Primary Care: NP vs MD

[sfaust2]

I know this question has been asked before but I have never been so confused in my life. I am a sophomore in a college that has a great nursing program- I was just accepted to the program and would graduate on time with my BSN.

I do not know if I have cold feet, but I cannot decide whether to accept my spot in the nursing program or to go full pre-med and go to med school. I would want to be a primary care pediatrician if I were to pursue medicine, versus an eventual PNP if I were to go that route. I have taken bio I/II, calc I/II and chem I/II. I would take orgo junior year and physics/biochem senior year and apply to med school as a senior- take a gap year. My GPA is mediocre at a 3.69. I am a pretty good test taker- 1550/1600 on SAT so hopefully with studying I can get a decent MCAT score.

My question is, is med school worth the extra time and debt, not to mention 3 years of residency, if I just want to do primary care and I could do pretty much the same thing as a PNP? I also really want a family and would love to work part time when my kids are young. I am very competitive and am not sure if I will ever be okay 'only' being an NP. But, I am not sure it is worth sacrificing 8 years of time and money if I could be doing close to the same thing as a PNP.

It would take one year full time to get my NP vs. 4 plus residency for med school.

Advice? Anyone been in my situation? I would be paying for med school myself.

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[DRsmartypants]

First of all that GPA is not mediocre, it is average for med school. Secondly, here is what I am going to tell you. The decision(at least for me) was cumulative, years of research, shadowing, being an EMT, learning about medicine, volunteering solidified my decision. It comes down to a few things, and you obviously have some things wrong. Don't become a doctor because you won't be "ok" with only being an NP. If you want to a be a physician, it typically means you love to help people, it means you love science and medicine, do you love bio, do you at least like chem? Are you interested in following algorithms or actually diagnosing? Are you interested in truly understanding the human body or just having a cursory understanding. Do you want to take the tough cases, do you like to think? These are things to consider. Medicine will open up a lot more options for you, if you wind up deciding you don't like medicine and you want to be a pediatric surgeon, or a pediatric subspecialist, you have that option. Do you like being the most up to date? Do you possibly like the idea of applying new basic science research to clinical situations?

I am paying for med school mostly by myself, and I study a crap ton, and it sucks at times, but I wouldn't trade it for the world because I know this is what I want to do with my life. My recommendation is do a lot of introspection.

If you want to work part-time, probably not that realistic as either a PNP or MD, most places aren't going to hire someone part time when they could hire someone full time. Lastly, understand, the time and money is just a means to an end. If you think you are going to dream every day of what could've been, don't be an NP. The philosophies are different. It would be minimally 12 years of education and training for the MD, but do you think you'll be happy? Don't do it because of the money or time, medicine is not worth it. Do it because you truly want to do it. Shadow some doctors, do some research, take some upper level bio, physio, anatomy courses, see what you are getting into.

 

[Lucca]

You would have more career flexibility and options in primary care (not to mention more training and professional scope, both technically and legally in most states) as an MD. Your GPA is not "mediocre", it is good at 3.7. A 1550/1600 on the SAT is strong if you mean M+V although that is not necessarily predictive of MCAT performance, it probably means you have some natural test taking ability and won't have to suffer on that front.


However, nobody can really decide this for you. Shadow an NP. Shadow a physician. Seek out mentors. Talk to upperclassmen. This is a pre-MD forum so guess what we're going to tell you? We're going to tell you to go MD. Hell, I think that's definitely the best option for what you want to do. Go and find out more about both professional paths and choose for yourself. It doesn't matter to me if you "just" want to do primary care, ideally PCPs ought to have a very broad knowledge base and be able to recognize not only a variety of pathologies and social determinants of disease but their own limitations. We can go back and forth about how closely this actually resembles reality but I for one would rather be the person with more stuff in their head when trying to play quarterback or babysitter for someone's care, whatever my role might be. So those are my 2 cents.

 

[Neutropix]

I would say go to nursing school based on the fact that you have been accepted. As an anecdote, the vast majorities of NPs I know are very satisfied w/ their jobs as opposed to the mountains of unsatisfied PCPs. My pool of personal research has come from emergency medicine NPs, CRNAs, and NPs working in "Minute Clinics." You will be earning far earlier, consistently, and will have the chance to change your mind more so than a physician. IMO don't choose medicine based on the fact that you're competitive. It won't make for a happy career based on everything I've ever read on SDN. That's my 2c.

 

[Averagemanboy]

that's an awful SAT lmao

 

[Neutropix]

that's an awful SAT lmao

Be nice, please. : )

 

[Saifa]

Here's the thing, as an ex-nursing student planning to rush myself into CRNA, I can offer some insight about having a similar plan.

Most important: there will be no "diving in" to being an NP or CRNA. If you're starting nursing school with the intent of having the lifestyle and authority of an APRN, you will have a horrible (and I mean horrible) time. You've got to be in it for nursing. You need to be an indoctrinated nurse from day 1. They will show you quasi emotional slideshows about the joys of nursing. They will bash doctors. You will take classes dedicated to converting grams to milligrams. Simply put, if you aren't in it because you LOVE nursing, GTFO. Like put a you-shaped hole in the wall and skip the door.

I don't think any undergrad is supposed to be actively pursuing NP/CRNA. These positions are meant for seasoned nurses that have stayed sharp over years of experience in a field that is taxing on many levels. They are not for hot shot bright students that want to skip the messy bits and start making six figures with a cool job.

Honestly I wish I could broadcast this to the world because the reality of nursing school was just horrific to me. I knew from day 1 that I was in the wrong place.

 

[sfaust2]

that's an awful SAT lmao

that's an awful SAT lmao

1550 out of 1600. 2320 out of 2400. don't think thats awful

 

[Saifa]

1550 out of 1600. 2320 out of 2400. don't think thats awful

Yeah, don't go to nursing school.

 

[sfaust2]

Thank you all for your replies! Yeah, I have been hearing that if I already know I want to become an NP, don't bother with nursing school and just go to med school. I think what is really holding me back is the fear of not getting in. I love anatomy and physiology and want to learn more about the human body, but cannot stand research and although I was decent at chemistry, did not love it. I love service and helping others but also want a family and life outside of medicine. I know I do not want to be a nurse for long- I would want to go back for my MSN within a couple of years of graduating. I hope this helps.. Thanks again!

 

[Perrotfish]

I know this question has been asked before but I have never been so confused in my life. I am a sophomore in a college that has a great nursing program- I was just accepted to the program and would graduate on time with my BSN.

I do not know if I have cold feet, but I cannot decide whether to accept my spot in the nursing program or to go full pre-med and go to med school. I would want to be a primary care pediatrician if I were to pursue medicine, versus an eventual PNP if I were to go that route. I have taken bio I/II, calc I/II and chem I/II. I would take orgo junior year and physics/biochem senior year and apply to med school as a senior- take a gap year. My GPA is mediocre at a 3.69. I am a pretty good test taker- 1550/1600 on SAT so hopefully with studying I can get a decent MCAT score.

My question is, is med school worth the extra time and debt, not to mention 3 years of residency, if I just want to do primary care and I could do pretty much the same thing as a PNP? I also really want a family and would love to work part time when my kids are young. I am very competitive and am not sure if I will ever be okay 'only' being an NP. But, I am not sure it is worth sacrificing 8 years of time and money if I could be doing close to the same thing as a PNP.

It would take one year full time to get my NP vs. 4 plus residency for med school.

Advice? Anyone been in my situation? I would be paying for med school myself.

A PNP does not necessarily do the same thing as an MD, it depends on where and how you practice. I am a primary care, rural Pediatrician with a traditional scope of practice. I see a full clinic. I cover an inpatient service. I am on call to resuscitate sick neonates on L&D. I run Pediatric education and set Pediatric policy for my hospital. I manage a number of medically complex patients in a community where the closest subspecialists are several hours away, if they exist at all. Finally I act as a true consultant: I receive calls from the ED and FPs concerning complex Pediatric cases. For all of that except for clinic you need to be a physician

There are also subspecialties of Pediatrics that are only open to physicians. There are no NPs who are yet really practicing subspecialty medicine unsupervised, and very few who practice as unsupervised hospitalists. If you really are as smart as your stats imply I suspect you might get bored in GenPeds and decide that Heme/Onc (or similar) is more interesting.

On the other hand, I do have a number of medical school classmates who are working at Pediatric clinics in large, subspecialty rich Childrens' hospital systems. Anything complex goes to the on call subspecialist, anything emergent goes to the ED, and the Pediatricians really are seeing the EXACT same clinic as the NPs. If you're married to the idea of GenPeds, in a large city, in an outpatient clinic then NP might be the better choice. Of course the physicians are getting a higher lifetime pay for the same work, so even still you might be better off being a doctor.

There's also a good chance you won't want to be a Pediatrician by the time you actually finish medical school. I know a lot of Pediatricians who went to medical school thinking they were going to be surgeons, and vice versa.

 

[doctorbob23]

As a nurse myself,

If you don't live in random states like Wyoming or like..Montana, where there are shortages in PCP. I would strongly suggest to NOT go into nursing with the hopes of being a nurse practitioner. I would even suggest doing PA, they are more respected, higher paid and more flexible with their career.

A NP is still a nurse, with a greater scope of practice. Usually with primary care things like your antibiotics and abuelos bp meds, along with educating patients. If you want to do any more than that go to medical school.

I think now is a good time to draw the line and decide whether you want to be a NURSE or practice medicine. 2 paths that are clear and distinctly DIFFERENT. If you want to practice medicine, go full premed. Nursing will be waiting for you if you don't make the cut.

 

[Perrotfish]

Thank you all for your replies! Yeah, I have been hearing that if I already know I want to become an NP, don't bother with nursing school and just go to med school. I think what is really holding me back is the fear of not getting in. I love anatomy and physiology and want to learn more about the human body, but cannot stand research and although I was decent at chemistry, did not love it. I love service and helping others but also want a family and life outside of medicine. I know I do not want to be a nurse for long- I would want to go back for my MSN within a couple of years of graduating. I hope this helps.. Thanks again!

Your other concerns:

Getting in: A reasonable concern, but you are doing all the right things, you have every reason to believe you will get in. Also its not like you haven't set yourself up to do an 18 month RN program after your Bachelors if the MD doesn't work out. Its not a long detour.

Research: Of the Pediatricians in my residency class, all but one had no published research. This is pretty standard for Peds. Dermatology we are not.

Life outside of medicine: The average general Pediatrician works 42 hours a week. I personally have 4 weeks of vacation a year, every major holiday, and a three day weekend every other month. Third year of medical school and residency are rough, but that's only 4 years. You get through it, and then you have a lots and lots of years left.

 

[DrFizition]

Just to give you perspective on career scope, I work with an APRN (I believe that's basically an NP) in the emergency room. He works as an emergency provider alongside PAs, MDs and DOs with PA level autonomy.

 

[allantois]

You went to nursing school; not us. Ask yourself whether you see yourself as an NP.

 

[Cali sunshine]

Thank you all for your replies! Yeah, I have been hearing that if I already know I want to become an NP, don't bother with nursing school and just go to med school. I think what is really holding me back is the fear of not getting in. I love anatomy and physiology and want to learn more about the human body, but cannot stand research and although I was decent at chemistry, did not love it. I love service and helping others but also want a family and life outside of medicine. I know I do not want to be a nurse for long- I would want to go back for my MSN within a couple of years of graduating. I hope this helps.. Thanks again!

I was an RN then NP and now I'm in medical school...Dont make your 1st choice your 2nd choice (or not even a choice) just because you are afraid of not getting accepted into medical school.

I was interviewed by the AAMC read my story:
https://www.facebook.com/aamctoday/posts/10154570093032926

Good luck!!

 

[Mansamusa]

Decide what is important to you. Do want a career that is the crux of your life or is family more important?

You said that you want a family and to work primary care. AAMC has a paper on the FIRST website that says that students going over $300K in debt may still be able to pay off their loans practicing primary care as long as they are in smaller cities. If you will be paying for med school yourself, would you be fine if you end up being limited in your location? You may also not be able to go part-time for a while until you pay off the debt, would be fine with that? And you may be competitive now, but there will come a point in your life when you stop caring what other people are doing and you will focus on your own happiness.

I say MD if you have parental financial support/scholarship/NHSC scholarship/live in a state with low tuition, otherwise I think NP will provide you with the life you are looking to have

 

[JDunc]

Get in and shadow.

I started undergrad with the thought that I would go to optometry school. I had the thought of "4 extra years of school and a 6 figure income." My uncle is an optometrist and my cousin is in optometry school. I shadowed several optometrists and realized I did not have the passion to do that all day, every day, for the rest of my working life. I was given the opportunity to research in one of my professors labs. From there I worked at a highly prestigious plant biology research institution. Now I am in graduate school pursuing a M.S. and PhD (but not in plant biology).

Moral of MY story? You will not know what you are passionate about and what you truly are called to do until you dive in and shadow/work. You will want a career that will pay decent but worry about that 2nd. Your happiness in what you are doing should be 1st. Income 2nd.


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[sunset57]

I think the decision depends on the importance you attach to different aspects of your life.

If achieving your goal quickly and maintaining a regular work schedule with a good salary are your primary goals, a NP is your best choice.

The quicker path and more mellow lifestyle come at a price however.

Your training will be significantly more superficial than if you attended medical school and a residency.

Your depth of knowledge will be significantly less than most physicians.

When a child is really sick, parents, and hopefully most NP's, will call an "expert"...who will be a MD.

You've got good grades (a 3.7 isn't mediocre).

Although a good SAT score doesn't always correlate with MCAT performance, it suggests you're comfortable with standardized tests.

You describe yourself as competitive.

Challenge yourself.

 

[Keepthedreamalive]

I was an RN then NP and now I'm in medical school...Dont make your 1st choice your 2nd choice (or not even a choice) just because you are afraid of not getting accepted into medical school.

I was interviewed by the AAMC read my story:
https://www.facebook.com/aamctoday/posts/10154570093032926

Good luck!!

Hi Cali sunshine, I'm an NP thinking about going to Med school, your story is inspirational but I'm not sure if is cost effective for me. I've always wanted to be an MD but because of "life" I could not do it at the time so I became a RN and now an NP. I make decent money, not enough but good. Going back to school for MS means school loans and years off work. I def would love to accomplish my bream but not sure, please let me how this situation worked out for you. Thank you!

 

[ChrisMack390]

Shadow them both. If you really want to do one, you will know which.

 

[FootballFoot]

I think NPs will have a lot more scope of practice + salary in the future since the nursing lobby is ridiculously wealthy. And you get a lot more lifestyle.

 

[Saifa]

Latest post is 8 months old.

I make decent money, not enough but good

And this is a terrible reason to consider medicine.