locomotive Posted January 29, 2018 Share Posted January 29, 2018 Hey this is my first time posting here, and I wanted some advice. I'm currently in school for a BSN, and I looked at both NPs/PAs but went with NPs due to the level of autonomy they had. And I couldn't see myself playing second fiddle or having to listen to a doctor fresh out of med school when I'm an older PA. However, I'm not too fond of the nursing model, as I appreciate the pathology and physiology of the human body. I would feel if I received a NP degree, I would feel less confident in my diagnosis and treatment. And I don't like being stuck in one specialty like NPs have. I would much rather prefer to have a variance of options that I can choose from to earn experience. So I wanted to see if I could become a RN, get a good year or so and then go into PA school, work as a PA for some time (3-10 years) and then obtain my NP degree, allowing me to work independently while allowing me to have PA training. This way I have both the nursing and medical model and I'm allowed to work in different fields and work independently from a physician. And I can open up my own clinic with a wealth of experience and become a better provider. I feel that PAs should be granted autonomy after a certain number of years, not NPs. Medical school is an absolute no because Orgo-Chem and Physics being the bane of my existence. If that wasn't the case, I would just become a MD. :D advice would be great. Thanks! Link to comment Share on other sites More sharing options...
Max PA17 Posted January 29, 2018 Share Posted January 29, 2018 Uhh.. wut? Have you researched any of this? Sent from my iPhone using Tapatalk Link to comment Share on other sites More sharing options...
mmiller3 Posted January 29, 2018 Share Posted January 29, 2018 Personally, I would not bother with both. If you ultimately want the perks of being an NP, and you will already have an RN...just go to NP school. Link to comment Share on other sites More sharing options...
mgriffiths Posted January 29, 2018 Share Posted January 29, 2018 Just from a fiscal perspective, having the debt from BSN --> PA --> NP would be crazy, might as well take on the debt of medical school and actually make the big bucks and never play "second fiddle" -- oh wait, can't forget the bean counters who control everything and understand nothing about medicine. Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted January 29, 2018 Moderator Share Posted January 29, 2018 I would recommend reconsidering MD. Emedpa here avoided MD for the same reasons, and regrets it. to answer your question, yes, you can. Assuming an NP school would take you, and I suspect you could find one that would. It’s soemthing I’ve seriously considered myself as a prior RN, but now that OTP is moving I think about it less. Cost would be super low since you could easily work while getting the second degree. Link to comment Share on other sites More sharing options...
camoman1234 Posted January 29, 2018 Share Posted January 29, 2018 1 hour ago, locomotive said: Hey this is my first time posting here, and I wanted some advice. I'm currently in school for a BSN, and I looked at both NPs/PAs but went with NPs due to the level of autonomy they had. And I couldn't see myself playing second fiddle or having to listen to a doctor fresh out of med school when I'm an older PA. However, I'm not too fond of the nursing model, as I appreciate the pathology and physiology of the human body. I would feel if I received a NP degree, I would feel less confident in my diagnosis and treatment. And I don't like being stuck in one specialty like NPs have. I would much rather prefer to have a variance of options that I can choose from to earn experience. So I wanted to see if I could become a RN, get a good year or so and then go into PA school, work as a PA for some time (3-10 years) and then obtain my NP degree, allowing me to work independently while allowing me to have PA training. This way I have both the nursing and medical model and I'm allowed to work in different fields and work independently from a physician. And I can open up my own clinic with a wealth of experience and become a better provider. I feel that PAs should be granted autonomy after a certain number of years, not NPs. Medical school is an absolute no because Orgo-Chem and Physics being the bane of my existence. If that wasn't the case, I would just become a MD. :D advice would be great. Thanks! Sounds like a big waste of time, some PA programs want O-chem and physics. Look into PA to DO at LECOM... Link to comment Share on other sites More sharing options...
ProSpectre Posted January 29, 2018 Share Posted January 29, 2018 There are PAs who are also NPs, but that is likely a result of a decision made after they already had one of the two credentials, rather than a plan made while they were still in undergrad. Like other posters have said, since you are still in undergrad it's probably worth it to simply tough it out and take your organic chemistry and physics courses, and go for the med school route; doing both PA and NP school would likely be similar cost-wise to attending many medical schools, and time-wise it would be pretty close as well (since most PA and NP programs are at least 2 years each) -- and the long-term payoff would be much greater. And remember, inorganic and organic chem is a prerequisite at most PA schools too. Like LT_Oneal said, OTP is gaining steam, and it seems that PAs are finally working towards having the level of independence NPs already enjoy. So if you like the PA model, then just go to PA school and get involved after graduation to help change things going forward. Or go to NP school and just take it upon yourself to do a residency/fellowship to practice at a higher level that way. Either way, I don't think I would do both, at that point it just makes more sense to go to medical school instead. Link to comment Share on other sites More sharing options...
DiggySRNA Posted January 29, 2018 Share Posted January 29, 2018 UC Davis has a dual NP-PA program. You can only apply through their MSN-FNP program which requires a previous BSN. A PA student in their MPA is not given that option. Apart from that, going NP then PA sounds like a big waste of time and money that could be invested elsewhere. For NP school and their lackluster curriculum...one can easily find a residency of choice that could help fill the knowledge + skill gap. As for being pigeon holed, many Faculty at my program stated this is not the case. A FNP can go from one specialty to another with ease (but more difficult going from outpatient to acute care). BTW: If you have both your NP and PA and you're hired as a PA...you will function as a PA at your job. Having your NP doesn't negate the PA-Physician collaboration requirement of that facility because NPs are "independent" there. Same thing as if you're hired as a NP at a facility...you cannot perform as a first-assist as a PA where that privilege does not include NPs. You will be functioning outside of your scope of practice which brings on a whole new liability issue. Link to comment Share on other sites More sharing options...
PACrankset Posted January 29, 2018 Share Posted January 29, 2018 As others have mentioned if you really are concerned about the autonomy aspect you should consider MD or DO. On the NP side of things while many states have independent practice, in many settings they are not allowed to practice independently because of facility policies if that makes sense. I know at my hospital NPs and PAs are treated as APPs and are governed by the same policies. Just some stuff to think about. Link to comment Share on other sites More sharing options...
locomotive Posted January 29, 2018 Author Share Posted January 29, 2018 23 minutes ago, Diggy said: UC Davis has a dual NP-PA program. You can only apply through their MSN-FNP program which requires a previous BSN. A PA student in their MPA is not given that option. Apart from that, going NP then PA sounds like a big waste of time and money that could be invested elsewhere. For NP school and their lackluster curriculum...one can easily find a residency of choice that could help fill the knowledge + skill gap. As for being pigeon holed, many Faculty at my program stated this is not the case. A FNP can go from one specialty to another with ease (but more difficult going from outpatient to acute care). BTW: If you have both your NP and PA and you're hired as a PA...you will function as a PA at your job. Having your NP doesn't negate the PA-Physician collaboration requirement of that facility because NPs are "independent" there. Same thing as if you're hired as a NP at a facility...you cannot perform as a first-assist as a PA where that privilege does not include NPs. You will be functioning outside of your scope of practice which brings on a whole new liability issue. @above: So I'm going to literally be either one or the other? That's unfortunate. Thanks for clarifying this. If you guys could do it again, would you go to NP/MD school or continue being a PA? I just don't like the disrespect people get as a PA and I fear having to be an older PA and having to take orders from a younger MD. Thanks for the replies. You've helped alot. I just fear getting a lackluster education (like some programs) and suffer in work. I've looked at John Hopkins's NP program, and John Hopkins is known for it's credibility, so I guess that's an option since it will give me the experience I need? I would hate to regret my career choice. Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted January 29, 2018 Moderator Share Posted January 29, 2018 2 hours ago, locomotive said: @above: So I'm going to literally be either one or the other? That's unfortunate. Thanks for clarifying this. If you guys could do it again, would you go to NP/MD school or continue being a PA? I just don't like the disrespect people get as a PA and I fear having to be an older PA and having to take orders from a younger MD. Thanks for the replies. You've helped alot. I just fear getting a lackluster education (like some programs) and suffer in work. I've looked at John Hopkins's NP program, and John Hopkins is known for it's credibility, so I guess that's an option since it will give me the experience I need? I would hate to regret my career choice. What they said is true to some extent, but not entirely. A FNP is limited by their education and experience. While a FNP would have a harder time practicing inpatient specialties, they do it. I’ve seen it as plenty of times when I was an ICU RN. So you could make the argument that you have, as a PA/NP, the training to do it all. You’re not going to see FNP in surgery or ICU though. That’ll be reserved for ACNP. However, most hospitals treat PAs and NPs on the same inpatient or ED service with the same amount of autonomy. Primary care is where you would really want to have the NP autonomy and the PA education. If I could go back in time where you are, I would have gone MD, but only going back to when I actually made the decision to pursue higher education, I still would have chosen PA over NP with residency. I’m still doing residency anyway, even as a PA. MD was off the table due to life circumstances. I went to NP school for 3 semesters when my university employer was paying for it as part of a benefits package. No regrets leaving that. Link to comment Share on other sites More sharing options...
PA-SGuy Posted January 29, 2018 Share Posted January 29, 2018 4 years nursing school for BSN, 2-3 years PA school, 3-4 years DNP = 9 years minumum. Get some cheap physics/O-chem books look at resources online(khan academy) or mcat prep book to ease yourself into it. Or get a tutor. All of which would be cheaper than going the route your're suggesting and provide you with the autonomy and training you seem to desire. I got 2 C's in gen chem before i buckled down and took biochem and had an A+ in the course going into the final, aced orgo. It can be done, just gotta put your mind to it. Link to comment Share on other sites More sharing options...
DiggySRNA Posted January 30, 2018 Share Posted January 30, 2018 4 hours ago, locomotive said: @above: So I'm going to literally be either one or the other? That's unfortunate. Thanks for clarifying this. If you guys could do it again, would you go to NP/MD school or continue being a PA? I just don't like the disrespect people get as a PA and I fear having to be an older PA and having to take orders from a younger MD. Thanks for the replies. You've helped alot. I just fear getting a lackluster education (like some programs) and suffer in work. I've looked at John Hopkins's NP program, and John Hopkins is known for it's credibility, so I guess that's an option since it will give me the experience I need? I would hate to regret my career choice. I'm not in PA school but I applied once already and did not make the cut (too expensive to reapply). If I wasn't in nursing school, I would have tried again but my education timeline is being streamlined to NP. 12 months BSN and then 15 months full-time MSN-FNP, or I'll apply to UC Davis' dual program. We'll see what happens in the next 7 months when I'm done with my ABSN. I plan on supplementing my NP education with a residency. Ive found a few strictly for Urgent Care and EM that I'm interested in. Link to comment Share on other sites More sharing options...
locomotive Posted January 30, 2018 Author Share Posted January 30, 2018 3 hours ago, LT_Oneal_PAC said: ."Primary care is where you would really want to have the NP autonomy and the PA education." If I could go back in time where you are, I would have gone MD, but only going back to when I actually made the decision to pursue higher education, I still would have chosen PA over NP with residency. May I ask why would a residency as a PA be beneficial? And haha, yes, I was considering the PA/NP thing for primary care because I would like to open my own clinic one day. You're influencing me to either try my best and attempt to do MD school or just get an ACNP (they seem to have the most scientific model of all the NPs). Everyone's replies are much appreciated, future and past. Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted January 30, 2018 Moderator Share Posted January 30, 2018 41 minutes ago, locomotive said: May I ask why would a residency as a PA be beneficial? And haha, yes, I was considering the PA/NP thing for primary care because I would like to open my own clinic one day. You're influencing me to either try my best and attempt to do MD school or just get an ACNP (they seem to have the most scientific model of all the NPs). Everyone's replies are much appreciated, future and past. ACNP is not any better than any of the others NP specialties. More acute care related, but not better. That was the program I was in before and if anything it was more frustrating because you felt like it should be more science and less fluff. But with a residency to get you up to speed could be a reasonable pathway, though there aren’t many NP residencies as there are for PAs. PA provides excellent general education to make a good primary care clinician that knows a little about everything, but you aren’t an expert in anything either. So residency in a specialty is very beneficial to A) quickly enhance skills to the level of a provider with several years experience B) get training in procedures or learn skills from off service rotations that one may never get in a lifetime of OTJ training. Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted January 30, 2018 Administrator Share Posted January 30, 2018 If I could do it all over again from 2010, I would still do PA school, because otherwise I would just be finishing residency, rather than 5 years into practice and having successfully worked myself into a couple of specialties that I like (and don't require me to see 20+ patients per day!) If I could go back to 18, I would have graduated from college at 21, med school at 25, and have been practicing medicine for over 20 years. Link to comment Share on other sites More sharing options...
skyblu Posted January 30, 2018 Share Posted January 30, 2018 Have you ever shadowed a PA? I have worked in EM and now in UC and have never had to “take orders” from anyone. I see my own patients now in UC, often as solo coverage or working with another PA. An MD signs my license but has no bearing on my daily practice. In the ED, I presented major cases when they were ready for disposition. Meaning, I evaluated, tested, diagnosed, and treated the patient and just ran it by the doc when I was ready to discharge, admit, or transfer. Or, of course, if I had questions or needed help with a case, but mostly each provider carried their own patient load. Things are different in different institutions, but maybe try to shadow different settings to make sure you have a realistic view of what PA practice is really like. Sent from my iPhone using Tapatalk Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted January 30, 2018 Moderator Share Posted January 30, 2018 4 hours ago, skyblu said: Have you ever shadowed a PA? I have worked in EM and now in UC and have never had to “take orders” from anyone. I see my own patients now in UC, often as solo coverage or working with another PA. An MD signs my license but has no bearing on my daily practice. In the ED, I presented major cases when they were ready for disposition. Meaning, I evaluated, tested, diagnosed, and treated the patient and just ran it by the doc when I was ready to discharge, admit, or transfer. Or, of course, if I had questions or needed help with a case, but mostly each provider carried their own patient load. Things are different in different institutions, but maybe try to shadow different settings to make sure you have a realistic view of what PA practice is really like. Sent from my iPhone using Tapatalk Another great point. I think some people only see the really restrictive places. In the military, my clinic is run completely autonomously. I even sometimes review the MDs charts or another PA for quality control. Same for me. Could be a PA, MD, or a NP reviewing my charts. Link to comment Share on other sites More sharing options...
MrsGPAC Posted January 30, 2018 Share Posted January 30, 2018 17 hours ago, locomotive said: @above: So I'm going to literally be either one or the other? That's unfortunate. Thanks for clarifying this. If you guys could do it again, would you go to NP/MD school or continue being a PA? I just don't like the disrespect people get as a PA and I fear having to be an older PA and having to take orders from a younger MD. Thanks for the replies. You've helped alot. I just fear getting a lackluster education (like some programs) and suffer in work. I've looked at John Hopkins's NP program, and John Hopkins is known for it's credibility, so I guess that's an option since it will give me the experience I need? I would hate to regret my career choice. I have a couple thoughts on this: "I just don't like the disrespect people get as a PA"--Then work hard and be a rockstar. Sure you'll get some disrespect here and there. It is inevitable. Take great care of your patients, do the right thing, and brush it off. As an aside, I've seen my docs disrespected as often as myself by various specialties. It's rampant in medicine. "I fear having to be an older PA and having to take orders from a younger MD"--If you fear taking any orders, you should just go to medical school. Many of my docs are younger than me. They are awesome. They do not order me to do anything (although I get in some specialties that would be the case). They provide fantastic support when I need help with complicated patients. They have my back all day every day. "I just fear getting a lackluster education"--then don't. If you want the PA education, be a PA. Many PA's (including myself) have great autonomy. I feel like maybe you haven't spent enough time with PA's. Have you shadowed in multiple specialties? Again, I work in an ED and unless a critical imaging report comes across the printer and one of my docs gets to it first, or they are just trolling the board and interested in what's going on with a patient, they leave me to take care of my patients. They regularly pull me in on their complicated/interesting patients as both education and point of interest. They ask me as many questions as I ask them. I learn from them every day--they make me a better PA. When all is said and done, I feel like you just need to get through o chem and physics and go to med school. The hoops you are wanting to jump through for a PA education with NP autonomy (which as mentioned above isn't across the board) seem much harder logistically and financially than just getting a tutor and muddling through O chem and physics. I am getting the impression that you want control and prestige--and that's not a bad thing--but if that's what you want, go to medical school or you will surely regret your career choice. Link to comment Share on other sites More sharing options...
Guest Paula Posted February 3, 2018 Share Posted February 3, 2018 Drop nursing school and take O Chem and physics. Stop wasting your time and money on your plan. It's idiotic. Go to Medical School. Link to comment Share on other sites More sharing options...
lkth487 Posted February 4, 2018 Share Posted February 4, 2018 Doing both NP and PA is not really shorter than doing med school. In the grand scheme of things, ochem and physics aren't that bad. Put your nose down and study. If you work as hard in those courses as you would in residency (80+ hours a week), you will ace them for sure. Link to comment Share on other sites More sharing options...
locomotive Posted February 4, 2018 Author Share Posted February 4, 2018 Everyone in here was really helpful, so I might as well just suck it up and try my best for med school. Hopefully I dont have any mental disability that prevents me understanding it, but thanks alot everyone. Link to comment Share on other sites More sharing options...
Moderator ventana Posted February 4, 2018 Moderator Share Posted February 4, 2018 I might go against the grain.... it is not a bad idea - it is odd but reasonable I am a highly experienced PA and see the political gains made by the NP lobby and I am envious. I have inquired if they ever would do a PA--NP bridge (nope) but you are 1/2 way there with the BSN already..... A better way might be to do NP AND then do a an intense as heck 1-2 yr residency maybe even stack two - ie do and IM hospital based, then ask for another year in a sub specialty - ie geriatrics... Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted February 4, 2018 Moderator Share Posted February 4, 2018 8 hours ago, locomotive said: Everyone in here was really helpful, so I might as well just suck it up and try my best for med school. Hopefully I dont have any mental disability that prevents me understanding it, but thanks alot everyone. Good luck. Study hard. Don’t take other hard science classes with them so you can focus. Remember DO schools do grade replacement if it doesn’t go well the first time. Link to comment Share on other sites More sharing options...
ProSpectre Posted February 4, 2018 Share Posted February 4, 2018 While I agree with the above advice, I just wanted to note that as of this year, DO schools no longer accept grade replacement in the official AACOM GPA calculation (all grades are averaged now, even repeated attempts). Just study hard, attend any supplemental instruction or tutoring sessions you need to, and use outside resources for the courses to teach yourself if you have to; it is definitely possible to get As in those courses if you put in the work (and just as importantly, the time). Source: https://www.aacom.org/become-a-doctor/applying/notice-of-repeat-coursework-policy-change Link to comment Share on other sites More sharing options...
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