MD or NP: How I Chose My Career Path

A major decision I had to make on my path to becoming a nurse practitioner was which type of medical career was right for me.  I completed the pre-med curriculum in college and earned grades that would make me attractive as a medical school applicant.  I had originally planned to become a physician.  So, naturally I should apply to medical school; after all, MD's earn more than NP's right?

For some reason, I began to doubt my decision to apply to medical school.  I didn't have any hesitation about my ability to complete the MD program but lacked confidence that it was the right career for me.  I was about to embark on an educational path that would take four years to complete followed by years of residency and then perhaps even a fellowship.  I would be nearly 30 or even older by the time I formally completed my education not to mention hundreds of thousands of dollars in debt.  

When I thought about my life I wanted a better balance.  I hoped to have a family one day.  Although I wanted a career in addition to a family, I wasn't sure that becoming a physician would allow me the flexibility and balance I hoped to enjoy later in life.  I wasn't committed enough to a career in medicine to take on so much debt and schooling- what if I decided the medical field was not for me?

So, in search of a better work-life balance and a career with fewer educational commitments I looked into physician assistant and nurse practitioner programs.  Vanderbilt University where I was attending school offered a two year nurse practitioner bridge program which was perfect for my needs.  I did not major in nursing so the first year of the program I would complete my RN degree followed by by my MSN.  The nurse practitioner field seemed the perfect alternative to becoming a physician.  I could still apply my love of science and medicine to my career but also obtain flexibility and balance in my profession.

I applied to Vanderbilt's nurse practitioner program as well as job shadowed a nurse practitioner to affirm my decision.  Although as you all know, my NP program itself had it's ups and downs, I remained confident that becoming a nurse practitioner was the right path for me.

To this day I have never regretted my decision to become a nurse practitioner.  In fact, if I had chosen the MD route, I would still be in school, working 90 hours a week trying to survive my residency.  Instead I am home with my husband and two puppies earning a good income and essentially stress-free.  The nurse practitioner route isn't the right choice for everyone evaluating the MD vs NP decisions, but it was the right one for me.

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I am currently in a PA program but have come to realize after taking all the course and talking to nurse I much prefer the patient-centered approach of nursing to the disease-centerer approach taken by PA/medicine. Until this point I had been so biased by the "status" of medicine and PA that I did not even think to pursue nursing until now. I am not sure whether to stick through with the PA program or to apply to an accelerated nursing program and eventually become a NP. I am currently 22 so I know that I am still young and can make the decision to change but I am concerned about debt and the nurse position saturation as well; I'm not sure if I'm also falling under the "grass is always greener on the other side" fallacy as well. I just feel there is more opportunity for nurses in terms of clinical setting, administration and research.

Mya

Hi Ashley, 

Becoming an NP or a PA is not an easy route either, so you certainly will not be a failure! There are definitely advantages to the NP/PA route over becoming an MD. You will begin your career more quickly and spend less on your education. 

One step you could take in helping with your decision is to job shadow both a physician and a NP or PA. This will help you get a real-life look at your options and decide next steps. 

Erin Tolbert

I know I am a bit late to the discussion but heres hoping my question will get answered. I got a AA degree and a High School diploma at the end of HS. I am now on the fence of wanting to become an MD. I have always wanted to be a Doctor since I was little but now after learning the process to become one I am not so sure anymore. I have been looking at PA and NP but I am afraid I will regret not becoming an MD. The thing is I look at the pre reqs and it does not appeal to me. I look at nursing reqs and it does. I like neonatology. I guess what I am trying to say is I don't want to feel like a failure.

Ashley

I am currently an RN getting ready to apply to NP school. I think it is important to state that the nursing model that NP schools are based off of and the medicine model that MD and PA schools are based off of are two different models of health care.

While the same goal sought after, the route that one clinician takes to get there are different. This is why I chose nursing over medicine. Not because I felt like I could not make it through Med School. Not because I have anything against MD's. But because my ideas on health care more closely resembled the nursing model.

Having said this, I do not think that one model is better than the other. I have the ultimate repsect for physcians and what they do. I find them indispensible. I could not practice with out them. I hope they feel the same way about RN's and NP's.

I post this comment to bring up a point that there is more to consider than just the schooling involved, the amount of time to graduation, the debt incurred, the salary following education and the life style after your schooling. One should examin the model of practice and use that in the decision making process.

Paul

Hi Chris,

Thanks for reaching out! An NP program will definitely require less time (and money!) than becoming an MD. I think you just need to weight what is most important to you. One thing to look at is a cost breakdown and look at average salaries for each where you live. Also, consider if the 'prestige' of being an MD is important to you. 

Psych NPs are in great need right now so you should have no problem finding a job. If you ever decide you do want to broaden your education, it is easy to go back to school and add on a family specialty as well. Some schools may even offer this as a dual degree.

As far as being a guy in an NP program- I wouldn't worry about it too much. In relation to your entire career, school is short! When practicing you will most likely be with other MDs, NPs, PAs, etc. I find that I actually work with a pretty mixed group overall. If depends on the practice, of course. 

Try posting these questions on the message board as well to see what other readers think!

Erin Tolbert

Hi Erin,
I've found your blog most interesting to read and helpful! I am currently faced with the same decision as many here---MD/DO vs NP. I am a post-bacc student, and have been completing pre-reqs for the past 1.5 years to apply to med school. Now I am feeling as if a career as an NP will allow me nearly all of the ability to practice medicine with less of a time commitment in residency etc. I am most interested in Psych NP programs----do you think that it is better to go the general NP route, in case I should ever want to switch? Also, what are your thoughts on being a man applying to NP programs and being an NP? I feel like I will definitely be a minority while in school and after, when practicing. Not that this is a negative thing, but something I'm pondering. Thanks for your posts!

ChrisC

Hi Bridget,

If you have completed the prerequisite courses for medical school, you likely have completed most of the prerequisite courses for an accelerated nurse practitioner program.  These programs are for students with a bachelor's degree in a field other than nursing and take only 2 to 2 1/2 years to complete.  Attending one of these programs would significantly cut the time to become an NP.  Also, you could consider becoming a PA.  PA programs are only about 2 years. The problem you may run into there is that most PA programs require experience in the medical field.

As far as being more family friendly, I think you can find a family friendly job as a physician or as an NP.  In my experience, family friendly jobs are more common for NPs than MDs but many clinics and hospitals are willing to work with both types of providers to create a schedule that works for them.  I think one major difference between the two is that as an NP, I don't have ultimate authority/ responsibility in my workplace.  While I am of course responsible for my patients, the physicians deal with the more serious cases and also more of the administrative duties.  For me, this translates to a less stressful work experience (most of the time) and not having responsibilities outside of the hospital (i.e. once I get home I am done with work).

Overall, both can be made into family friendly professions.  The main benefit of the NP would be a much shorter schooling. Hope this helps, it is certainly a difficult decision!

Erin Tolbert

I am debating between medical school and becoming a nurse practitioner. I am finishing up my bachelors and I have completed the medical school requirements with grades that make me a competitive candidate for medical school. However, I want to have a family and a life outside of work. The idea of four years of medical school plus residency has forced me to reconsider becoming a physician. While I am interested in becoming a nurse practitioner, I am also looking at a substantial amount of schooling. I have to finish up prerequisites for an accelerated BSN program and then spend another 3-5 years to become the NP. Will life as an NP really be more family-friendly than working as a physician?

Bridget

Hi Kristy,

It is a difficult choice!  You do have the advantage of time since you are only in high school.  I didn't choose between becoming a MD or NP until well into my undergraduate degree.  You can always start your undergraduate degree and take pre-med courses while you decide or even get a BSN for your undergraduate degree then apply to medical school or a NP program making the choice a few years from now.  Just make sure you take all of the required medical school and/or nurse practitioner program prerequisite courses if you go this route to keep your options open.

I have never been to medical school but have close friends in med school and residency.  It is definitely harder than a nurse practitioner program.  Medical school requires much longer hours, especially during residency.  Depending on what type of physician you want to become, you may still be in residency until the age of 30 plus.  This is why I chose the NP route.  By the time I am 30 I will have already been working 6 years.  Yes, I do make less money than a physician but I am still able to live a very comfortable life on my salary.  Also, I am married and hope to have children in the future.  I think my choice to become an NP will allow me to continue to work while still having plenty of time for myself and my family.  There are certainly benefits to each career, but for me flexibility and convenience of the NP education outweighed the higher MD salary.

I hope this helps!  Keep us updated on your decision!

Erin Tolbert

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