PA over NP

[Biaboyd345]

Hi all, I have an interview scheduled and am having a difficult time answering the question “ why PA over NP”.  I don’t want to sound incorrect in my answer with regards to what NPs do when compared to PAs and don’t necessarily want to include ability to change to different professions being that my schools mission is to cultivate PAs who will provide primary care. Any insight is greatly appreciated! 

[hmtpnw]

A couple big differences, in my opinion at least:

As a NP you pick a population focus while as a PA you’re trained as a generalist. Although the school’s mission may be primary care focused, it’s okay to mention that you may be open to working in specialties if that’s the truth. It’s better to be honest than to regurgitate a program’s mission statement. 

PAs also receive about 2000+ hours of structured, clinical training while (I believe) NPs are only required to receive 500 - 750 depending on the program. That’s a massive difference and the piece that I would focus on if I were asked this question.

There is also the “nursing” vs “medical” model of instruction. Feel like this one is kind of a “meh” answer and can lead you down a rabbit hole. Caring for patients is caring for patients. Being trained in the medical model doesn’t mean you aren’t taking a holistic look at patients and for me it’s really just semantics. I wouldn’t bring this one up personally  

[Bf555]

Number of health care hours is huge. NPs get trained in one specialty and are then stuck in that specialty unless they go back to school for another certificate. They don’t have any gross anatomy lab (that was huge for me). The foundation is you learn anatomy, what’s is normal —> then pathophys for what’s abnormal —> then medicine to treat what’s abnormal. It’s kinda contradictory to me personally to not dissect a cadaver but just assume you know what the inside of the human body looks like


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[ek1114]

My main answer is going be about the specialties. NPs are stuck with one, whereas PAs are much more diversified. Also, like @Bf555 said, NPs don't have gross anatomy labs, which is super important for me. I mean, we are caring for patients and their bodies, so I really want to understand what the human body actually looks like and how it functions inside.

[hmtpnw]

32 minutes ago, ek1114 said:

My main answer is going be about the specialties. NPs are stuck with one, whereas PAs are much more diversified. Also, like @Bf555 said, NPs don't have gross anatomy labs, which is super important for me. I mean, we are caring for patients and their bodies, so I really want to understand what the human body actually looks like and how it functions inside.

A decent amount of PA programs don’t actually have cadaver labs. That or they are heavily prosected by the time the PA students use them. 

Make sure the program you’re interviewing at has a full cadaver dissection lab before mentioning how important it is to your education. 

[MelissaRNtoPA]

As a nurse, that is a question I get asked all the time. Besides the number of clinical hours PA students do vs NP students, most NP programs are online, meaning you set up your own clinicals and preceptors. I don’t learn well on an online forum, and all PA programs have to set up clinicals for their students, so it’s one less thing you have to worry about as a PA student. And, NP school is writing a lot of papers, and who wants to do that? 

[Notfall]

Full cadaver Lab is so understated... 20% of PAs are in a surgical subspecialty, huge negative for those schools that don’t offer full disection. At the same time it helps a lot for anatomy tests if the cadavers are professionally prosected (UNTHSC cadavers take 200+ hours by professional anatomists to dissect near perfectly, as opposed to Heffs BBQ cadaver me and the girls just got finished with), which would you want to be tested on lol.

[hmtpnw]

36 minutes ago, Hopeful2018 said:

Full cadaver Lab is so understated... 20% of PAs are in a surgical subspecialty, huge negative for those schools that don’t offer full disection. At the same time it helps a lot for anatomy tests if the cadavers are professionally prosected (UNTHSC cadavers take 200+ hours by professional anatomists to dissect near perfectly, as opposed to Heffs BBQ cadaver me and the girls just got finished with), which would you want to be tested on lol.

When talking about the negatives associated with prosected cadavers I was referring to programs that utilize cadavers that have already been dissected by MD or other health profession students.  I don’t know of any specific programs that do this, but I’ve heard that it happens and cadavers are pretty torn up by the time students get to them. 

That being said I can definitely see the benefit to using a professionally prosected cadaver! 

[Notfall]

Yes so at each school this is one of the defining differences. Having “PA Student only cadavers” is a big deal. UNTHSC is the only one in Texas that has professionally prosected cadavers.

[Anachronist]

To me it is basically the following, though some may disagree, and I of course respect those disagreements.

The bottom line, the role of MDs and medicine itself has changed somewhat over the last 30-40 years, and a highly skilled RN can do most of the run-of-the-mill clinical stuff a MD can, they just can't legally sign off on it. In come "mid level practitioners." Interestingly, I learned that the creator of the PA profession Dr. Stead at Duke initially approached nurses about additional training to fill that role, but they weren't keen on it at the time, so he went about it independently. Anyway, PAs were born a few years later.

PA and NP are basically two different paths to "basically" the same thing. Not counting politics, state specific differences, or specialization differences. In the grand scheme there is like a 80-90% overlap. So why 2 different paths?

Well, say you have a RN who has been one for a long time and wants to advance; the PA route would be difficult because of the UG prereqs and other academic requirements (not that they couldn't handle it, they would just have a harder time getting accepted, or would have to take a lot of classes post bac). And say you have a medic, tech, etc who wants to advance but can't or doesn't want to go to med school. They would have to start over in nursing to be a NP; and they may have no interest in nursing. Both the RN in question and the medic/tech/etc should have the opportunity to advance, and are capable of doing so, they just have to chose the path that is best for them. (If you can pick from either because of your background, then it boils down to logistics, which you should be able to explain).

Now there are of course exceptions like direct entry NP programs and low prereq/GRE/GPA accepting PA programs. But what I mentioned is the overall situation for a great number of PAs and NPs.

P.S. The argument of being flexible in practice by not having to "officially" specialize is indeed a legitimate one. It was a big reason why I chose PA over MD, and I wasn't shy about telling AdComs about it. I even know a current 2nd year med student who is taking a gap year just so he can decide which of the 4 residencies in oncology they want to pursue. Getting pigeon holed into a highly specific field is no small sacrifice to make.