confused101 Posted February 11, 2011 Share Posted February 11, 2011 Hi, I posted in the professional PA forum because I felt as if practicing PAs would be best able to guide me in this decision. I'm a college senior graduating this Spring (I'm 21y/o). I have acceptances for both a PA program and a Direct-Entry Nurse Practitioner (MSN) program. I can't believe I put myself in this situation, it's impossible to decide! They are the same tuition, the same time commitment, and at the end in the same geographical location, the only thing different is in one I get a Masters as a PA and in the other I get a masters as an NP. The only HCE experience I have is a year as a MA at a Physician's office. For the sake of reality, I wholehartedly believe in PA training, and see it offers me much more knowledge (in my opinion) than NP/Nurse school, but I happen to live in a state that seems to give more legislative freedom to NPs than to PAs. And lately I'm seeing how much more it matters than I initially perceived. It also seems as if it may be easier to in the future own a practice (ultimate goal-->10 years into my career) as an NP. Although, I believe as a PA I would be "better trained" and more confident to practice medicine. I can't seem to decide, I need to make my decision in the next couple weeks and it could decide my future. Even after shadowing both NP/PAs I seem to come to a blank. What would you do in my position?? ANY feedback will be appreciated. Thank You. Link to comment Share on other sites More sharing options...
queenofhearts Posted February 11, 2011 Share Posted February 11, 2011 I would also like to know what others tell you since I am also debating between the two! Link to comment Share on other sites More sharing options...
queenofhearts Posted February 11, 2011 Share Posted February 11, 2011 duplicate. Link to comment Share on other sites More sharing options...
Contrarian Posted February 11, 2011 Share Posted February 11, 2011 Get the MSN/NP... One test, less headache, more jobs, greater autonomy. Link to comment Share on other sites More sharing options...
Moderator ventana Posted February 11, 2011 Moderator Share Posted February 11, 2011 I will be the first one to through out a concrete thought if you are positive you want outpatient primary care the NP is likely a slightly better route (if you can tolerate the BS of nursing theory) - it would be easier to set up a practice as an NP If you are not 100% sure you will go this route do PA as the flexibility as a PA is unmatched and the education is better. PA school is harder then NP school but 2-4years out it is all about rather you stay up to date and keep learning or if you just avoid learning anything new. Overall you will be better educated with PA but I routinly ask NP's questions that are good in their speciality. As a PA looking to set up my own practice (which has been outlawed in NY!) but their is specific laws allowing NP's to own practices it would be nicer to be a NP in that one realm. oh yeah and as a final thought - why not get a DNP so you are at a terminal degree? (get those flame throwers out....) Link to comment Share on other sites More sharing options...
marilynpac Posted February 11, 2011 Share Posted February 11, 2011 this belongs in the prepa section... Link to comment Share on other sites More sharing options...
confused101 Posted February 11, 2011 Author Share Posted February 11, 2011 thats tough. if you dont mind me asking, what programs? dont feel any pressure to say if you dont want to, im just curious. Both PA & NP programs are in NYC... I will be the first one to through out a concrete thought if you are positive you want outpatient primary care the NP is likely a slightly better route (if you can tolerate the BS of nursing theory) - it would be easier to set up a practice as an NP If you are not 100% sure you will go this route do PA as the flexibility as a PA is unmatched and the education is better. PA school is harder then NP school but 2-4years out it is all about rather you stay up to date and keep learning or if you just avoid learning anything new. Overall you will be better educated with PA but I routinly ask NP's questions that are good in their speciality. As a PA looking to set up my own practice (which has been outlawed in NY!) but their is specific laws allowing NP's to own practices it would be nicer to be a NP in that one realm. oh yeah and as a final thought - why not get a DNP so you are at a terminal degree? (get those flame throwers out....) These are my thoughts exactly. The NP program is definetely the "cop-out". It's much easier both in classes/expectations and other commitments. But, they just seem to have less restrictions on what they can do. It's kind of wierd because I've been a PA advocate for years, and now that the time has come to decide, I'm leaning towards NP not because it's what I want to do, but because it just seems to be less of a headache. Also, NPs don't have to recertify, which is another reason I'm leaning towards it. But, most importantly I'd like to keep the option of opening up my clinic in the future maybe. NPs make about 5-10k less than PAs where I live, but seem to have a much more organized state chapter that hes no problem fighting for their rights, while the PA chapter hasn't really done anything to promote themselves in forever, and seem to get walked-all-over by any new rules that the medical board imposes on them. And as-per the DNP, they don't have any Direct-Entry DNP programs that I know of. It's certainly an option for the future, but as of now, the only programs that take biology/non-nurse undergrads are the programs which accelerate the nursing portion in a year and then allow you to get the MSN over two years. Even though getting a PA degree is 2x harder than an NP degree (from my observations), I keep on seeing advantages for getting this MSN. The PA program I am accepted to is HIGHLY competitive and it just seems hard to forego that spot to go to an NP program that has average GPAs like 3.3-3.4. BTW, is this recertification process every 6 years a headache? How about CME? (I think NPs need less?) Link to comment Share on other sites More sharing options...
klb48 Posted February 11, 2011 Share Posted February 11, 2011 I would go with what will work in your area. If NPs are more favored in your area then do it. Sure the training won't be as good but education is mostly what YOU put into it. So study hard whatever you decide and you will end up being a great clinician. Link to comment Share on other sites More sharing options...
delco714 Posted February 11, 2011 Share Posted February 11, 2011 Stupid question, are you receiving your BSN in May while you also did prePA prereqs? Link to comment Share on other sites More sharing options...
confused101 Posted February 11, 2011 Author Share Posted February 11, 2011 both programs start in fall 2011. 1st year for the NP program IS the BSN and then over the next 2 years, they award the NP. So its: PA --> 32ish months starting fall NP --> 12 months BSN, then 24 months MSN Link to comment Share on other sites More sharing options...
x98peterson Posted February 11, 2011 Share Posted February 11, 2011 What specialty are you looking at? Primary care, surgery, OB? That makes a huge difference. Every PA/NP wants to have their own practice. So I would not base that on your decision. You will probably change your mind on that, IMO. Also, look at salaries and job openings in your community and go for the one that has the most bang for your buck. Good luck and congrats on the tough decision- it is a good predicament to be in! :) Link to comment Share on other sites More sharing options...
Hemegroup Posted February 11, 2011 Share Posted February 11, 2011 Get the MSN/NP... One test, less headache, more jobs, greater autonomy. less money ... Link to comment Share on other sites More sharing options...
CJKitty Posted February 11, 2011 Share Posted February 11, 2011 Personality-wise, how do you feel about being completely independent vs. having a supervising physician? Would it bother you? If truly being independent is a major goal in life, the NP route definitely has more open doors. You can always hire an SP as a PA and several of you can collectively own a practice depending on your state, it's just a slightly different path. Honestly (uh-oh, here we go) I'm maybe 70% sure I would have gone the NP route if I was in that position. Getting the BSN first would have been a PITA, but both in a row sounds much more reasonable. As has already been said, you get out of your education what you put into it. You won't get the same amount of clinical hours or focus, but if you're willing to go above and beyond your coursework and continue to be actively involved in peer-reviewed publications you can come out of it well-prepared. Do NPs have any sort of "residency" positions ever available to them? Maybe consider getting your ACCN certification as well and possibly working a year or two in ICU or a progressive care unit to get your feet wet and see a good variety of the medical and trauma side. I would also start working with a "supervising" or at least collaborative physician in my first years, personally I would not feel ready to go solo after the NP training. You know yourself better than we do, of course. :) Link to comment Share on other sites More sharing options...
Contrarian Posted February 12, 2011 Share Posted February 12, 2011 less money ... Not if you own the practice and don't have to be beholden to a Physician to practice... Link to comment Share on other sites More sharing options...
GREATMDPA Posted February 12, 2011 Share Posted February 12, 2011 I've been hearing about how NP can be indepedent, but midlevel is midlevel right? Just because they get trained in a different model doesn't make them "competent" to be independent clinicians. Most of the job postings I have come across so far usually state NP slash PA, which they're equivalent, either/or. Regarding having your own practice, you would still need to have a supervising physician either as a PA or NP, it's not like if you're an NP, and you could open your own practice w/o any supervision like MDs can. So having said that, I would go the shortest route with the kind of education I know I would most enjoy. It is really hard to swallow the study materials if you don't believe in them. There's a lot of theory in NP that I would personally find difficult to accept. Good luck with your future endeavor, whichever you decide. Link to comment Share on other sites More sharing options...
kyboynp Posted February 12, 2011 Share Posted February 12, 2011 I agree with the person above that the education is what you make of it. I just graduated from a nurse practitioner program, and I am starting work in an emergency room. For me, I was already a nurse, so the nurse practitioner program made more sense, but I did look at some PA programs, and their were some benefits to those as well. What I do like about the NP role is that in my state where I plan on living, we do have more autonomy, and around here, we make just as much as PAs as well. I know it varies from state to state, but in my state, NPs can practice pretty much independently. We do have to have a collaborative agreement, but the physician never has to sign any charts, or be on site at any time. They just have to agree that they are available for consultation. We have to have a seperate collaborative agreement for controlled substances, and we have to practice a year before we obtain a DEA. I've heard that in many cases, PAs have better opportunites to work in ERs, and that is probably true in some areas, but I had no trouble getting hired in two different ERs immediately upon graduation. As far as specialty practices, such as ortho, cardio, etc. you can get hired into those areas as an NP, but you may not necessarily get a rotation in those areas. In my FNP program, our instructors did allow us to spend some clinical time in specialty practices, and even ERs, but the focus was of course on family practice. I do think you should explore the job market for both PAs and NPs in your area and your state. Explore salaries if possible. Talk to physicians, PAs, and NPs in various settings to see what they think about their roles. I personally love the fact that in my state, if I want to practice independently one day, I can. There are rumblings that the collaborative agreement requirement for everything other than controlled substances may be a thing of the past within a few years in my home state, but I'm not really sure that it's a good idea. It's pretty much only an agreement that the physician will be aviailable for consultation, and I think that is a good thing. I believe in the training that I received, and I know that you really learn to be a provider when you become one. I read, I study, and I work hard to learn as much as possible. I've worked alongside some wonderful NPs, and I've worked alongside some wonderful PAs. Neither is necessarily superior to the other. The education is just different, but as mentioned before, it's what you make of it. It really is. Good luck with your decision. If your desire is to be a competent, qualified medical professional, you cant' go wrong with either if you are willing to put the time and effort into it. Good luck agiain!! Link to comment Share on other sites More sharing options...
Contrarian Posted February 12, 2011 Share Posted February 12, 2011 ...Regarding having your own practice, you would still need to have a supervising physician either as a PA or NP, it's not like if you're an NP, and you could open your own practice w/o any supervision like MDs can... Simply INACCURATE/WRONG/INCORRECT in about half of the states...!!!! Link to comment Share on other sites More sharing options...
browndog Posted February 12, 2011 Share Posted February 12, 2011 For what it's worth.....I am an NP who would love to have received a PA education. NP school was VERY disappointing to me, and I have voiced this many times. That said, I find myself still glad that I am an NP for legistlative and local market reasons. I would have loved a PA/NP dual cert. Oh, and don't let the salary thing be the main difference. There is a tremendous amount of variability in pay. Link to comment Share on other sites More sharing options...
Hemegroup Posted February 12, 2011 Share Posted February 12, 2011 I would have loved a PA/NP dual cert. UC Davis offers one. Link to comment Share on other sites More sharing options...
Just Steve Posted February 12, 2011 Share Posted February 12, 2011 Hi, I posted in the professional PA forum because I felt as if practicing PAs would be best able to guide me in this decision. I'm a college senior graduating this Spring (I'm 21y/o). I have acceptances for both a PA program and a Direct-Entry Nurse Practitioner (MSN) program. I can't believe I put myself in this situation, it's impossible to decide! They are the same tuition, the same time commitment, and at the end in the same geographical location, the only thing different is in one I get a Masters as a PA and in the other I get a masters as an NP. The only HCE experience I have is a year as a MA at a Physician's office. For the sake of reality, I wholehartedly believe in PA training, and see it offers me much more knowledge (in my opinion) than NP/Nurse school, but I happen to live in a state that seems to give more legislative freedom to NPs than to PAs. And lately I'm seeing how much more it matters than I initially perceived. It also seems as if it may be easier to in the future own a practice (ultimate goal-->10 years into my career) as an NP. Although, I believe as a PA I would be "better trained" and more confident to practice medicine. I can't seem to decide, I need to make my decision in the next couple weeks and it could decide my future. Even after shadowing both NP/PAs I seem to come to a blank. What would you do in my position?? ANY feedback will be appreciated. Thank You. Disclaimer...I am going to be antagonistic. If you are not in the mood to read an opinionated retort to this situation, just skip the following words Am I to understand correctly that you view the education of the PA world to be better, embrace evidence based medicine, have very little medical experience as of right now, but would rather go the route that offers the least resistance and the most autonomy? So you want to take the easy road to put yourself in a position to practice medicine on real live people with only a sub par education (your inferred description)? Even more so, you want to OWN a clinic while you feel your path to that point is not a good standard? I think in some circles, we call that "selling out". If you came out and said that nursing theory is a very credible practice style that you believe is a good fit with your own personal ideals and that you feel you can sleep well at night practicing as an NP, then I would say "go for it". At that point, your motivation and ideals are coming from the heart and I firmly believe if your intentions come from your soul, you cannot fail. But if your motivation comes simply from the drive to be the top dog in the fastest, easiest method possible, then I would lay money you would easily get side tracked. If you embark on a journey with the intention of finding the easiest path...where do you draw the moral line of "oh I won't do that" when it comes to finding the path of least resistance? If we all achieved our dreams with the ease of just cruising along our lives would be empty. There is no greater reward than the reward we earn with the greatest of efforts. Link to comment Share on other sites More sharing options...
bmc11 Posted February 12, 2011 Share Posted February 12, 2011 Nursing is great. We need them and I admire and respect competent nurses who work hard and take the extra step and make the most out of their career and education. Yet I just don't understand how NPs have more autonomy to practice medicine, but are educated on nursing not medical model? And that, like others have mentioned, it is the route that has less resistance and clinical experience. Not to mention graduate level courses like "nursing concepts" or "professionalism in nursing" and other things that should be common sense to any compassionate person entering a healthcare field. Yes, they learn the necessities of anatomy, physio, med term, pharmacology, diagnosis and treatment... but some NP programs are a joke to me (and some are very good). I was looking at student doctor net the other day in a thread regarding the possible future name change of physician assistant to associate or some other title. A physician there was discussing his/her views on all of the changes occurring now with NPs, DNPs and the possible PA name change. (S)he said something along the lines of "Some NPs I have worked with have been incompetent. I have yet to meet an incompetent PA." That was a pretty striking comment, IMO, regarding the quality of PA education and the way PA curriculum and rotations prepare PAs. Autonomy-wise, it seems sensible to go the NP route. Education-wise, it seems sensible to go the PA route. But from what I gather, you already know all of these things and you are just struggling between maybe what you'd want to get from your education versus the option that may get you further in the long term. No one here has really said much that you don't already know. Nor can anyone really help you make the decision. I think I'd be very frustrated in nursing school because I don't like nursing for me haha. But if you can see yourself learning nursing and happy taking this other route that might allow you more autonomy later in your career, then that will be what is right for you. I, personally, don't care if I am working under a "supervising" physician. There is a mutual respect in a good partnership and supervision does not mean (obviously) that the doctor is actually watching you work. The PA I shadowed extensively in the emergency department works just as the physicians do, only consulting specific cases with them and having the charts just signed off. Patients don't know who is the doctor or the PA and often address the PA by "Dr." It is not the fact that they called her "Dr." that matters (then that would be like I'm saying we all need to become doctors) but what it represents. It represents that she is competent enough to work alone, has the respect of her colleagues and her patients, and is confident enough in her skills to know that she is prepared enough to assess, diagnose and treat patients. I want that confidence and I will get it through the route that makes me best able to practice medicine, not the best able to practice "alone". For me, that is why I chose the PA route. Good luck! Hope whichever one you choose allows you to be happy and successful in reaching your life and career goals.:=D: Link to comment Share on other sites More sharing options...
SocialMedicine Posted February 13, 2011 Share Posted February 13, 2011 You want to stay in NYC? By the way NYC is saturated with PA and NP programs and providers .... But if you still want to practice here the big question is what type of medicine. if you think inpatient or surgical PA is the way to go. Primary care I would go the NP route. Interested in things "outside" of the clinic ... academics and policy and managing the NP route might be best again. While I feel the PA curriculum and experience translates better into the academic and policy so very few of us do it .... its a bit strange to be honest. I suspect either direction will make you happy. Congrats on a big achievement... both are hard to get into. Take this situation seriously ... but in the end you will likely do well either way. :) Link to comment Share on other sites More sharing options...
Joelseff Posted February 13, 2011 Share Posted February 13, 2011 UC Davis offers one. IIRC, Only if you were a RN (BSN) prior to acceptance or else the non nurses and ADN's come out just PA...You prob knew this but worth pointing out. edit: oops premature posting before reading original quote, i see he/she was already a NP:=-0: oh well still good to point out. Link to comment Share on other sites More sharing options...
Joelseff Posted February 13, 2011 Share Posted February 13, 2011 I find myself still glad that I am an NP for legistlative and local market reasons. This is A HUGE benefit IMHO. This alone trumps what few thousand we make over you guys. Link to comment Share on other sites More sharing options...
browndog Posted February 13, 2011 Share Posted February 13, 2011 The UC Davis program would have been great, but, at my ripe old age, that ship has sailed. I prolly should change my name from browndog to olddog. Link to comment Share on other sites More sharing options...
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