Help me decide: PharmD, MD, CRNA

[kcha95]

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Long story short I am a 5th year PharmD student with a premedical minor. I planned to take the MCAT for the first time this August but gave up after a month of studying full time. I primarily attribute this to not taking a break after my most recent semester. My goal has been to apply to medical school with hopes of becoming an anesthesiologist after completing my PharmD. I initially felt that I would come back to the MCAT at some point, probably during my semester break.

After failing to stay on track with the MCAT I have spent the remainder of my summer working full time and shadowing. I recently started shadowing a CRNA in the OR and loved every second of it. I shadowed the OR Pharmacist the following day and the role of the CRNA seemed much more interesting to me by comparison. I have shadowed anesthesiologist several times as well, but not in the OR.

I figure if I wanted become a CRNA I could do a 12 month accelerated BSN after completing my PharmD, work for a year in the ICU, and then apply to and hopefully complete a CRNA program in 2 to 3 years. So it seems this would be about the same time frame as becoming anesthesiologist, but without the requirement of a residency from my understanding. I understand the pay is less than an anesthesiologist, but I am not too worried about salary as long as I can afford to support a family and pay my student loans. I would much rather be satisfied with the work I do.

 

[RNthenDoc]

If you have *all* of your prerequisites done and you’re totally sold on gas, you could try for an MD. I actually know of a PharmD MD who did a similar path, but... you have to recognize the time and financial commitments here. If you’re coming from PharmD school with loans, you need to sit down and do some serious math. This kind of situation can turn into 7-digit debt that is insurmountable.

Aforementioned friend made it out okay, but they worked as a pharmacist for years to make it fiscally feasible....

 

[andalusite_angles]

Unless you also like the idea of being a nurse, CRNA is a terrible financial decision in your situation.

1 year of ICU experience is a bare minimum requirement for CRNA schools - that’s typically the 3.8-4.0 sGPAs with CVICU experience. CVs don’t hire new grads unless they know you and you are exceptional - such as you have been a CNA on their unit (the techs on my unit were also EMTs) or you excelled in the hospital’s nurse residency program. Nursing school teaches you enough not to accidentally kill your patient, you learn the art of nursing on the job. If you are a new grad, your charge nurse is NOT going to be giving you unstable patients. You will also find many ICU managers won’t write a letter of recommendation to grad school without X amount of time on their unit. You want your hands on as many patients with Swans as possible prior to anesthesia school - those don’t go to newbies, and you don’t see them very often anymore outside CVICU or SICU. Why Swans (PA catheters)? Hemodynamics. Instability. Waveform recognition. Complication recognition and management. I was a nurse for 5 years, with 4 years of ED/Level I Trauma experience prior to starting CV, and I was overwhelmed, I can’t imagine being a new grad.

Fastest track to CRNA success that would make me comfortable with you taking care of my son:
BSN school preceptorship in a CVICU, complete a nurse residency at a university hospital (you’re not going to find a nurse residency program unless you go to a very large facility), work in a university CVICU for three years following nurse residency prior to application to school (you would likely get accepted with only two years unless your science and nursing school grades are mediocre at like 3.5). At that point, you will have become somewhat more comfortable in your abilities as a nurse as you will have begun to develop your spidey sense when it comes to patients heading south, learned time management with your meds and gtts while providing high quality care (yes, you should be able to draw your labs/ABGs q2-4h, electrolyte replacement, q 15 minx4 then 1hr Is&Os and VS, titrate your pressors/insulin/heparin gtts, hang your abx, q2h and PRN mouth/vent care, q shift CHG bath, q2h turns and sliding Mr. Wiggles back up in bed PRN, manage their temporary pacemaker, Foley audit/ sepsis screen paperwork, charting q2h assessments/restraints and actually doing said assessments, educate family with their 8000 questions while they cry, report to mid levels and physicians when it’s convenient for them, facilitate extubation or advocate for why they’re not ready so you don’t end up reintubating... and then still take care of your other patient unless this patient is also on ECMO and/or CRRT...this isn’t even close to covering all your duties), and somewhere along the way you will have developed your ability to think critically while under pressure. When you can land an oozy aortic valve replacement with ease and can run a code in your sleep, you’re probably ready to apply to school - otherwise, I don’t want you touching my loved ones because I want you to be comfortable handling the worst of situations.

The vast majority of CRNA schools have transitioned (or are transitioning) to the DNP (you’ll also see it abbreviated as DNAP for clarity between nurse practitioners and nurse anesthetists) = 3 years. Working during anesthesia school is highly discouraged, some schools will make you sign a contract, this was exclusionary for me as a single parent with an uncooperative ex.

Let’s run numbers as if you were from my region:

7 years and $210K investment: 1 year accelerated BSN (unsure of your program cost... $30K?), bare *minimum* 3 years back breaking ICU work prior to matriculation making an abysmal $19-23/hr (dear god, please don’t go to school after one year, you might be my son’s anesthetist one day), 3 years anesthesia school at $180K total COA. I personally do not know a CRNA (n>40) who was an RN for less than 3 years prior to school. $130K starting salary (dropped from $160K due to oversaturation)

Or

8 years and $240K investment: 4 year residency with $50-$60K with frequent 24h call/80 hr wks. $350K (anesthesia, OB/GYN, ED... feel free to adjust the years and salary with the field, either way, it’s more than a CRNA will top out at unless you go into primary care). One more year to be an MD/DO, triple your income, and never have to experience the bedside care (and subsequent back strain) of an 800 lb ventilated patient with a fecal impaction.

TLDR: CRNA school isn’t a short cut and it’s expensive. Unless you would be happier being a bedside nurse for several years, I’d sit down and study for the MCAT or finish pharmacy school. If you were already a nurse, I’d encourage CRNA school for you. You’re not, and as such, MD/DO is a far better investment of your time and money.

 

[chicandtoughness]

[awesome post here]

... it's posts like these that give me so. much. respect. for nurses. Seriously. Y'all run the place.

 

[BC_89]

Long story short I am a 5th year PharmD student with a premedical minor... I am not too worried about salary as long as I can afford to support a family and pay my student loans. I would much rather be satisfied with the work I do.

Using a PharmD as a gateway to another career is financially terrible from the start.

I don't understand the "5th year PharmD student" phrase. Did you go to a school that does a 0-6 program straight out of high school? If so, have you been given an actual bachelors or just pre-reqs straight toward a professional doctorate?

How much debt do you have now? What will you have when its all said and done? Are you willing to sacrifice another year to clear up prereqs for an MD/DO route plus an additional 4 years of Med school + 4 years of residency + fellowships if you wish to specialize in pain management / pediatric / obstetrics as an anesthesiologist? CRNA is a whole other discussion with anchored costs of its own.

If this is the plan, you need to work a few years with whatever job you can land as a pharmacist and HIT your loans HARD and fast. Save up an emergency fund. Save and save some more so you don't cripple your job satisfaction with debt that is not bankrupt-able nor will ever go away. Please also keep in mind, studying your years in pharmacy + CRNA or Med School will cause a mental burn-out and emotional baggage as time goes on. Nonetheless, working a few years as a licensed pharmacist in a rural BFE region is your best avenue to preserve your own health, current or future family, as well as getting closer to job satisfaction with a career switch.

I truly wish you the best.

 

[Rich91]

Long story short I am a 5th year PharmD student with a premedical minor. I planned to take the MCAT for the first time this August but gave up after a month of studying full time. I primarily attribute this to not taking a break after my most recent semester. My goal has been to apply to medical school with hopes of becoming an anesthesiologist after completing my PharmD. I initially felt that I would come back to the MCAT at some point, probably during my semester break.

After failing to stay on track with the MCAT I have spent the remainder of my summer working full time and shadowing. I recently started shadowing a CRNA in the OR and loved every second of it. I shadowed the OR Pharmacist the following day and the role of the CRNA seemed much more interesting to me by comparison. I have shadowed anesthesiologist several times as well, but not in the OR.

I figure if I wanted become a CRNA I could do a 12 month accelerated BSN after completing my PharmD, work for a year in the ICU, and then apply to and hopefully complete a CRNA program in 2 to 3 years. So it seems this would be about the same time frame as becoming anesthesiologist, but without the requirement of a residency from my understanding. I understand the pay is less than an anesthesiologist, but I am not too worried about salary as long as I can afford to support a family and pay my student loans. I would much rather be satisfied with the work I do.

it will take you atleast 2 years of icu as theyll just see a person who did the minimum requirement to get into CRNA school

competitiveness will likely double in next 3-4 years

salaries will drop to pharmacy levels if schools expand