Different Options

[dw10]

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I am trying to decide between a few different career paths. I've considered getting an MD or PhD but those paths are so long and extremely stressful (and putting many years into the difficult pre-reqs while making no money, with no guarantee of being admitting is terrifying) . So, I am currently thinking becoming an NP (direct entry program) but am pretty concerned about feeling like I have settled and that I do not have the knowledge base to provide the best possible medical care to my patients. Not that I believe NP's do not have good training for a specific role, but in the specialty I am interested in they perform basically the same role as the doctor with a lot less training, which is kind of scary to me. I am also concerned about dealing with a lack of respect from patients and other healthcare professionals throughout my entire career, and even from nurses because I would have no experience as a bedside nurse going directly to NP.

Another career path I am considering is genetic counseling. The pay is a lot less, but I am wondering I would be less likely to feel disrespected in this role because the role is different enough from that of a doctor. I'm also very interested in working in a teaching hospital, and a lot of these jobs are in that setting.

Whatever career I chose, I am not straight out of college so it will probably have to be the one I stick with.

Any thoughts?

 

[deleted432032]

If your still in college, I say complete the prerequisites for med school. They can be done while you are completing your bachelors degree and will not take years to do. There are only 8 -10 classes total.

I don't agree with direct entry NP. Many that go this route without a nursing background I feel are unable to truly grasp the simple concepts that are taught. Nursing is not a field to jump into at that high of a level without prior experience, in my opinion.

Counseling can be a good career, but also requires years of schooling, just like medical school and nursing school.

I would go and shadow a few people in each of these career paths to get a good idea of what they are like. Shorter training for something does not mean you will enjoy the work. Become informed about the work and life, then start looking at which one you like. You are never too old to go down any if these paths, and you can have a life and start a family in all of them; many people start families in med school and residency with no issues.

 

[dw10]

Here is my problem: I am not in undergrad, I am three years out. Thanks to getting a basically dead-end bachelor's degree (psychology), I have been living at home with my parents since graduating since my job does not pay enough that I could live comfortably on my own. I've taken 3 of the prerequisite classes for med school already, so I wouldn't qualify for most formal post-bacc programs/ they are very expensive. Therefore, if I take all the med school pre-req's and study for the MCAT, it will be three years before I can enter medical school, assuming I do well enough to get in. I know that every situation is what you make of it, but I don't know if I could handle the anxiety of those three years not knowing if I will even have anything to show for it at the end, and spending most of my 20's dependent on my parents and without "grown up things" like an apartment of my own, etc.

Genetic counseling is a 2 year program, and I've shadowed in this area quite a bit. In certain settings I think it is very interesting because you see a variety of different disorders and help to diagnose them. Other settings it seems kind of repetitive, but isn't that true for all healthcare careers? Direct entry NP is 3 years, and has benefits such as high pay and more jobs available.

I know that I won't have the kind of prestige that a doctor has with just a master's degree. However, I do want to feel like my role is respected and I have the proper education to do it well.

 

[deleted432032]

There is always a do it yourself postbacc, taking all classes full time (3 at a time per semester) would only be 2 years. I do see what your saying about the direct entry NP, but I don't think it's worth it. Without the nursing background I don't feel anyone can truly be prepared, plus most will require a RN degree or a ton of prerequisites done prior to entry. This would put you in the same position as med school. Counseling would be inline to your dead-end psych degree (by the way I have a psych degree and don't find it useless nor a dead-end).

Prestige is not a factor, nor do all docs have this anymore in this time and age. Many have done all these option not being reliant on their parents. If you want to be reliant on them through what ever process you choose you can, but many do it independently. Just don't chose the easy way because you are too lazy to put in the hard work (this in no way is an attack on you personally, just something many come on here wanting to do and looking for advice on how to take the easy way out), this is what makes people that do not help in medicine and others will resent later. Trust me, it will be obvious to others by the quality of your work. Medicine and nursing, psychology also, are fields that take a lot of work to do correctly and safely.

Good luck on making your decision.

 

[AnnoyedByFreud]

I'm doing direct entry psych NP and don't regret it at all. It's a lot of work (especially the accelerated RN training), but I enjoy it. Try not to let what you read on the internet overly influence your decision-making process, especially on a site as biased as this one. I think you have to really consider what you want to do life-long and do a cost-benefit analysis. Is it worth it to go to medical school? Is the PA or NP role more suited for you? Or would you rather do something entirely different? Try not to let stupid things like 'prestige' get in the way of what you actually want to do. Have you shadowed MDs, NPs/PAs, or genetic counselors? What are the job opportunities/salaries like in the area where you want to work? To me, shadowing seems like the essential thing to do, since you'll be able to see if these positions appeal to you on a day-to-day basis.

Also, the marked disrespect on this forum for nursing, 'midlevels', etc., does not reflect reality at all. Just so you know. I spent a whole year post-undergrad working and being wishy washy about my career goals (afraid to take the NP plunge, thinking about just going back to my original plan of applying to clinical psych PhD programs because that's what I had just spent 3+ years making myself competitive for despite realizing it wasn't the right career for me. I had connections and top notch research experience, excellent LORs, strong GRE, etc. It's hard to spend so long working your tail off to be an impressive PhD applicant only to totally change your mind - but I am so glad I did.) Looking back, it was a wasted year and I was being immature. I wish I had just been logical from the beginning and not let small issues like prestige, status, etc., get to me. That's one year psych NP salary lost (~110k!) due to my indecision. In my field, people want someone who is competent, compassionate, and can actually help them. Honestly, if you carry yourself well, act professionally, and know what you are doing - the respect will come. At the end of the day, the painful part is deciding. As we know from psychology, once we have made a decision our brain does a good job of convincing us it was the right one. Best of luck deciding!

 

[pamac]

If you are struggling with the prestige aspect, watch a new resident working in the hospital. They work long, hard hours (80+ per week), don't get a great deal of praise from either staff or other doctors, and have to balance their personal life with their training. My hospital is full of folks who are really respectful to one another from the docs, to RNs, to PAs and NPs, to staff, so I don't think much of the prestige aspect.

The other day I watched an NP get essentially every aspect of care wrong then they presented it to that NPs physician supervisor. That week, a resident did the exact same thing to my patient, and had to have the attending doctor step in and say "no, you aren't seeing the big picture, we need to do this (alternate treatment plan) right now." Since we all are respectful of one another, it isn't a huge deal. The docs and residents are humble, dignified folks who are the right kind of personality for dealing professionally with those around them.

The NP that got all the treatment selections wrong was a nurse for a long time and thinks that that should count for a lot more than it does, and as a result it restricts his/her views. You see it when this NP tries to throw their weight around, especially on the phone when telling the nurses things like "let's see how fast X-ray will get down here when they are talking to me instead of a floor nurse" as if they are helping us out by coming to the rescue by wielding the title. You'd probably never hear that from the docs or resident. What the doctors or resident understands that this NP doesn't is that true respect is earned. They might also know that X-ray will get to it when they get to it, and an NP isn't going to get to the front of the line with a scan for a chronic condition... Certainly it won't bump someone with an active issue.

So essentially, you'll get respect and prestige if you A) behave yourself, and B) do your job well. I'm not the best at my job, but the folks around me see how much effort I out into it, and I'm not cocky at what I can do well, so I get slack and help when I need it. If that NP behaved a bit better, they wouldn't have staff talking behind their back about how they worry about that NP taking care if their patients. I don't criticize like that, but I've heard those things.

 

[AnnoyedByFreud]

pamac, it sounds like you work for a great hospital. That NP sounds god awful though! Putting down other nurses, not knowing what she/he is doing... ugh, I wonder what school the NP attended?

 

[pamac]

I like where I work, but I dont know anything else. It just seems like everyone likes to get along and do their jobs. I like to think the rest of the medical world is like that.

That NP isn't terrible, but what that NP lacks is approaching their new role with humility, rather than acting like their decade plus years of RN experience mean something in that new role. It's not that I want that NP to dial it down a notch out of envy, just that it would help them a lot if they did. Being new is being new... Just accept the fact that you are new and have a lot of ground to cover before someone gets hurt. Seems the residents and most all if the new PAs and NPs know that. But yeah, 85% of the time this NP is tolerable, and 90% effective in what we need from that person. I just learned firsthand that years as an RN doesn't automatically mean equivalence to being a provider. In some cases it's a hinderance if it gives undue confidence. I personally think this NP is terrified at the learning curve, and just acts out like that occasionally because reaching back to their experience as a nurse is a way to latch on to something that they feel like they were good at vs the terror of their new role and what it entails. I was tempted to reach back to my other hce when I was a brand new nurse for the same reason. Made more sense to just accept that I was new, and the expectations for me was to be new like anyone else, so why fight it for pride sake? I'd get farther by being teachable than have a chip on my shoulder. Does more for your reputation as well.