Advice on Psych NP vs. Psychiatry MD/DO

[ReInventor]

Can anyone here give me some advice on the pros/cons of these career paths (psych NP v. psychiatry MD/DO) compared to the other? There are obvious differences like time in training, but any ideas/opinions would be appreciated.

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[psychphan]

This comes up fairly often. As you said there are pros and cons to both. But what it really comes down to is what are you looking for. If you want to be a true expert in the field, become a psychiatrist. IMO, the level of education and fund of knowledge you will have as a NP is not even close to the level you will have as a board certified physician psychiatrist. Don't get me wrong, I know a number of psych NPs who are great people and do a good job of helping out there patients, but it's pretty clear their level of expertise in both medical and psych issues is no where near that of the psychiatrists I have met. There are many other pros and cons that I will let others discuss, but what it comes down to is if you want to be a true expert and have no limitations as to how you practice than MD/DO is the way to go. If on the other hand, you are just looking for a well paying job where you are involved with and help the mentally ill, and aren't willing or wanting to put in the years required to become a BC psychiatrist, an NP is a good option. Just know that the tough cases (and even more traditional simple things that have limitations like controlled substances Rx'ing) will have to go to someone above you.

 

[digitlnoize]

Depends on what you want to do. NP's don't have full practice rights in many (most?) states. If you want to be your own boss, or be the "top dog" so to speak, MD/DO is the only way to go.

As an NP, you'll most likely always be subject to someone else's authority. Of course, this also happens to MD/DO's practicing in a large healthcare organization, but as far as I know, it's almost unavoidable in NP-world.

 

[Abider]

I considered it heavily from the early stages in a more generalized sense. Not pertaining to my interest in psychiatry which was a recent discovery.

I think there is an inherent weakness in the idea of cruising straight through nursing experience on the way to a clinical career as an NP. The model was initially created with the idea of taking very experienced nurses and army medics, capitalizing on their experience, and making them into NP's and PA's with quicker turnover to get at underserved populations.

There is much more strength in that notion and process. The bridge joint BSN/NP programs are not going to produce a fraction of what a board certified physician can do. Some will say due to the science and pathology training but I tend to think because of the long phase of learning clinical decision making with people up the chain from you to guide you--ie. 3rd and 4th year medical school on up to senior residency status.

The upside being of course the ease of transition from start point to paycheck making. That is huge.

So depends on what you want out of your career. In the later stages of either career paths if both were diligent in self-education I could see where the difference may be much less significant.

 

[BobA]

For outpatient level of care, I don't think there's too much difference other than that a well-trained psychiatrist knows more about using psychotherapuetic interventions and referring more to psychotherapy. In my residency, I'll be doing well-supervised psychotherapy for 2.5 years before I graduate. I can't imagine that an NP would have that experience.

Also, I enjoy the breadth of practice available to me as an MD. I feel very competent at complex consults, geriatrics, and addictions and feel able to practice in all these areas. Sub-specialty training is also available to me should I choose to do that.

 

[Shufflin]

I see psychiatry over the next 50 years as much more than a job. It's a booming field of change and discovery that will see pioneers emerge who will bring together neurology with biochemistry with personality with technology. The role of the psychiatrist will grow even more.

Do you want to be on the crest of that exciting wave that will change the face of medicine? If so, then you need the MD.

 

[notdeadyet]

You might also try to get some impressions on the nursing forum. I think it's "Clinicians (NP/PA/etc.)" or somesuch.

Most folks who frequent this board opted to go the psychiatry route. You might get very different opinions of those who went the NP/PA direction.

Best of luck with your decision...

 

[AnnoyedByFreud]

This site doesn't have a lot of practicing NPs, so you're going to get responses skewed towards medicine, obviously. You should post or do a search on allnurses, as well. Although that site is kind of a pit, there is good info, if you know where to look, haha.

 

[ReInventor]

Thanks for the help everyone.

 

[NJWxMan]

If it weren't for NP's, there would be many, many psychiatric patients in my city not receiving the care they need. However, some of the worst psychotropic regimens that I have ever seen have come from the hand of an NP. When I see Seroquel, Adderall, Lexapro, and Lamictal prescribed to one patient I instantly cringe.

 

[fiatslug]

If it weren't for NP's, there would be many, many psychiatric patients in my city not receiving the care they need. However, some of the worst psychotropic regimens that I have ever seen have come from the hand of an NP. When I see Seroquel, Adderall, Lexapro, and Lamictal prescribed to one patient I instantly cringe.

Don't forget Latuda and Pristiq!