MD or NP: 5 Things to Consider

The decision between becoming a physician or a nurse practitioner is a pivotal one for many students.  It was for me personally.  How do you decide if you should become a MD or a NP?  Here are a few things you must consider.

1. How Much Do You Want to Make?

It's no secret that physicians make more than nurse practitioners.  In some specialties they make a whole lot more.  The average nurse practitioner salary is just over $90,000.  If you work in a specialty such as emergency medicine or dermatology, you can expect to make over $100,000.  As a physician, however if you work in family practice you will earn an average of $176,000, nearly double the salary of the NP equivalent.  Should you choose a career as a more specialized physician, for example a cardiovascular surgeon, you will earn over $400,000 each year.

If your career goals include becoming somewhat wealthy rather than simply earning a comfortable living, then the MD is your obvious pick. 

2. Where Do You Want to Practice?

Nurse practitoiners have infiltrated nearly every medical specialty.  We work in cardiology, internal medicine, ICU, emergency medicine, dermatology and family practice.  But there are still some fields that remain, and will remain, out of our scope of practice.  Want to perform surgery?  Unless you will be satisfied with removing moles on occasion, you should become an MD.  Nurse practitioners do not preform major surgeries.  Plan to specialize in radiology?  Then the MD is for you.  Although nurse practitioners often read X-Rays in their work, MD's are the experts here.  If you plan to enter a clinic-based medical specialty such as family practice or pediatrics chances are you can do so as a NP. 

3. Length and Cost of Education

Physicians earn more than nurse practitioners and they certainly put more time and money into their education to do so.  Medical school is a four year program as opposed to nurse practitioner programs which take anywhere from one to three years depending on your previous education and if you complete the program on a part-time or full-time basis.  Following medical school, physicians in training must then complete a three to five year residency.  Nothing similar is required by nurse practitioner programs.  Medical school will take you anywhere from seven to eleven years to complete including your residency.  Although you are paid about $45,000 a year during residency you would be earning more during this time working as a NP.

Overall, medical school is lengthy and more costly than becoming a nurse practitioner.  You will likely graduate with a greater amount of debt as a medical student.  But, your end salary will be much higher.  You must decide if completing a lengthy, more costly program is the right choice for you. 

4. Work-Life Balance

I know plenty of physicians who work part-time and have families as well as many nurse practitioners who work 70 hour weeks.  But, in general the nurse practitioner profession offers greater flexibility and work-life balance than the life of a physician.  As a nurse practitioner, you are usually not the one making the biggest decisions in your practice, dealing with administration and treating the sickest patients.  This amounts to less stress in your work day.  Additionally, a wide variety of NP positions are available.  You can work only weekends, long or short shifts, part-time or PRN- it's up to you.  Although these options may be available as a physician, they are often harder to come by.  As a nurse practitioner, you can easily switch specialties throughout your career entering different types of medical practice.  Life as an NP involves less stress and offers more flexibility than that of an MD. 

5. Politics and Professional Culture

With the recent election, health care is all over the news.  Politicians are seeking ways to reduce the cost of care and provide medical services to the large number of individuals who are becoming insured.  Nurse practitioners are being called on to fill this position.  As a result, the job market for nurse practitioners is rapidly expanding promising opportunities for future NP's.  Physicians, however are taking heat for inflated salaries and the high cost of medical care.  They are expressing dissatisfaction with their jobs and it is projected that many will leave the profession prematurely.

In the current political climate, NP's are on the rise.  The profession is experiencing positive momentum.  The MD profession however seems to be in decline.  I believe there will still be ample opportunities in each field whether you choose to become an MD or an NP but it can be difficult to enter a profession with a negative outlook.  You must consider the current political climate when making your decision. 

Need a personal perspective?  Read my story.

Is there anything else you think that needs to be considered in the MD vs NP decision process?  Comment below!