Nurse to Physician

[AllyCAT13]

A little background: I'm currently a nursing student in an accelerated bachelors program (11.5 months, BS-to-BSN). I have a previous degree in Human Development. I went into nursing because I love direct patient care and I find it hugely fulfilling to make a direct impact in the lives' of others. I'm excited to get into the field of nursing (I'm interested in cardiology and critical care), but I have always known that I plan to further my education after receiving my BSN degree. My plan originally was to work as an RN for about 3 years (preferably in critical care), then start working toward a DNP degree.

However, I have lately been considering Med School as another option. Working in healthcare, I have seen that the role of an NP (at least in the setting where I work) focuses mainly on patient education and placing orders when the physicians are too busy with procedures or seeing patients, and they do not get to do very much in the realm of interventional or direct patient care. While they are an integral piece of a care team, I no longer think that the role of an NP is exactly what I am looking for. The autonomy, knowledge, and specialized background that is obtained through medical training appeals to me more.

I know I would still have a long road if I did pursue medicine, as I would have to take all of the prerequisites (as for nursing I only needed 1 semester of each science course as opposed to 2 semesters).

Could I be a competitive applicant in the future for medical school? My GPA is around a 3.6, and I have plenty of healthcare experience (soon to be plenty more when I become a nurse). Realistically I would be about 28-29 before I would be able to apply, is that typical? Any thoughts or general advice? Anyone who has done the RN-MD/DO route able to weigh in?

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[RNthenDoc]

The “allied health” sciences don’t count for medical school application unless they were majors-level, so check and make sure your Chem 1 and bio 1 fit!

My advice is to finish your degree and start working and taking prerequisites. You need fantastic grades for medical school. You could reasonably work for 3 years and take prereqs slowly to take advantage of an employer’s tuition reimbursement.

Just be prepared for a long, lonely haul. It took me 2.5 years to finish premed stuff, and I will matriculate to med school near the age you posted.

Something to note is that you can’t really learn much nursing in the first year... you need a few years of work before you’ll have gained a whole lot that will help you. (That’s the reason most travel agencies require at least 2 years of experience. For the more legit jobs, they want 5)

I have 3 acceptances so far, so I’m proof that it can be done. There’s a thread here full of RN to MD/DO posters.

 

[operaman]

I've known people who have done it. You've set yourself up well with a decent GPA; obviously the more A's you earn going forward the better that little number will be.

I will say that I think you may be getting a somewhat skewed view of the roles available to advanced practice nurses. This varies widely from place to place and practice to practice, so it might be worth taking a look around and seeing what else might be available to you. Obviously the NP route is the most straightforward from where you are currently. I know NPs who do what you see - patient education and inpatient scut work. I know others who do quite a bit of supervised procedural work in the critical care setting. When I was an intern they definitely helped me out quite a bit on the floor at night and if for some reason I had to do a line or something haven't done in awhile, I would probably still call and ask one of them to help me. I know other NPs who see their own full clinics, both within the primary care real and within the specialty realm and for both peds and adults. I also know some NPs and PAs who do a lot of operating with various surgeons, so this is also open to you.

My general thought process, however valid or flawed, goes like this:
1) Figure out what you want your actual practice to look like when you're done training. Not what field, but what you actually want to do at work every single day -- a key distinction. Do you want to see patients in a primary care clinic setting? Do you want to do procedures? Read films? Give anesthesia? Figure out what you would actually like to DO day in and day out.

2) Is there a way to have that sort of practice as an advanced practice nurse? For primary care, it certainly is, with less and less supervision. Same goes for many other roles within healthcare.

3) If you can get where you want to go using the path you're already on, it's probably wise to take it. I have a hard time rationalizing an extra decade of schooling and training to do the exact same job you could do 3-4 years from now while also getting paid.

4) If you can't have the practice you want via the nursing route, then by all means go for medical school. I tend to argue strongly in favor of getting into school as quickly as possible. If you finish your nursing program in May, that would mean jump into pre-reqs in June and aim to apply June 1st 2019 an matriculate August 2020. Maybe pick up a few shifts as an RN while your doing that, but really there's nothing to be gained by working and taking classes over 2-3 years. The only limiting factor in the pre-reqs is the chemistry sequence with gen chem typically required before organic, so most post-baccs do gen chems in the summer with the organic sequence starting in the fall. You can double up orgo 2 and biochem pretty easily in the spring.

 

[Darth Doc]

I have a hard time rationalizing an extra decade of schooling and training to do the exact same job you could do 3-4 years from now while also getting paid.

I frequently get asked why I decided to go to MD school after being a PA for 15 years. "Why would you go back to school when you already had a great paying job, a mortgage, kids in school...?"

I watched my husband get his online NP degree (it had been a while since I'd taken my PA classes). It's scary how basic those classes are and how much autonomy is being given to providers who know very little about pharmacology and pathophysiology. (He didn't go to Walden either - he has a degree from a reputable university.) I considered buying an established practice from an MD and paying her for oversight to run the practice - basically as autonomous as a PA can get - but decided against it because after 15 years there was still so much I knew I'd miss in the clinical setting simply because I hadn't been taught it and hadn't seen it before and didn't have the pathophysiology knowledge to know when something else was going on.

I worked as a PA while going through medical school and watched my thought process improve and grow astronomically from the first semester on. There really is a difference in knowledge between a PA/NP with years of experience and a MD.

If you want to be the best medical provider you can be, get the MD degree. If you just want to get out there and treat people, the NP is fine. NP and PA have traditionally been called midlevel degrees for a reason. Even years into practice they will still miss things due to lack of knowledge. I have other issues with the NP degree such as the lack of oversight for clinical rotations (often NPs have to find their own rotations and I've heard of MDs using them for free office work and not teaching them anything yet still signing the paperwork for the hours they were in the office). Sure, MDs can miss things too, but the standardized education, the excessive hours of residency, and CME and testing requirements (NPs have no testing requirements after the initial NP exam) to prove competency mean that I'll be the best and most knowledgeable me that I can be for my patients.

Maybe I'm weird because that means something to me.

I didn't know when I got the PA degree that I was going to love medicine. It turns out that I really do. Going back to school, even with kids, to get the MD has been one of the best decisions I've made in my life. I don't regret it.

I don't know which path is best for you, but there are reasons why you should consider taking the time to get a MD.

Side Note: I ran the numbers, and financially I'll be better off with the MD degree even after incurring debt.

 

[AllyCAT13]

The “allied health” sciences don’t count for medical school application unless they were majors-level, so check and make sure your Chem 1 and bio 1 fit!

My advice is to finish your degree and start working and taking prerequisites. You need fantastic grades for medical school. You could reasonably work for 3 years and take prereqs slowly to take advantage of an employer’s tuition reimbursement.

Just be prepared for a long, lonely haul. It took me 2.5 years to finish premed stuff, and I will matriculate to med school near the age you posted.

Something to note is that you can’t really learn much nursing in the first year... you need a few years of work before you’ll have gained a whole lot that will help you. (That’s the reason most travel agencies require at least 2 years of experience. For the more legit jobs, they want 5)

I have 3 acceptances so far, so I’m proof that it can be done. There’s a thread here full of RN to MD/DO posters.

Yeah, I anticipated that if I were to pursue this path I would need to retake pretty much all of my sciences, as I only got 1 semester each of bio, chem, and ochem to get into my nursing program - and no physics. If I decide to work toward this I will probably work as a RN for ~3 years and retake all of those courses during that time. Thanks for the insight though! Good luck in medical school!