PA VS NP - what's smarter financially?

I recently got accepted into a uni that guarantees that I’ll have a seat in PA school as long as I have good gpa + interview. With their aid, I would have 20,000 loan per year + PA school loan. I also got a scholarship where I can go to any public state college for free. Looking at how much loan I’ll have with the PA rout, Im starting to wonder if it would be smarter for me to just become a nurse for free (w scholarship & my state schools are awesome) and then go to NP School, where I can find a cheaper price and maybe have my hospital help out w/ NP school tuition too. I have always loved the PA profession more, but as a NP, I will still be diagnosing and treating patients, which is what matters the most to me (plus their salary is similar), so I don’t think it’ll be too much sacrifice. Only problem is my family looks down on Nurses and are against me going that route. Anyone has thoughts/advice?

What is the GPA that you need? What is your estimated total debt by the end of the PA program? Are your parents willing to take out the loans? You will not be able to borrow $80k+ in your name. Have you calculated what the monthly payment on that level of debt would be? There was another post where the person was going to have more than a $3k/ month for 10 years to pay for their PA program.

80K of undergrad debt plus PA school debt is a lot of debt. Even if you perceive the prestige of a PA to be higher than an NP (which is fundamentally false anyway), perceived prestige isn’t going to go far toward sugar-coating a decade or more of being a wage slave to a six-figure debt-load.

NP’s can do essentially the same jobs as NP’s, plus there are all sorts of other options within the nursing profession as well. (Who knows - maybe after some exposure to the field, you’d decide to become a nurse anesthetist or a surgical nurse or an ICU nurse or… etc. NP is a great path to advancement but not the only one.) You could work for a few years to gain experience and save money before going back for your NP, which is good in a whole range of ways: financially, professionally, and emotionally, as a change of pace from the inevitable academic burnout. I have definitely known medical professionals who are uneasy with how “unseasoned” entry-level PA’s can be as compared to NP’s whose minimum level of clinical exposure is higher - getting some real-world mileage as an RN adds a whole additional dimension to your clinical judgment.

People who look down on nurses are uninformed and have generally been blessed not to have their life depend upon the expertise of a nurse. (Yet.) I don’t think the path you propose will be a sacrifice at all; I think it’s a win-win. If you had a comparable financial deal for PA school, then maybe there would be a basis for debate, but comparing where you’ll be at undergrad graduation (debt free and wildly employable vs. 80K underwater with your clinical license still 2-3 years and another 80K off?)… I don’t think the direct-entry guarantee is worth what you’d be giving up.

@Eeyore123 the gpa is 3.5 (which is very doable for me I think) and the PA program costs $116,857 total. Im not fully sure about the 20,000 loan yet, because the college still has one more scholarship open & ill apply to city scholarships as well & there will be work study later. My parents are willing to take out loans but I don’t really like that because I know they want to buy a house and taking a loan for me will be a huge burden. I haven’t calculated any of the months payment things yet because I’m not sure how to…aaa this is all very stressful, going between my head vs my heart.

A 3.5??? Then it is easy. Go the RN route. A 3.5 GPA in college is very high GPA.

@aquapt see, when you put it like that, the better option seems like a no brainer. The np option clearly looks like a better one. But its just so hard to when your entire family looks down on what could be your future profession you know? and with the culture that im from, I KNOW my South Asian society within my city will be talking down on me if I choose nursing (ugh) never mind the fact that np also treat and diagnose. One other problem is that I do prefer how much option PA has, with its specialty vs NP which is one of the main thing that conflicts me. I love how PAs can switch and have more surgical options as their specialty. One other thing is that my mom might make me go to the closest state school if I go NP route because she doesn’t think with a career like nursing I need to go to any well known or just a better state school since nursing is a “whatever” career. But I know my entire high school is going there and I really need a new environment right now…Financially NP seems like the smarter choice but then my emotions are getting in the way ugh.

@Eeyore123 thanks for the feedback! Im getting scared looking at the money ill owe, so the RN option is looking more realistic for me right now

Paging @carachel2 , who is extremely knowledgeable on this topic…

I think you’re right to be put off by the debt. Your family probably has not experienced the level of competitiveness and expertise of the nursing profession in the US today. It takes top stats to score direct admission to a nursing program these days. Occasionally you’ll see people on CC telling aspiring premeds that they can always go into nursing if they’re not competitive for med school, but these folks are not up to date on the realities of nursing education today - students who don’t have the grades to get into med school will have a tough time getting into nursing programs too.

You might want to do some networking and find someone from your family’s cultural background who has a high-level nursing position (clinical or faculty) and can help you address their misconceptions.

And if you have funding to go to any state school, why would you need to chose the closest one? I would think the main consideration would be making sure you secure a direct-admit spot in a strong nursing program. Just because you have a scholarship to your public U’s generally, doesn’t necessarily mean you’re automatically admitted to a specific major.

Are you male or female? Sounds like perhaps the issue could be bias against nursing as a career for a guy, whereas PA is historically more of a male path?

Chiming in late here but happy to help. Is it an option to take the full scholarship at the state school for all of your PA pre-reqs and then go to PA school?

A couple of comments–

  1. although it would mean sacrificing the guaranteed admission to PA school, you could attend a state U for free THEN apply for PA school. This more traditional route is how most students get to PA school.

You could also do a nursing degree then apply to PA school. Historically PA schools looked for paramedics, nurses and others with hands on medical experience. In fact PA schools still require anywhere from 500 to 3000 hours of direct hands of PAID patient care experience for admission. It quite common for PA applicants to have worked in a healthcare field for a year or several years before applying.

  1. In the NP vs PA career debate. PAs have more options w/r/t to specialization than do NPs who are most commonly employed in primary care, ERs, urgent care or out-patient psychiatric care. But NPs have more autonomy and can practice independently in a number of states. In contrast PAs must[//u] work under the supervision of a physician.

BTW, NP programs also typically at least 18 months of hospital nursing experience before you can apply for them.

Are you from NJ? I feel that in my gut.

It’s true - even committing to an undergrad BSN path wouldn’t mean that you couldn’t go to PA school. You could absolutely stay with PA school as your default goal, no matter your undergrad school or major.

The question here, fundamentally, is whether an admission guarantee with a 3.5 GPA threshold is worth 80K of undergrad debt.

I would contend that it isn’t. The level of performance required to avail yourself of the guarantee is so high that you could pretty much get into PA school anyway, so… what are you really buying with that 80K that you don’t have??

My opinion is, take the free undergrad degree. If you can get direct-entry to a nursing program, that would be a very smart major to start out in IMHO, as it would make you highly employable after undergrad and keep both the PA and NP paths open. But even if you major in something else, maintain the 3.5+ GPA you would have needed anyway, and take all of the pre-health prerequisite classes… you can still apply to PA school, entry-level MSN programs, or whatever.

Regardless, the 80K of undergrad debt for a pre-PA degree with no marketable credential in its own right, and the guaranteed-admit that depends on a GPA that would get you into PA school anyway…? That’s a hard pass, in my mind, when you have a debt-free alternative.

Not directly answering your question here but long-term career options would be much greater with the BSN/MSN/NP. If you go through nursing and then eventually an NP program and decide clinical hands on care is not for you, you still have a lot of options. Pharmaceutical companies are well-known for hiring nurses for a lot of non-clinical work such as research, sales, medical and regulatory affairs. They typically pay very well for those jobs, too.

Another route to consider is becoming a CRNA as someone else mentioned. Salary-wise a nurse anesthetist will typically blow away a PA, no matter what specialty, but you will absolutely need at least a year of strong ICU nursing under your belt. Also, very difficult to get into a CRNA program but definitely pays extremely well and most get hired right out of school.

You can do undergrad nursing and then go to PA school. Actually IMO it’s the better route because it opens you up for PA or NP.

Hi there - chiming in late but hope you will see this. With the stress it seems you are under it can be hard to see the forest for the trees. TAKE THE FREE UNDERGRAD. In Nursing or another field with strong science and math prep. Then apply to PA school. A BSN with strong preparation and GPA will get into a PA program. Or you could practice for a year and apply to med school. Or become an NP. In any case, you will need that money and freedom from debt to help with the next step. Good luck and I’m rooting for you.