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PA vs. NP


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I work as an ER tech and there is one NP who works in our ER and about 6 PAs. I don't see any difference between them (what they do and what they know). I'm having a hard time conveying why I'm choosing PA over NP. My main reasons are:

1) Education - NPs usually have to be RNs before going into NP school or at least working as an RN while in NP school. So it takes a bachelors degree, some RN experience and then NP school, which is another 3 years depending on the program, which means it's 8-9 years before you become an NP. PA is undergrad - 4 years and then PA school - 27-32 months, which means 6-7 years before you become a PA for the most part.

2) Speciality - PAs can specialize in all areas MDs can, NPs cannot do that.

3) PAs are taught on the medical school model (disease-centered), so more pathology, pharmacology, physiology, and clinical diagnostics to diagnose/treat diseases. Nurses are taught on the nursing model, which I do not know what exactly it is but have been hearing about when compared to PA. I have researched this numerous times online or asked PAs in my ER and no one knows the difference between the medical and nursing models. 

Are there any differences that you know that I have missed? Differences I can state during an interview that doesn't put down another field? These are my top 3 reasons for not wanting to become an NP. I feel like they sound cliche and everyone says this so how would I be different.

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a few issues. in 2017 one does not need to be an RN before becoming an NP. there are direct entry 2nd degree rn to np programs that take 3 years, so the grad of this program gets their rn in 1 yr then spends 2 more in an np program without ever working as an rn aside from school rotations.

so BS in biology for example(same requirement as PA) + 3 years= NP, so 7 years.

To be fair, there are also direct entry PA programs now that require minimal to no hce and can be done right out of high school as combination bs/mspa programs in 5-6 years.

the traditional route to both is prior experience x several years + a bs/bsn then enter into pa or np training.

There are significant differences in pa and np didactic and clinical training. you owe it to yourself to compare the curriculum of a pa and an np program at the same school. PA school looks a lot more like med school with more hard sciences and significantly more clinical time(2000 hrs vs 500-800 for np).

you also need to understand the political landscape. depending on what field you want to pursue, some are better for PA than NP or vis versa. also the NPs have "independence" in something like 22 states and require no physician collaborator. we will get there eventually, but that is probably 10+ years in the future for most pas in most states.

best of luck whatever you decide.

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I'm currently in an accelerated 1 year BSN program with the option to go directly into their FNP program upon 1: graduating the BSN with a 3.2+ and 2: passing the NCLEX-RN. One thing that I've noticed in nursing school is that there are a lot of "fluff" courses. Nursing school is very heavy with research/theory base courses (informatics, professional practice, research). This is why they're so successful politically because they drive this into us very early in our BSN and they push us into research, administration, and politics the minute we have our first class. I careless for these but I sure do enjoy my pathophys, pharm, and health assessment courses. 

The PA curriculum > the NP curriculum because they focus on disease prevention and disease treatment (aka medical model) whereas the nursing model focuses on patient education (lifestyle behaviors), patient safety, and then disease prevention...in that order of importance.

I was on track to pursue PA school throughout my 1st undergrad but I cannot dedicate multiple years trying to get in with no guarantee of acceptance. One of my classmates tried 3 years in a row while I tried once. Had she pursued NP first, she could be out practicing by now or nearly done. 

My timeline to enter medicine as an advanced practice provider has been: 

PA: 5 years undergrad (including 2 years of PCE ~ 3500+) --> 2 years of PA school = 7 years.

APRN: 5 years undergrad --> 1 year BSN --> 2 years MSN-FNP = 8 years or 3 years DNP-FNP = 9 years. 

PA education cost = 100K-150K vs. NP education (BSN + MSN/DNP) = 30K-70K with scholarships available by the dozen.

I agree with EMEDPA in regards to the significant differences in PA and NP didactic...I for one will be tailoring my NP education to mimic that of PA (although it will still not be enough) by not working and doing it full time and be in the clinical setting 40 hrs / week with my preceptor instead of what I've read about only requiring 500 hrs. This will allow me to have nearly 2000 clinical hours upon graduation. 

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A PA or NP program is what you make of it. you can do the bare minimum or decide to go anywhere and do anything to get the best educational experience. If your criteria for picking rotations is "they must be close to home" you can probably do that and your rotations may be hit or miss. If your criteria is " I want the best rotation possible to prepare for a career in X specialty" you will find yourself all over the country. I wanted the best possible prep I could get to practice emergency medicine and was all over the eastern united states for Trauma surgery in D.C, Peds EM in Hartford, CT, EM in Rochester, NY, etc

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