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RN deciding between PA and NP

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Hey guys.  Sorry if this is the wrong place to post this.

I'm at a crossroads in terms of deciding what path to pursue in the next couple of years.  I'm currently a nurse who works on an inpatient surgical unit.  I've recently started to lean toward the PA route due to the rigor and standardization of the program.  Originally, I swore to myself that if I went the NP route, it'd only be at a brick and mortar ACNP program like UCSF's (as I am beholden to the Bay Area d/t family reasons, though I "think" I'm a fairly strong candidate).  However, even UCSF's program, despite appearing more rigorous than your typical, run-of-the-mill program and promising to find inpatient rotations for you, only offers 570 hours of clinical training.  I don't think that's anywhere close to enough.  In addition, what started as research on Reddit as lead me to a subset of physicians on the r/residency forum that absolutely despise NPs, and though they are extremely vitriolic, pearl-clutching, and mean-spirited people, there is some nuance in the discussion to be had about the quality of training NPs generally receive and how they have to work really hard to fill that large gap in knowledge after they graduate.  Suffice to say, in any occupation, you solidify what you've learned in school on the job and much of the detail you do learn in school is eventually purged from your brain if it is not relevant to your practice.  However, PA school offers a standardized, rigorous approach to training that I can get behind, and that's why I'm leaning toward it.  It'd certainly take longer to go that route vs the NP route as I'd need to take a few more prereqs (I have Anatomy, Physio, Micro, Gen Chem 1, Stats, and Calculus done.  The schools I've looked at, Samuel Merrit, Stanford, and Yale's Online Program, don't seem to have an absolute course-time limit.  Samuel Merritt says they'd prefer certain prereqs to be done less than 5 years ago but make exceptions for people that work in healthcare), the GRE, and shadow a PA.

Obviously, you all can't make my decision for me, but maybe you can provide me some food for thought.  Thanks, you guys.

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19 minutes ago, FiremedicMike said:

FWIW, they hate PAs too.. 

 

Oh most definitely.  But, suffice to say, if there are any valid points to extract from their horribly toxic arguments in their echo chamber of hate, it's that NP programs are not standardized and many are not as rigorous as they should be.  Suffice to say, I'm sure there are plenty of great NPs who can compensate by picking well-regarded schools and gleaning everything they can from them, and then doing a lot of self-studying on the side to learn the trade.  But, if presented with a choice between both pathways (NP and PA), despite my nursing background, PA appeals to be more because of its fairly intensive training.  I know the job market is better for NPs but I want to be as competent as I can be on the other side of graduate school.

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It probably depends most on your ultimate career goal. If you want to work in primary care, NP might be the easier route. If you want to do something technical like surgery, PA would work out better.

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I used to work with a great nurse who quit his DNP program after almost a year because he hadn't learned anything he didn't already know (he was an RN without a BSN or advanced degree). The school affiliated with my program also has a DNP program. They are required to have 500 clinical hours for graduation whereas we are required to have 1800. The average across all PA programs is around 1700.

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1 hour ago, CJAdmission said:

It probably depends most on your ultimate career goal. If you want to work in primary care, NP might be the easier route. If you want to do something technical like surgery, PA would work out better.

I want to work on the inpatient side.  Not really interested in primary care.  I currently work on what is essentially a surgical oncology unit so I wouldn't mind say being on a colorectal or thoracic service, but I'll take what I can get.  IM doesn't sound too bad either.

 

1 hour ago, TheFatMan said:

I used to work with a great nurse who quit his DNP program after almost a year because he hadn't learned anything he didn't already know (he was an RN without a BSN or advanced degree). The school affiliated with my program also has a DNP program. They are required to have 500 clinical hours for graduation whereas we are required to have 1800. The average across all PA programs is around 1700.

 

See, that's my issue.  NP programs vary so widely in terms of quality.  That's why UCSF's is really the only appealing one because of its affiliation with top tier clinical sites and the fact that it seems to favor a bit more rigor over the nursing theory bullshit.  Still only 570 hours of clinical rotations is not amazing, even if it requires 2 years of inpatient RN experience (since that doesn't necessarily translate to being a competent provider).   However, UCSF does offer an inpatient NP residency which could make up for things, but I'd like to be prepared out of the gate and not struggle to catch up.

Edited by itisisntit123

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I'm choosing NP because I'm not going to have the time available to drop everything for 2 years for PA school, I'm also greatly turned off by the pre-reqs.. 

I know going the NP pathway means not only do I need to be diligent in choosing a good program, but also that I'll need to do more study on my own to bridge the gap.  Lastly - I'm planning on doing a post grad fellowship..

 

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ED nurse here applying this cycle! I also been traveling for 3 years. I wanted to go the medicine route before I even finished my BSN. Now after working directly alongside PAs and NPs for so long, this has only solidified my decision. PAs (for the most part) seem more knowledgeable, well-rounded, confident, put together etc. I want to to be the best provider I can be, and I feel I will fulfill that going the PA route. Also, that would be good if your gen chem counts because mine did not!

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2 hours ago, FiremedicMike said:

I'm choosing NP because I'm not going to have the time available to drop everything for 2 years for PA school, I'm also greatly turned off by the pre-reqs.. 

I know going the NP pathway means not only do I need to be diligent in choosing a good program, but also that I'll need to do more study on my own to bridge the gap.  Lastly - I'm planning on doing a post grad fellowship..

 

Best of luck!  I hope post-grad fellowships become more widespread.

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1 hour ago, Kirby219 said:

ED nurse here applying this cycle! I also been traveling for 3 years. I wanted to go the medicine route before I even finished my BSN. Now after working directly alongside PAs and NPs for so long, this has only solidified my decision. PAs (for the most part) seem more knowledgeable, well-rounded, confident, put together etc. I want to to be the best provider I can be, and I feel I will fulfill that going the PA route. Also, that would be good if your gen chem counts because mine did not!

It should.  The community college I took my nursing prereqs at had medical chem for nursing majors, gen chem for pre-meds/bio majors, and gen chem for engineers/chem majors.  I took gen chem for pre-med/bio majors.  However, I may have to retake it seeing as I took it roughly 5 years ago.  I'd much rather just self-study all the gen chem 1 stuff I've forgotten and apply it toward the Gen Chem 2/O-Chem course I would need to take.

 

Same goes for Anatomy.  There was an a&p course for pre-nurses and an anatomy course for pre-PT/PA/med school.  I took the latter.  Very time-consuming but I enjoyed it thoroughly.

 

Good luck to you!  ED nurses are badass, except when you send me patients at shift change! 😁

Edited by itisisntit123

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13 minutes ago, itisisntit123 said:

 

Good luck to you!  ED nurses are badass, except when you send me patients at shift change! 😁

And you're cool till yall refuse report at shift change 😂😂 (haha kidding. Just friendly banter.)

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4 hours ago, itisisntit123 said:

Best of luck!  I hope post-grad fellowships become more widespread.

The NP program I am interested in is associated with a medical school and a major hospital which also runs NP fellowships.

If I manage to get into that program and not be a terrible human, it should align me pretty well into one of those fellowships..

 

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