EMNP Posted April 9, 2015 Author Share Posted April 9, 2015 I got into a CA PA program and I also got into a couple California State University FNP programs. the PA program costs around 70K in tuition compared to 25K for the FNP programs. If I go to the PA program I won't be able to work the first year which is a year worth of salary (~80-85K as an ICU RN). If I go to the PA program I would use all my savings (~80K) in living expenses, so in all if I chose PA I would be losing more than 200K in lost salaries, tuition and savings. If I go FNP tuition is much cheaper, and I would still be working and keep my savings... I would much rather do PA because of their medical model and the PA program being a top choice..but is it worth it??? As an NP I can do the same things PAs do in (primary care) and ER (CEP America) and they both get pay exact the same thing I am not interested in doing surgery at all.At my current hospital, they hire both PAs and NPs to work as hospitalists and are paid the same thing.... So the answer or decision should be obvious, but I'm simply stressing out... Also as you know NPs have a very strong lobby and their future in terms of autonomy is bright compared to PAs.. What do you think? If you were in my shoes, what would you do... Link to comment Share on other sites More sharing options...
Nonlegit Posted April 9, 2015 Share Posted April 9, 2015 There are some quality responses in my similiar thread, OP. http://www.physicianassistantforum.com/index.php?/topic/13039-pa-vs-npin-the-future/ Link to comment Share on other sites More sharing options...
browndog Posted April 9, 2015 Share Posted April 9, 2015 I'm an NP. That said i would reconsider being in any long term career that is considered "mid level". If you are young enough then pursue MD/DO. If I had to choose an APC role, I would choose PA over NP due to initial training. I would give serious thought to CRNA as well. Now, will someone please cover my shift tonight? After reading all of these wonderful comments I'm pretty sure that I am barely competent to tie my shoes let alone take care of folks in an ED. Link to comment Share on other sites More sharing options...
SocialMedicine Posted April 9, 2015 Share Posted April 9, 2015 FNP is 25 k likely bc it is part time/not the best program, and requires an RN degree prior. I doubt it awards a masters degree. My opinion given that education is unfortunately expensive and when you see a deal it usually means it is not a deal. I would become a PA. But I understand the NP interest. The DNP and scope of practice laws will advance NP's. So if someone wanted to be a pediatric or adult primary care then perhaps NP is the way to go ? The rapid PA growth (150 - 190 schools in 5 years and many of those 150 programs inc in size) is going to fuel work force change and AAPA/PAFT power (if people participate). There is NO PA workforce model that is public available which predicts what we will look like in 10 or 15 years. Also the urgent care and large group /hosp based practice will knock off private practice docs one by one, even in specialties. These larger groups are run by MBA types and powerful. I suspect they will be pro NP and PA especially if we can begin demonstrating our quality of care through academic productivity. Link to comment Share on other sites More sharing options...
LESH Posted April 9, 2015 Share Posted April 9, 2015 I got into a CA PA program and I also got into a couple California State University FNP programs. the PA program costs around 70K in tuition compared to 25K for the FNP programs. If I go to the PA program I won't be able to work the first year which is a year worth of salary (~80-85K as an ICU RN). If I go to the PA program I would use all my savings (~80K) in living expenses, so in all if I chose PA I would be losing more than 200K in lost salaries, tuition and savings. If I go FNP tuition is much cheaper, and I would still be working and keep my savings... I would much rather do PA because of their medical model and the PA program being a top choice..but is it worth it??? As an NP I can do the same things PAs do in (primary care) and ER (CEP America) and they both get pay exact the same thing I am not interested in doing surgery at all.At my current hospital, they hire both PAs and NPs to work as hospitalists and are paid the same thing.... So the answer or decision should be obvious, but I'm simply stressing out... Also as you know NPs have a very strong lobby and their future in terms of autonomy is bright compared to PAs.. What do you think? If you were in my shoes, what would you do... It is totally out of character for me to say this, but you should consider NP. I know several California NPs with your stats and they are doing very well, and yes one of them is a CEP NP. Still, your PA program is stellar should you go that route and if you can swing it finacially I would say something different. MexicanPA there is no shame to your game if you go NP. Just sayin. Link to comment Share on other sites More sharing options...
jer_sd Posted April 9, 2015 Share Posted April 9, 2015 Speaking as a NP. PA initial training is better, but after a few years in practice you will be comparable. NP has less flexibility in areas, if down the road you want to work psych you need more credentials, hospital privileges can be have obsticals for a FNP for procedures, for example one hospital I was credentialed PA automatically can apply for first assisting NP requires RNFA course (I agree with this type of restriction though) However looking at the cost difference between the programs I would encourage you to look at the FNP program. You might need further training down the road if your career goals change but if both paths reach your goal I vote for less debt and more savings. Jeremy Link to comment Share on other sites More sharing options...
Guest Paula Posted April 9, 2015 Share Posted April 9, 2015 I've never understood the concept that after a few years the PA/NP will be comparable? How so? It makes me think that we believe we hit a plateau and PAs can't learn anymore and NPs get to that level and then we grow stagnant together. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted April 9, 2015 Moderator Share Posted April 9, 2015 I've never understood the concept that after a few years the PA/NP will be comparable? How so? It makes me think that we believe we hit a plateau and PAs can't learn anymore and NPs get to that level and then we grow stagnant together. agree. also not all pas (or nps for that matter) in a given field will reach the same point after 5 years. I have worked as an em pa now for almost 20 years and year 1 in practice was doing things em pas with 20+ years experience were not doing because I was a 911 paramedic before becoming a pa and they were not. I was comfortable with a variety of procedures and situations that 100% of the time they deferred to a physician (intubation, IOs, cardioversion, running codes, etc). The stuff I learned early on was stuff that medics don't do: fracture and dislocation reduction, LPs, etc. Even with those skills, coming from a medic(cowboy) background I was more willing to try new things many of my colleagues were afraid to try like central lines, paracentesis, etc. I'm one of only 2 pas in my group of 20 who has ever run a code, intubated, put in an IO, cardioverted, or done a paracentesis. the other guy is also a former medic. Link to comment Share on other sites More sharing options...
Guest Paula Posted April 10, 2015 Share Posted April 10, 2015 Ultimately, the success of a PA/NP is 100% dependent on the individual PA/NP. MexicanPA can end up being the best PA or the best NP because he/she wants to learn, grow,stretch, study, progress, be wiling to be mentored and told that he/she will make mistakes, and will always keep the curiosity about medicine active in the brain. It behooves all of us, whether PA or NP to strive for excellence. If we do that it may not matter in the end which profession one picks. Link to comment Share on other sites More sharing options...
Guest JMPA Posted April 10, 2015 Share Posted April 10, 2015 Once again, Pa and NP are not interchangeable. Its like putting chevy parts on a ford. it may work for a lil while but will ultimately fail. Know the difference. nursing thought process is entirely different than PA/MD. It is in this that the true difference lies in the training. no amount of time will equalize the difference. Link to comment Share on other sites More sharing options...
whoRyou Posted April 10, 2015 Share Posted April 10, 2015 It was possible up to 1985 or1986 I think. Then the pathway was closed. I remember that E. Im not sure but I think that pathway is closed also. LesH, do you know why the PA/NP and why closed down? Link to comment Share on other sites More sharing options...
SoCalPA Posted April 10, 2015 Share Posted April 10, 2015 Op I think you have appropriately weighed the pros and cons. I would urge you to consider CRNA with your ICU experience. Also, if you want to go into critical care or EM as an FNP won't you need to go back to get a CCNP or something like that? Barring that I'd go NP. No shame!!! Link to comment Share on other sites More sharing options...
LESH Posted April 10, 2015 Share Posted April 10, 2015 LesH, do you know why the PA/NP and why closed down? The professions "evolved". PA as I recall was getting to the point where there were 50 or so PA programs and it was determined that it was better to certify graduates of those programs than allow foreign trained physicians and other medically trained individuals to challenge the exam. For those that remember this more clearly feel free to correct me because I was just graduating at the time and have a simple recollection. At one time In Califoria RNs who became PAs could become an NP by taking an addtional class (I don’t recall content but maybe it was on advance nursing theory) and clinical skills verification of some kind. I remember that from my USC faculty days because I worked with a RN, PA-C. FNP faculty who would coordinate that for any RN that went through the PA program. With the increase in the number of NP programs over the years, it would only make sense to finally close that pathway Link to comment Share on other sites More sharing options...
db_pavnp Posted April 10, 2015 Share Posted April 10, 2015 I've never understood the concept that after a few years the PA/NP will be comparable? How so? It makes me think that we believe we hit a plateau and PAs can't learn anymore and NPs get to that level and then we grow stagnant together. Law of diminishing returns. It is commonly enough suggested that practicing PAs reach their MD counterparts in a handful of years. By extension, NPs do, too. Now, JMPA obviously feels that the educational models are so different that this doesn't work. But I feel that for such an opinion to be valid, one must be able to argue that Step 1 is insignificant. This same trap is used by MDs to discount PA education. If you ask them how important their Step 1 education is to their practice they will laugh at the question. But if you ask them why they are the top dogs and PAs are second fiddle, they will say Step 1 sets their education head and shoulders higher. Link to comment Share on other sites More sharing options...
whoRyou Posted April 10, 2015 Share Posted April 10, 2015 This same trap is used by MDs to discount PA education. If you ask them how important their Step 1 education is to their practice they will laugh at the question. But if you ask them why they are the top dogs and PAs are second fiddle, they will say Step 1 sets their education head and shoulders higher. Correct me if I am wrong, but is it not suggested that WE (PAs) should study from the Step 1 for the PANCE because of the similarities? My point is, if I remember reading that then WE should laugh at THEM (tongue in cheek) because WE don't have to be in school as long as THEM. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted April 10, 2015 Moderator Share Posted April 10, 2015 Correct me if I am wrong, but is it not suggested that WE (PAs) should study from the Step 1 for the PANCE because of the similarities? My point is, if I remember reading that then WE should laugh at THEM (tongue in cheek) because WE don't have to be in school as long as THEM. pance is actually more like step 2 and step 3. most PAs would fail step 1 as we do not cover the basic medical sciences to the same degree. if we did, we would be physicians. step 1 (and the residency) is the difference between a pa and an md/do. Link to comment Share on other sites More sharing options...
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