Understanding educational pathways for NP, PA

parentologist
Fri, 28 Jan 2022 14:32:02 +0000

The main difference in practicing as an MD vs as a PA or an NP is that MDs are trained to understand WHY they do what they do, and hence recognize variations from the most common presentations of illness. (Cue the chorus of NPs claiming that their training is equivalent, nay, better, because they do it with feeling). There is no question that the basic science training for MDs is at a much more challenging, in depth, and comprehensive level, and the clinical training is many, many more hours of training. I once totaled it up, and effectively MDs who do only a three year residency effectively undergo about ten times as many hours of clinical training than do NPs or PAs. But the reality is that our society has decided to allow NPs to practice medicine independently, and PAs to do so under the most nominal supervision. It is what it is.

Physician assistants are trained to be exactly that - assistants to physicians, who undergo continuing training by the physicians with whom they are working. I have seen PAs for neurosurgery, who were trained by the neurosurgeons with whom they worked to do many procedures, to assist the MD.

NPs are trained along a completely different philosophy, one that is more independent of physicians.

Your daughter sounds as if she is capable of going to medical school. But the reality is that it is a difficult path, and many become discouraged by the weed out nature of the premed classes (especially Organic Chem), and drop out of the premed track. Her disposition sounds as if she is also very suited for the NP track, or the PA track. Frankly, if one is suited for the NP track, that is the least academically challenging and least expensive route, and compensation can be excellent. I agree that the cheapest way to do it is a community college RN, followed by a state college RN to BSN program, followed by an NP program or the new doctor of nursing certification, with some work in the field in between every level of training. Alternatively, it may be worth the expense for her to apply to direct admit BSN programs at your state college, so as to finish the BSN quickly. She is certainly capable of getting into direct admit BSN programs.

One can also apply to T20 level nursing schools, such as Penn or Duke, and assuming that you’re full pay, pay a lot for the training and have a T20 college experience. But unless one wants to go into academic nursing, it’s a lot of tuition for essentially the same earning power as one would have coming out of your state college.

If your daughter wants a full understanding of medicine, to understand WHY she is doing what she is doing once out in practice, to have all options of medical practice open to her, then she should try for medical school. If she finds the premed track too challenging, she can switch into a BSN in nursing, if she is at a college with a nursing school - since the level at which premed classes are taught is higher than that for nursing school basic sciences, it is possible to transfer into nursing. But from what you describe, she sounds as if nursing, with the goal of becoming an NP, is the more appropriate track for her.

The reason that BSNs don’t apply for PA school is that the BSN doesn’t fulfill the prereqs for PA school. The basic science classes for BSNs are taught at a lower level than are the prereq sciences for MD and PA school.