5 would be her husband becomes a stay-at-home dad and she goes to med school/residency, but seeing as he's MilMed I don't think he could become a stay at home dad all that soon.

In my version of an ideal world, they (all of us actually) would each work half time and have the professional fulfillment of working, and personal fulfillment of spending lots of time with their kids. I wish as women entered the workforce at large that we had the wisdom to do this as a society. Imagine kids growing up with a half-time stay at home mom and half-time stay at home dad--I think that would be something.

 

[VelmaBoots]

@RangerBob fully agree with you and essentially that’s what I was trying to say. I hope the OP finds a fulfilling solution what works best for her and her husband. This is likely something that every female physician who is also a wife and/or mother has had to consider. It’s just so disconcerting for me to see the opinion offered that a woman reconsider her dreams of being an MD and instead be a wife/mother and “work as an NP with/for her husband” who did chase his dream of being an MD. Of course we all have our own goal / opinions and this just happens to be mine and may or may not be inline with what the OP wants. I’m glad that this other physician’s wife is happy with a non related minimal wage job. I would not be and it sounds like OP would not as she continues to have the desire for med school despite RN/NP degrees. I’ve been fortunate to find the best of both worlds and I hope she (the OP) can too!

 

[RangerBob]

@RangerBob fully agree with you and essentially that’s what I was trying to say. I hope the OP finds a fulfilling solution what works best for her and her husband. This is likely something that every female physician who is also a wife and/or mother has had to consider. It’s just so disconcerting for me to see the opinion offered that a woman reconsider her dreams of being an MD and instead be a wife/mother and “work as an NP with/for her husband” who did chase his dream of being an MD. Of course we all have our own goal / opinions and this just happens to be mine and may or may not be inline with what the OP wants. I’m glad that this other physician’s wife is happy with a non related minimal wage job. I would not be and it sounds like OP would not as she continues to have the desire for med school despite RN/NP degrees. I’ve been fortunate to find the best of both worlds and I hope she (the OP) can too!

I apologize--I didn't mean to cause an offense by suggesting the OP work as an NP with a husband who was able to chase his MD dreams. Just that it might be a really nice way to work--I'd love to work with my wife in any capacity.

The "other physician's wife" is my wife, as I was the one that made that statement. My wife had very ambitious corporate careers goals when we were younger and I supported those wholeheartedly, but she ultimately decided she's happier at home with our son. She was miserable when she was working for those large companies. Fortunately with my income we didn't need her to work, the way we did when I was a med student/resident. So now she teaches kid's music--really for the fun of it, as the income is almost negligible. She gets to pursue her creative arts side (which I'm very jealous of!). She supported me in medical school and residency, and now it's my turn to do the same.

It's a team effort, and ultimately it's never fair--typically the woman is still expected to take care of the kids more and the man is expected to earn more/work more and be the primary breadwinner, but hopefully individual couples are able to arrange things so that they're both happy. It's all about give and take.

I agree that what my wife is doing is likely not something that interests the OP. I was just using a personal example of how sometimes our career dreams can change dramatically after we have kids. I went from planning on working at a big academic or VA hospital on the other side of the country to working at a small community rehab clinic in a fairly rural area only 10 minutes from family. That change was entirely because of the birth of our son.

 

[Meerkatology]

the op is barely 30?
hypothetically, if she prep for a year and got in, she would be ~35 when she graduates and a 3 year residency would put her at 38

she can have her kids then, at that point her husband would also be working and have financial stability/time.

38 is not an ideal age to have kid but its still doable probably.
small price to pay for a career that she's always wanted.

also i went to an IM residency and some female residents had pregnancies during residency. IM residency isnt that hard

 

[MusicDOc124]

small price to pay for a career that she's always wanted.

Trading life and personal goals for a career (when a career with good potential and pay if she switches jobs) seems like a steep price to me.

 

[newdoctobe]

Trading life and personal goals for a career (when a career with good potential and pay if she switches jobs) seems like a steep price to me.

I have not read this who thread….but….For some people, life and personal goals essentially are a career.

 

[MusicDOc124]

I have not read this who thread….but….For some people, life and personal goals essentially are a career.

yes, but someone who takes the time to make a post and says "I have a strong desire to be a mom, but I also have this huge itch to go to medical school." is not typically one of those people.

 

[PB2464]

the op is barely 30?
hypothetically, if she prep for a year and got in, she would be ~35 when she graduates and a 3 year residency would put her at 38

she can have her kids then, at that point her husband would also be working and have financial stability/time.

38 is not an ideal age to have kid but its still doable probably.
small price to pay for a career that she's always wanted.

also i went to an IM residency and some female residents had pregnancies during residency. IM residency isnt that hard

the op is barely 30?
hypothetically, if she prep for a year and got in, she would be ~35 when she graduates and a 3 year residency would put her at 38

she can have her kids then, at that point her husband would also be working and have financial stability/time.

38 is not an ideal age to have kid but its still doable probably.
small price to pay for a career that she's always wanted.

also i went to an IM residency and some female residents had pregnancies during residency. IM residency isnt that hard

I would say the risk of not being able to have kids at 38 is more than "a small price to pay".
Hey, well I guess there is always IVF if you believe in that sort of thing. But be prepared to knock off some of that new found salary.