Remster825 Posted February 18, 2014 Share Posted February 18, 2014 Hi all, I was lucky enough to get into all the programs I applied to and have narrowed it down to 1 PA program in CA (private school, respected but not a UCD/Stanford/USC type name) and 1 direct-entry FNP program (It's a UC in a city with a famous orange/red bridge, if you catch my drift). I applied to both PA and NP programs because I was very geographically limited to the Bay Area because of my husband's job. I have been PA all the way but recently I have done some more digging and was told that the the UCs, Stanford Med Center, Palo Alto Medical Foundation, etc. basically hire PAs for surgery and that's it. Surgery is not my interest area... thinking potentially cardiology but I want to keep an open mind regarding specialty (although I know I do want to be a specialist of some sort rather than primary care). With all that said, do I go to the globally recognized FNP program or to the PA program that I truly loved that is not a "big name" school? Do you see FNPs or PAs being hired more in CA and for what types of positions? If you could do it over again, what would you choose? Thanks for any guidance you can provide! Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted February 18, 2014 Moderator Share Posted February 18, 2014 northern ca NP>PA at most places unfortunately. southern cal is about = now. Link to comment Share on other sites More sharing options...
Remster825 Posted February 18, 2014 Author Share Posted February 18, 2014 northern ca NP>PA at most places unfortunately. southern cal is about = now. I'm concerned because the program is for FNPs but Acute Care NPs seem to be preferred for inpatient, correct? So not only is NP 3 years of school instead of 27 months for PA, I may have to get an additional credential for Acute Care afterwards it seems? Is that right? I also want to have a family pronto and postponing yet another year is hard to think of. In addition, spending my entire first year of the NP program learning to be a nurse (rather than the second two years training to be a provider) doesn't sound great as I really have no interest in ever working as a floor nurse. Ugh this is tough. Would you do anything differently? Happy with being a PA regardless? Sent from my iPhone using Tapatalk Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted February 18, 2014 Moderator Share Posted February 18, 2014 I would still be a pa due to the nature of the training. others may feel differently. Link to comment Share on other sites More sharing options...
Joelseff Posted February 19, 2014 Share Posted February 19, 2014 Hi all, I was lucky enough to get into all the programs I applied to and have narrowed it down to 1 PA program in CA (private school, respected but not a UCD/Stanford/USC type name) and 1 direct-entry FNP program (It's a UC in a city with a famous orange/red bridge, if you catch my drift). I applied to both PA and NP programs because I was very geographically limited to the Bay Area because of my husband's job. I have been PA all the way but recently I have done some more digging and was told that the the UCs, Stanford Med Center, Palo Alto Medical Foundation, etc. basically hire PAs for surgery and that's it. Surgery is not my interest area... thinking potentially cardiology but I want to keep an open mind regarding specialty (although I know I do want to be a specialist of some sort rather than primary care). With all that said, do I go to the globally recognized FNP program or to the PA program that I truly loved that is not a "big name" school? Do you see FNPs or PAs being hired more in CA and for what types of positions? If you could do it over again, what would you choose? Thanks for any guidance you can provide! There are still some private practices here in the bay area and even some like Sutter Foundation who still hire us but other big Groups are moving in (Stanford, UC system etc) and buying these guys out. FP is almost non existent outside of a small practice. There is the prison health system for PC at quentin or vacaville. Kaiser is pretty much owned by the NPs in fields other than surgery, ortho etc. Even ED and UC at kaiser is NP dominated. ED through CEP is still PA friendly and the VA is too... ETA: I am still glad I became a PA! (But would do a np bridge if it were available) 8) Sent by my Samsung S4 Active via Tapatalk Link to comment Share on other sites More sharing options...
Remster825 Posted February 19, 2014 Author Share Posted February 19, 2014 Hey there thanks for all this info. I truly appreciate it. Sorry for the ignorance here but when you say FP do you mean Family Practice and PC being primary care? I don't know what CEP is... sorry lots to learn regarding these abbreviations! :) Also, the PA school I'm considering said they don't even need a new grad employment placement assistant service because all of their grads have jobs after the program (his explanation for this was that they usually secure jobs during rotations). Do you think this is accurate? Does the VA favor PAs for all specialties or just ED? I'm really interested in the VA. Also, do you think the name matters (see original post). Thanks everyone- this is really helpful. :) Sent from my iPhone using Tapatalk Link to comment Share on other sites More sharing options...
Joelseff Posted February 19, 2014 Share Posted February 19, 2014 Hey there thanks for all this info. I truly appreciate it. Sorry for the ignorance here but when you say FP do you mean Family Practice and PC being primary care? I don't know what CEP is... sorry lots to learn regarding these abbreviations! :) Also, the PA school I'm considering said they don't even need a new grad employment placement assistant service because all of their grads have jobs after the program (his explanation for this was that they usually secure jobs during rotations). Do you think this is accurate? Does the VA favor PAs for all specialties or just ED? I'm really interested in the VA. Also, do you think the name matters (see original post). Thanks everyone- this is really helpful. :) Sent from my iPhone using Tapatalk Yes FP Family Practice Pc os Primary Care. CEP is a company that does most if not all the ED hiring for non kaiser hospitals in this area, more or less. Touro? Samuel Merritt? (Im guessing these may be the private school(s) you mentioned) Im not sure but my program most of us had jobs lined up before graduation and a bunch got hired through CEP. As far as VA, I have PA friends at urgent care, IM, inpt, surgery, and ED. They work side by side with NPs. The practices/hospitals in the area near a school are VERY familiar with the PA grads so I would say the name wont matter if its not as "well known" as others. Im sure a UCSF or Stanford would be recognized far and away but shouldnt close doors to those from other schools. Sent by my Samsung S4 Active via Tapatalk Link to comment Share on other sites More sharing options...
Remster825 Posted February 19, 2014 Author Share Posted February 19, 2014 Last thing... in my position what would you choose? Since you would do the NP bridge program but still love being a PA.. would you do NP first at the prominent school and then maybe PA after? At this rate I feel like med school would almost be similar in regards to time commitment- lol. Do you know if its FNPs ( vs. Acute Care NPs, Ped NPs, Adult NPs) that are getting these jobs in hospitals? Another thing I don't like about NP is I had to pick a track and as FNP could see all patients (peds, pregnant women, adults, gerontology, etc) so that is what I chose (and acute care was not open to direct entry nursing students so it wasn't an option). But my understanding is that Acute Care NPs are being utilized for inpatient and FNPs more for outpatient. I think I really would like to work in the hospital so my guess is that I'd need to work as a floor nurse in med surg/acute care to get a job in that setting as an NP (and I really have no interest in working as a floor nurse). So I feel like I'm in a state of analysis paralysis... and I just don't know which way to turn. Thanks for any additional thoughts/guidance. Sent from my iPhone using Tapatalk Link to comment Share on other sites More sharing options...
Joelseff Posted February 19, 2014 Share Posted February 19, 2014 Last thing... in my position what would you choose and why? Sent from my iPhone using Tapatalk I dunno...thats a loaded question. I would still choose a PA track because i believe the training is still superior. B U T, NPs have the advantage of successful and powerful lobbying. That is why I stated, partly tongue in cheek, about the NP bridge.... Sent by my Samsung S4 Active via Tapatalk Link to comment Share on other sites More sharing options...
Remster825 Posted February 19, 2014 Author Share Posted February 19, 2014 Sorry I edited and expanded on the question above. I knew it was a loaded question so I tried to clarify. lol Sent from my iPhone using Tapatalk Link to comment Share on other sites More sharing options...
Joelseff Posted February 19, 2014 Share Posted February 19, 2014 Sorry I edited and expanded on the question above. I knew it was a loaded question so I tried to clarify. lol Sent from my iPhone using Tapatalk No worries. Lol I was editing too. But if you are going NP just stick to NP. I wouldnt go back to do PA school...don't even know if that would be feasible but theres a poster here named Oneal who did NP and stopped to go to PA school. So they may shed better light on this. I am not crrtain if tge NPs they worked with were FNP or not. Not too familiar with NP specialtization....I do have NP friends who are FNPs and one worked in Uro so dunno about how that works out... Sent by my Samsung S4 Active via Tapatalk Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted February 19, 2014 Moderator Share Posted February 19, 2014 If I were to do both, definitely do PA first. I can say this though as I am already a nurse. Don't think, not sure, I would consider doing both if I had to go through RN as well. If I were to do only one, and I emphasize that personal opinion, I would do PA. If I were to do NP first, I would not go to PA school. I did PA because I wanted a broader view of medicine and more in-depth sciences. I really disliked nursing school for the lack of this and felt like NP was nursing school 2.0. However, you may value the freedom over the training. Not that NPs are bad or have sketchy training. I just believe PA is better and it was definitely better for me. Link to comment Share on other sites More sharing options...
Remster825 Posted February 19, 2014 Author Share Posted February 19, 2014 Thank you all so much. I am still definitely favoring PA- I like the training better too and it just seems to fit best with my life and goals. I appreciate each of your perspectives and guidance- thanks again!! :) Sent from my iPhone using Tapatalk Link to comment Share on other sites More sharing options...
db_pavnp Posted February 19, 2014 Share Posted February 19, 2014 I would like to be corrected if I am wrong, but bridging from PA to NP is at least in the realm of possibility, while bridging from NP to PA is far less likely. Link to comment Share on other sites More sharing options...
Lexapro Posted February 19, 2014 Share Posted February 19, 2014 I would like to be corrected if I am wrong, but bridging from PA to NP is at least in the realm of possibility, while bridging from NP to PA is far less likely. I think they're both equal. Why would it be easier to go from PA to NP than the other way around? I guess an NP might have to take some more prereqs before they applied, but if the PA isn't already an RN they will have to go through RN school. I frankly think it doesn't make sense and if one isn't happy as a PA (or NP) then they should probably just bite the bullet and pursue medicine instead. OP - I would consider what setting you want to work in, where (and what type of provider is favored in that setting), if you have any aspirations towards management/research/teaching, etc. I would not just focus on the mode of education (school is temporary) but the decades you will spend actually practicing in the profession. Which one matches best with what you want to actually do? You are right that NPs dominate the bay, even working as hospitalists and in the ER, but are you planning on never leaving the bay? eta: Just saw you are geographically limited to the bay. Hmmm. Maybe contact some cardiology practices and see how they feel about PAs vs NPs? Link to comment Share on other sites More sharing options...
Remster825 Posted February 19, 2014 Author Share Posted February 19, 2014 I think they're both equal. Why would it be easier to go from PA to NP than the other way around? I guess an NP might have to take some more prereqs before they applied, but if the PA isn't already an RN they will have to go through RN school. I frankly think it doesn't make sense and if one isn't happy as a PA (or NP) then they should probably just bite the bullet and pursue medicine instead. OP - I would consider what setting you want to work in, where (and what type of provider is favored in that setting), if you have any aspirations towards management/research/teaching, etc. I would not just focus on the mode of education (school is temporary) but the decades you will spend actually practicing in the profession. Which one matches best with what you want to actually do? You are right that NPs dominate the bay, even working as hospitalists and in the ER, but are you planning on never leaving the bay? eta: Just saw you are geographically limited to the bay. Hmmm. Maybe contact some cardiology practices and see how they feel about PAs vs NPs? Great points! Yes, my husband works in tech so we will likely be in Silicon Valley area permanently (as he needs to be located where the majority of the teams he manages are/where HQ is located and that's usually here). He also has a team in Austin, TX which is a thought for the future but I looked at the Texas thread and it appears Austin is also NP dominated. I will try to call some cardiology practices and see what they think! Sent from my iPhone using Tapatalk Link to comment Share on other sites More sharing options...
db_pavnp Posted February 19, 2014 Share Posted February 19, 2014 There are several reasons I can imagine which make it easier to go PA to NP. Post Master's Certificates to generate NPs from MSNs appear common. These programs already have the tools and policies to accept Master's educated students, process transfer credits, and assess incoming student ability for advanced placement in coursework. PA programs do not appear to exhibit these traits. The bridge is unusual - you need to find someone who will bite. NP programs are also available online, so when you find that bridge, you wouldn't have to move to it. PA programs are more broad, more hours. If you try to Post Master's from NP to PA, I really feel they are going to insist you take their full curriculum. They are full of clinicals and subject matter which wouldn't be covered in an NP specialization. These are only my observations of the issue. NP programs already have a significant precedent in place to generate NP's from Master's with abbreviated programs and PA programs simply do not appear to participate in this. Link to comment Share on other sites More sharing options...
Lexapro Posted February 19, 2014 Share Posted February 19, 2014 Right, but the PA must still become an RN first... and the vast majority of post-masters NP programs are for those who already have an MSN, not just any masters degree. So the PA will have to become an RN and then go on to NP school, where they may or may not be able to waive a few classes (maybe). The NP will have to likely take some prereqs and then go to all of PA school (maaaybe they could waive a course or two as well, depending?). I think it's a wash going either direction. Link to comment Share on other sites More sharing options...
Remster825 Posted February 19, 2014 Author Share Posted February 19, 2014 Just to clarify I do not have an RN. The program I would enter is a 3 year FNP program. You get your accelerated RN in one year, and then your master's as an NP in your second two years. Summers are off and the second two years are like 3/4 time so many work as RNs as well while in the second two years of the program. Sent from my iPhone using Tapatalk Link to comment Share on other sites More sharing options...
Remster825 Posted February 19, 2014 Author Share Posted February 19, 2014 For me, it looks like I'd get my FNP and then have to work as a floor nurse for a year or two in a critical care setting and/or pursue my Acute Care NP cert, and then I could work inpatient as a cardiology NP. Just seems like a long road compared to PA to actually get to do what I want to do. However, if there are no jobs available for cardiology PAs in the Bay Area, then I'd rather take the long road that will get me to where I want to be. I'm just so surprised with the ACA and this mass influx of patients I keep hearing of that the UCs, Stanford, PAMF, etc can exclude PAs in general. Don't they need mid level providers period?! How can they be so exclusive? Sent from my iPhone using Tapatalk Link to comment Share on other sites More sharing options...
db_pavnp Posted February 19, 2014 Share Posted February 19, 2014 Right, but the PA must still become an RN first... and the vast majority of post-masters NP programs are for those who already have an MSN, not just any masters degree. My intuition tells me that if a PA queried twenty post-msn np certificate programs, one would take the bait. The post-msn programs are 20-ish credits. If an NP queried forty PA programs, not a single one will offer an abbreviated program and all ~130 credits would be necessary. Intuitions differ between people. Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted February 19, 2014 Moderator Share Posted February 19, 2014 There is no way a PA without a RN could "bridge" to NP. AACN standards wont allow it, NLN wouldn't allow it. It's a clear and direct violation of accreditation standards. Have to be an RN before Np school and even MDs can only get the one year accelerated RN at best. Now if you are an RN and a PA, shaving off some credit hours in the NP portion may be in the cards. Still doubt it because, while you took the same classes, they aren't in the same department. Link to comment Share on other sites More sharing options...
Lexapro Posted February 19, 2014 Share Posted February 19, 2014 For me, it looks like I'd get my FNP and then have to work as a floor nurse for a year or two in a critical care setting and/or pursue my Acute Care NP cert, and then I could work inpatient as a cardiology NP. Just seems like a long road compared to PA to actually get to do what I want to do. However, if there are no jobs available for cardiology PAs in the Bay Area, then I'd rather take the long road that will get me to where I want to be. I'm just so surprised with the ACA and this mass influx of patients I keep hearing of that the UCs, Stanford, PAMF, etc can exclude PAs in general. Don't they need mid level providers period?! How can they be so exclusive? Sent from my iPhone using Tapatalk Wait. So you're talking about doing 3 years to get your RN/FNP, then working several years as an RN, then going back for ACNP? Why not just go to medical school? Honestly, to work inpatient cardiology, you don't need to go through that torturous path. Become an FNP and get 1-2 years NP experience if you can't get a job right away in cardiology (you might have a hard time going directly into cardiology as a new grad). Once you have some experience you'll have a much easier time getting the job you want. Or become a PA, but I'd caution that route since the bay area is so overwhelmingly dominated by nursing (for better or worse) and you won't be able to move to a more "PA friendly" state. Link to comment Share on other sites More sharing options...
Lexapro Posted February 19, 2014 Share Posted February 19, 2014 My intuition tells me that if a PA queried twenty post-msn np certificate programs, one would take the bait. The post-msn programs are 20-ish credits. If an NP queried forty PA programs, not a single one will offer an abbreviated program and all ~130 credits would be necessary. Intuitions differ between people. My intuition tells me that you don't know a lot about nursing education... but yeah, no PA is going to get around the RN requirement. You cannot become an NP if you don't hold an RN license, period. Also, when it comes to whether or not NP programs will take PA credit (or vice versa), we're just purely speculating. My program has to force people with PhDs to take the research class through the school of nursing here, because the BRN has very strict requirements for licensure. It's not the school, it's what the BRN requires to be on your transcript in order to receive the license. Link to comment Share on other sites More sharing options...
db_pavnp Posted February 19, 2014 Share Posted February 19, 2014 It's not pure speculation. There is precedent for PA to NP, not vice versa (unless you can find it). I know folks (PAs with bsn) who have negotiated individual "bridge programs" in which they did no clinicals and took only np didactics that pas don't do (stuff on the profession mostly). took about a yr of part time coursework. this is on a very case by case basis of course. Link to comment Share on other sites More sharing options...
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