Advice moving forward

[anewmanx]

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Greetings all, long time lurker here.

Life threw me a curveball and I find myself at a crossroads, heavily considering pursuing some type of work in healthcare. not sure what direction to go, so open to advice.

Educational background: 4.0 undergrad in theology the last 3 years of college. Multiple hard fails in community college 15 years before that in math / science due to family medical crisis. Lack pre-med prerequisites, etc but maintained a 3.83 in graduate school (seminary) but left program after second semester due to stress. Before you laugh that off, a friend in the same program is a Pediatrician and he said the seminary schedule was rougher on him than his time in medical school 20 years ago. I was averaging 4 hours of sleep a night and in addition to classes, the work crews and mandatory chapel service ate up 16 hours of each day. I found it unmanageable having small kids.

Finances aren’t really a concern as I have a military pension and I can afford whatever schooling I want / have veterans benefits left over, etc. so I can study whatever I want.

I have been interested in medicine since I was quite young, but don’t see how I could realistically handle the stress with 4 kids under the age of 6 and I have some physical disabilities / ptsd, et. from military service. I’m of the opinion now that’s not likely an achievable dream.

Do you guys think an accelerated direct entry MSN followed by NP would be a reasonable route? I completely understand that the educational difference between the two careers is vast, clinical hours are vastly less, etc. I’m not under the illusion that NP’s are doctors. Mostly interested long term in working as a Psychiatric NP under the supervision of a Psychiatrist.

I plan on taking prerequisites starting this fall after our fourth child is born. Anyone have an idea of how hard time wise a direct entry 18 month MSN would be? I could do 12 hours a day, but 16 would kill me. I’m almost 40 and those days are behind me.

 

[MusicDOc124]

If you're open to NP (and presumably PA), then likely either of those will bode well for you rather than the stress and time required for med school since you CAN see yourself as something other than a physician. Most NP programs require you have your RN and/or BSN prior to NP. There are a few programs out there I believe that build it in. Various NP programs are notable stronger than others (typically in person versus online). In addition to that requirement, many if not most of those programs want you to have some experience as a nurse before apply as well. PA (although you don't mention it), I'll add also requires healthcare work experience with direct patient care.

I'd say that the direct-admit MSN you mention would likely be your best route here.

 

[anewmanx]

Thanks for the input. I would have loved to have been a physician, but I don’t believe that’s a realistic goal in my circumstances. It took years to swallow that fact, but reality is a wall you eventually run up against isn’t it?

I am comfortable not having al, the answers, being a strong mid-level provider, knowing my limitations, and expanding my knowledge over time to fill in the gaps.

I have a friend who is a PA and loves it, but I don’t now much athat field. a PA misdiagnosing my injury in the military led to six years of limb paralysis and permanent nerve pain so I suppose I may not have looked into the field out of prejudice. What’s would you say is the major difference between what a PA does and an NP?

 

[MusicDOc124]

Thanks for the input. I would have loved to have been a physician, but I don’t believe that’s a realistic goal in my circumstances. It took years to swallow that fact, but reality is a wall you eventually run up against isn’t it?

I am comfortable not having al, the answers, being a strong mid-level provider, knowing my limitations, and expanding my knowledge over time to fill in the gaps.

I have a friend who is a PA and loves it, but I don’t now much athat field. a PA misdiagnosing my injury in the military led to six years of limb paralysis and permanent nerve pain so I suppose I may not have looked into the field out of prejudice. What’s would you say is the major difference between what a PA does and an NP?

Both are mid level providers. Both are masters degree-trained except for the newer DNP degree, of which PA is trying to catch up with a DMS degree.

PAs get more training while in school with around 2000 clinical hours whereas NPs get around 500-700. PA absolutely requires a few hundred (minimum) patient contact to apply and be competitive, whereas NP usually (used to?) require a BSN and a few years experience to apply - this has changed in recent years with direct admit DNP programs.

NP programs seem to be fairly specific (family practice, psych/mental health, peds, etc). PA is more general under a medical mode like how physicians are trained prior to residency, but lots abbreviated.

Either way, practice is generally the same. Pay is similar. NPs in some states have more independence. PAs across the board have more flexibility.

 

[anewmanx]

Both are mid level providers. Both are masters degree-trained except for the newer DNP degree, of which PA is trying to catch up with a DMS degree.

PAs get more training while in school with around 2000 clinical hours whereas NPs get around 500-700. PA absolutely requires a few hundred (minimum) patient contact to apply and be competitive, whereas NP usually (used to?) require a BSN and a few years experience to apply - this has changed in recent years with direct admit DNP programs.

NP programs seem to be fairly specific (family practice, psych/mental health, peds, etc). PA is more general under a medical mode like how physicians are trained prior to residency, but lots abbreviated.

Either way, practice is generally the same. Pay is similar. NPs in some states have more independence. PAs across the board have more flexibility.

Sounds like NP would be the way to go. Plus I can’t move with kids in school, etc.

If you were in my shoes and had 1 year of gi bill left would use it toward 2/3 of an 18 month direct msn and eat the other 30k tuition plus cost of the np program at a state school (15k), or would you take an extra year to go the adn route at a CC, then do the BSN through WGU (12k or so to do both) so you could ultimately use the gi bill to pay for the one year np portion?

Am I right in thinking that the 1 year of lost of np wages essentially outweigh the advantage of the cheaper state school route?

 

[MusicDOc124]

I don’t have enough info on the particular programs to advise.

Do you have a VA rating where you may qualify for Voc rehab?

 

[anewmanx]

I don’t have enough info on the particular programs to advise.

Do you have a VA rating where you may qualify for Voc rehab?

indeed. 90% schedular 100% p&t for tdiu

I’ve had some trouble getting them to work with me in the past though. The Vrehab office here didn’t even try to contact me last time I applied; they missed the 30 day window, never so much as sent a letter.

I ran the numbers and the direct 19 month msn route followed by 1 year np pmhnp certificate pathway makes the most financial sense. 30k our of pocket, but start making money faster by 1 year. Made a huge difference in the numbers.

I will say though; it’s a little frightening to me than an NP doesn’t require more education / hours. Wow. They really shouldn’t have independent practice rights without a few years under supervision.

 

[MusicDOc124]

I would reapply. There is a chance the letter was delayed or lost in the mail. That's relatively automatic when applying.

You'd likely have a decent shot at getting approved.

And yes, that does seem like the better route if it will save you a year for marginally more money upfront if you end up paying.

I feel as though many people would agree with you there, especially with newer and online programs. In previous times, much more bedside nursing experience was required. Now they have some programs out there that will take people immediately out of a BSN program without experience other than their clinicals.

 

[anewmanx]

I would reapply. There is a chance the letter was delayed or lost in the mail. That's relatively automatic when applying.

You'd likely have a decent shot at getting approved.

And yes, that does seem like the better route if it will save you a year for marginally more money upfront if you end up paying.

I feel as though many people would agree with you there, especially with newer and online programs. In previous times, much more bedside nursing experience was required. Now they have some programs out there that will take people immediately out of a BSN program without experience other than their clinicals.

much appreciated for the info. I will reapply. I guess I fell through the cracks. At least now I have a decent idea of a path forward.

 

[anewmanx]

If you're open to NP (and presumably PA), then likely either of those will bode well for you rather than the stress and time required for med school since you CAN see yourself as something other than a physician. Most NP programs require you have your RN and/or BSN prior to NP. There are a few programs out there I believe that build it in. Various NP programs are notable stronger than others (typically in person versus online). In addition to that requirement, many if not most of those programs want you to have some experience as a nurse before apply as well. PA (although you don't mention it), I'll add also requires healthcare work experience with direct patient care.

I'd say that the direct-admit MSN you mention would likely be your best route here.

Thank you for the excellent advice. There were two excellent programs nearby and I’m applying to both. One is a bsn/msn accelerated program that finishes in 21-24 months. The other is a 16 month accelerated bsn which I would follow up with an accelerated msn such as cappella or wgu then an np cert in pmhnp.

If I get to the end of this educational road and can’t stand it, then it just serves as good prep for the clinical portion of medical school and will make knocking out prerequisites a little easier. The extra salary won’t but either. Right now I have 4 kids under 6 and can’t uproot them from school for medical school.

A plus note is both schools accept straighterline for prerequisites which is alternative credit; it’s giving me the chance to learn topics like A&P, Chemistry, Microbio, Statistics, etc. without it having an affect on my science gpa. When I actually take the classes in a post-bac they will be that much easier.

‘thanks again for the great advice!

 

[jhmmd]

Thanks for the input. I would have loved to have been a physician, but I don’t believe that’s a realistic goal in my circumstances. It took years to swallow that fact, but reality is a wall you eventually run up against isn’t it?

I am comfortable not having al, the answers, being a strong mid-level provider, knowing my limitations, and expanding my knowledge over time to fill in the gaps.

I have a friend who is a PA and loves it, but I don’t now much athat field. a PA misdiagnosing my injury in the military led to six years of limb paralysis and permanent nerve pain so I suppose I may not have looked into the field out of prejudice. What’s would you say is the major difference between what a PA does and an NP?

OP the main difference between PA and NP is that NPs follow the nursing model, which empahsizes communication, care, and medicine, and PA school is more geared toward the medical model, which emphasizes pathophysiology, tx, etc.

If you feel like you will feel regret/bitterness toward physicians for the rest of your life, are you sure that you still want to pursue a career in healthcare (if MD/DO isn't realistic?) What are your reasons for wanting to go into medicine? IMO you strike me as a business person, but that's just my $.02. Good luck.

 

[anewmanx]

OP the main difference between PA and NP is that NPs follow the nursing model, which empahsizes communication, care, and medicine, and PA school is more geared toward the medical model, which emphasizes pathophysiology, tx, etc.

If you feel like you will feel regret/bitterness toward physicians for the rest of your life, are you sure that you still want to pursue a career in healthcare (if MD/DO isn't realistic?) What are your reasons for wanting to go into medicine? IMO you strike me as a business person, but that's just my $.02. Good luck.

I’ve had a longterm interest in medicine. I was an extremely ill child with intractable nocturnal epilepsy that eventually was controlled until I aged out of it through a high dose of gabapentin that had some unfortunate side effects. That piqued my interest, but I was academically unprepared to pursue medicine as a young man because the gabapentin left me pretty zoned out in high school. Shortly after that my first child was born at 25 weeks gestation and had grade III & IV IVH, shunt placement, 9 revisions, and iirc 5 other various surgeries, strabismus repair, necrotizing endocolitis repair, etc.I failed out of community college after he had a particularly bad shunt failure and 5 revisions in 32 days. I just had to stop attending in the middle of a semester and never completed the rest of the work. The situation had a profound impact on my interest in healthcare, but it also made finishing school even more unlikely. I joined the military in order to afford supporting my children and education at the same time, plus needed the health insurance for my son. I became severely disabled in a military accident. I ended up with various orthopedic injuries and complex regional pain syndrome from a crushing injury to my right upper extremity. They retired me at 26. It took about six or seven years for my pain to become manageable enough to finish college, and to learn to manage the anxiety the injury and chronic pain induced. After that I knocked out my last 3 years of undergrad in 2 calendar years with a 4.0. Since then I’ve had 4 more children that are under age 6. So I definitely have too much on my plate for medical school right *now*.

I have a slight prejudice toward lazy and incompetent providers. I absolutely love people who take their job seriously and study hard. I do definitely have greater respect for most md/do vs np or pa, etc. due mostly to the additional clinical hours. It’s a vast gulf as I’m sure you know. But that isn’t to say there aren’t some amazing mid-level providers. A neonatal-np saved my son’s life. She was in her mid 60’s and was one of the first neonatal specialist np’s in the country.. She was amazingly well versed in the field. Great provider.

 

[anewmanx]

If you're open to NP (and presumably PA), then likely either of those will bode well for you rather than the stress and time required for med school since you CAN see yourself as something other than a physician. Most NP programs require you have your RN and/or BSN prior to NP. There are a few programs out there I believe that build it in. Various NP programs are notable stronger than others (typically in person versus online). In addition to that requirement, many if not most of those programs want you to have some experience as a nurse before apply as well. PA (although you don't mention it), I'll add also requires healthcare work experience with direct patient care.

I'd say that the direct-admit MSN you mention would likely be your best route here.

Your words are quickly coming back to haunt me. Two months ago I started up and now have nearly finished the prerequisites for two direct entry msn programs that take straighterline (ace alternative credit, similar to ap/clep, not an educational institution so no impact on future amcas gpa as I understand it.) Now I face a real dilema. After reading Seeley’s Anatomy, Prescott’s Microbiology, Burge’s Chemistry, and a few other books in each field I am seriously questioning whether or not I can live with NOT being a physician. I loved the material. I loved understanding the underlying mechanisms in disease and seeing the body as a cohesive logical system. I blew through sufficiency tests for precalc, statistics, general chem, microbiology, and A&P 1&2 in 9 weeks with little to no background in the material. I think if I worked on the premedical prerequisites at a brick and mortar institute and took my time I could pull straight A’s with this previous study.

decisions decisions!