KEVINMD blog post on NP. (even neonatologist is fooled)

[Mr.S]

The discrimination against nurse practitioners must stop

Did you guys happen to see this blog post on KevinMD.

Basically, this neonatologist is saying DOcs are discriminating against nurse practitioners.
So ridiculous.
Docs have no problems with NPS but they do have aprob with NPS who refer to themselves as DR, and want complete independence.And no, my job is NOT to empower nurses to improve their job satisfaction. I am not responsible in empowering anybody except myself. Whats next? I have to empower the phlebotomist, x ray tech, scrub tech janitor to improve their job satsifaction?

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[Psai]

Lmao this doc is off her rocker
Respecting others is what you should do. That doesn't mean that their education is equal or that their opinions deserve the same consideration. There is no replacement for medical school and fake, inadequate nursing "doctorates" is a discussion that doesn't need to be repeated. Btw today's "bachelor" and even "masters" trained nurses have educations that are greatly inferior to what nursing schools used to produce. Nursing students today can't even clean a patient or place an iv, never mind have an understanding of pathophysiology that rivals a physician's.

 

[Ho0v-man]

A few weeks ago I watched a CCU RN and an NP with over 20 years of experience debate what a pH is. I’m not talking logarithms, Henderson hasselbach, yadda yadda. I’m talking “is a low pH acidotic or alkalotic.” Theres only two options here and they were somehow both wrong.

So I don’t care about their hurt feelings. They would be respected just fine if they stayed in their lane. But they just keep trying to push on docs only to get butthurt and triggered when they can’t measure up.

 

[Oso]

Wtf is pH

 

[operaman]

Wow I don’t know where the author of the linked article practices but it sounds like a different planet.

From her website, it looks like she’s trying to bolster her career as a public speaker and influencer by setting up cliched strawmen arguments. It was so poorly written with such flimsy rhetoric that all I can say is 1975 called and it wants its article back.

 

[thegreengreatdragon]

"Nurses not only are required to have a bachelor’s degree..."
"I believe that the elitism that continues to be taught in medical school feeds this discriminatory pattern of interaction with nurses, despite the common knowledge that nurses now practice with at least a bachelor’s degree if not more."
...has this woman never encountered an LPN?

 

[KeikoTanaka]

"Physicians diagnose while nurses provide the care"..................

Yes, that is what an RN does. It is not want an NP wants to do lol

 

[alprazoslam]

so I had friends that were also nurses and went to NP school the same time I went to med school. They have been out a year working and I’m still stuck here paying tuition for another 1.5 years.
Catch is they also worked while in np school and still got done faster.


So by her logic I should be able to do everything independently by now.

Lolllll

 

[jbax42]

Am I the only one who sees the irony of an honorary degree title complaining about someone else using that title? I'm guessing most of the people in this post don't realize that MDs were granted the ability to use the title by the department of education (and other foreign nations) as a courtesy and that they are not officially recognized as Doctors except for in the honorary use of the title. Every government which allows MDs to use the title doctor is pretty clear about this. You can go to the DoE page and read the memo. A medical degree is considered a professional degree and does not meet the requirements for the usage of the term doctor since they are not required to perform original independent research and contribute to their field which is the sign of truly understanding a field and being a doctor of that field. Ironically, DNPs or Doctor of Nurse Practitioning, while considered a professional degree, it does meet the criteria without a honorific waiver. So the irony here is that they are actually real doctors in the eyes of the government. The proper, and only accepted term that is considered earned, is physician for those with MDs. It involves coursework and on the job training. It is no different than any other post graduate professional degree other than the type of material being learned.

 

[Psai]

I'm sorry but writing a poorly designed "research study" about how great NPs are compared to doctors at titrating statins doesn't count.

Everyone knows what a doctor is and a nurse practitioner will never be a real doctor no matter how many letters you put on your name or how many white coats you don.

 

[jbax42]

I'm sorry but writing a poorly designed "research study" about how great NPs are compared to doctors at titrating statins doesn't count.

Everyone knows what a doctor is and a nurse practitioner will never be a real doctor no matter how many letters you put on your name or how many white coats you don.

Most physicians are not doctors but we (society, educators, doctors) allow them to use the title out of respect. You don't see me saying "go get your PhD and see how hard it is to actually earn the title of doctor". Most of the MDs that I have worked with who decided to come get their PhDs lamented the difficulty of a PhD and many opted out. That doesn't mean that I get in their face and say "you just wanted to take the easy way out and use the same title by getting an MD". As for their research, don't knock it until you try it. Produce original research worthy of peer review then you can come back and say that it was poorly designed or no challenge.

 

[Cryc_to_the_point]

. A medical degree is considered a professional degree and does not meet the requirements for the usage of the term doctor since they are not required to perform original independent research and contribute to their field which is the sign of truly understanding a field an

There is nothing "original" and frequently not even "independent," about DNP synthesis projects. Physicians are the masters of medicine. I understand your angle but you seem to have missed the forest for the trees.

Interestingly, 3 of my classmates are PhDs. All 3 of them said their PhDs were dramatically easier to obtain than medical school thus far which supports something I've noticed. The rigor of a PhD varies greatly by institution and field.

 

[Mr.S]

Am I the only one who sees the irony of an honorary degree title complaining about someone else using that title? I'm guessing most of the people in this post don't realize that MDs were granted the ability to use the title by the department of education (and other foreign nations) as a courtesy and that they are not officially recognized as Doctors except for in the honorary use of the title. Every government which allows MDs to use the title doctor is pretty clear about this. You can go to the DoE page and read the memo. A medical degree is considered a professional degree and does not meet the requirements for the usage of the term doctor since they are not required to perform original independent research and contribute to their field which is the sign of truly understanding a field and being a doctor of that field. Ironically, DNPs or Doctor of Nurse Practitioning, while considered a professional degree, it does meet the criteria without a honorific waiver. So the irony here is that they are actually real doctors in the eyes of the government. The proper, and only accepted term that is considered earned, is physician for those with MDs. It involves coursework and on the job training. It is no different than any other post graduate professional degree other than the type of material being learned.

I think we are discussing/debating/arguing nomenclature.
Doctors equals "physicians" for eons. we can substitute "doctor" for "your royal highness"
If someone other than a physician calls themselves "your royal highness"
It would still be fraud.
The term Doctor or why it's used is not in question. The fact that "DNP" are using the title to confuse patients even more to make them believe they have equal qualifications as a physician is fraud. And of course the weak politicians will let this one go until the pharmacist, pharmacy tech, endo tech etc etc wants the same respectful title. Since they work hard too.

 

[jbax42]

There is nothing "original" and frequently not even "independent," about DNP synthesis projects. Physicians are the masters of medicine. I understand your angle but you seem to have missed the forest for the trees.

Interestingly, 3 of my classmates are PhDs. All 3 of them said their PhDs were dramatically easier to obtain than medical school thus far which supports something I've noticed. The rigor of a PhD varies greatly by institution and field.

To be honest, I don't know which program, MD or NP is harder or easier (or similar). As a bioengineering researcher, I worked with both and I can tell you that neither had a monopoly on people who didn't understand basic biochemistry. My issue is strictly with the complaining going on here about title usage. Academia, and society (government, etc), has determined that a DNP is sufficient enough to be called a practical research degree and that they perform research with significant enough rigor to have earned the title doctor. No government or academic body has done so for MDs or DOs. You guys are literally complaining about someone earning a title that you did not earn and using that title appropriately.

Personally, I have looked into the MD programs because I am trying to pick one to go into and I'm married to someone in the NP program and going through the coursework, books, and reviews, the actual material is extremely similar. It just seems to be organized differently. The main difference seems to be only on the job training time. Some MD programs have some minor ochem, biochem, etc in the beginning but that is just review with very little new knowledge from everyone I've talked to if you actually paid attention when previously taking the courses (referring to people who coming from undergrad). In regards to PhDs, yes they differ by school in rigor just like MD, undergrad and every other program.

 

[jbax42]

I think we are discussing/debating/arguing nomenclature.
Doctors equals "physicians" for eons. we can substitute "doctor" for "your royal highness"
If someone other than a physician calls themselves "your royal highness"
It would still be fraud.
The term Doctor or why it's used is not in question. The fact that "DNP" are using the title to confuse patients even more to make them believe they have equal qualifications as a physician is fraud. And of course the weak politicians will let this one go until the pharmacist, pharmacy tech, endo tech etc etc wants the same respectful title. Since they work hard too.

Physicians have been calling themselves doctors since 1912 and ironically it was simply due to wanting greater stature because they lamented the stature of PhDs. So no, it wouldn't be fraud for the title to be used properly.

 

[jbax42]

You played your hand too soon, nurse. 1/10 trolling.

Huh? No, I'm a researcher which means I understand bias and identifying bias. Unfortunately, we are not paid like MDs even though we do, and in many cases head, a lot of research with MDs. So, it makes sense to get MD.

 

[Cryc_to_the_point]

The material covered is not similar. come back when you've attended a medical school. Further, you're painfully biased with your personal entanglement and I think anything more than a cursory look will show you the vast gap in material covered.

 

[jbax42]

The material covered is not similar. come back when you've attended a medical school. Further, you're painfully biased with your personal entanglement and I think anything more than a cursory look will show you the vast gap in material covered.

You've never attended NP school, so how do you know the gap? I never said I knew the gap and I have made my situation clear to make my bias and knowledge base clear. Maybe you need to identify your bias?

 

[Cryc_to_the_point]

Physicians have been using the title "Doctor," since the middle ages... It fell out of favor for the title "professor," for some time but did come back into vogue in the early 20th century.

You sound a lot like the CRNAs qho try to claim "nurses were the original anesthesia peoviders," only to find out that:
1. It was a dentist
2. That whole field bloomed and the developments were driven by doctors (or physicians since that's somehow in question)
3. Nurses lead the field when it was literally passing chloroform and ether. That's it.

 

[Cryc_to_the_point]

You've never attended NP school, so how do you know the gap? I never said I knew the gap and I have made my situation clear to make my bias and knowledge base clear. Maybe you need to identify your bias?

I haven't attended but I've helped NP students pass their classes by providing the cliff notes of my own training...

Come work with them, you'll see.

 

[KeikoTanaka]

Yeah, I took Biochemistry in undergrad, then I took biochemistry in medical school. Medical Biochemistry was way harder. I'm sure NPs take "Pathophysiology" but just given the nature of the fact that you can literally work full time while getting an NP degree goes to show that maybe it's not as hard or as demanding as medical school's curriculum.

 

[Mr.S]

Physicians have been calling themselves doctors since 1912 and ironically it was simply due to wanting greater stature because they lamented the stature of PhDs. So no, it wouldn't be fraud for the title to be used properly.

Whatever the reason physicians are called doctor does not matter. What matters is that nurses want to call themselves DR to confuse patients even more by equating themselves to physicians.

 

[Mr.S]

Physicians have been using the title "Doctor," since the middle ages... It fell out of favor for the title "professor," for some time but did come back into vogue in the early 20th century.

You sound a lot like the CRNAs qho try to claim "nurses were the original anesthesia peoviders," only to find out that:
1. It was a dentist
2. That whole field bloomed and the developments were driven by doctors (or physicians since that's somehow in question)
3. Nurses lead the field when it was literally passing chloroform and other. That's it.

actually chloroform you needed skills that is why all the anesthetists are physicians in Europe.
Ether, you needed considerable less skills which is why ANYBODY was doing it for the surgeons. They would get the mop-cleaner to hold the ether mask on. I mean we are talking very crude operations.

 

[Psai]

Obvious nurse troll is obvious

 

[Gurby]

As for their research, don't knock it until you try it. Produce original research worthy of peer review then you can come back and say that it was poorly designed or no challenge.

Many/most MD students at least dip their toes in the water when it comes to research, and for more competitive specialties having a handful of articles in press is the norm.

 

[liquidcrawler]

.

 

[Iz_FtB]

Interestingly, 3 of my classmates are PhDs. All 3 of them said their PhDs were dramatically easier to obtain than medical school thus far which supports something I've noticed. The rigor of a PhD varies greatly by institution and field.

PhD was miles harder. Not even remotely close. Can't imagine what field of study your pals did a PhD in that was easier than med school.

 

[Mr.S]

PhD was miles harder. Not even remotely close. Can't imagine what field of study your pals did a PhD in that was easier than med school.

While I want to agree with you. The hours a PhD candidate holds is pretty chill

 

[Cryc_to_the_point]

Parasitology and some form of Oncology. I admit I'm not familiar with the third's area of expertise. Refer above that rigor varies, a lot.

 

[jbax42]

While I want to agree with you. The hours a PhD candidate holds is pretty chill

This statement makes it pretty clear that you have not been involved with a PhD program in any capacity. It is a very ignorant statement. Never mind the fact that there is no hand holding (in MD, I was informed by many individuals that there's a large amount of directed learning), the hours you put in as a PhD candidate are atrocious and stressful. You are not only working on your original research, you are also collaborating on countless other original research from other researchers. By the time you earn your degree, you understand your field on the most intimate level. It is all critical thinking. Not directed learning. It is literally the opposite of MD school in which you are using previously discovered knowledge to solve known problems with known solutions. That said, after med school, some MDs eventually get to the point where they begin to contribute but that's not the point. We are talking about the credentials after obtaining a degree not after years of experience. A master of engineering, after obtaining much experience, can produce papers and research and have a level of knowledge and understanding that reaches a doctor (PhD). We are talking about the level of the individual after obtaining their degree.

 

[Gurby]

the hours you put in as a PhD candidate are atrocious and stressful. You are not only working on your original research, you are also collaborating on countless other original research from other researchers.

 

[jbax42]

Lol, sorry, I didn't mean to get preachy there. Just trying to throw some further information out there. I don't think many people here understand, let alone acknowledges, their biases

 

[DPTinthemaking15]

To be honest, I don't know which program, MD or NP is harder or easier (or similar). As a bioengineering researcher, I worked with both and I can tell you that neither had a monopoly on people who didn't understand basic biochemistry. My issue is strictly with the complaining going on here about title usage. Academia, and society (government, etc), has determined that a DNP is sufficient enough to be called a practical research degree and that they perform research with significant enough rigor to have earned the title doctor. No government or academic body has done so for MDs or DOs. You guys are literally complaining about someone earning a title that you did not earn and using that title appropriately.

Personally, I have looked into the MD programs because I am trying to pick one to go into and I'm married to someone in the NP program and going through the coursework, books, and reviews, the actual material is extremely similar. It just seems to be organized differently. The main difference seems to be only on the job training time. Some MD programs have some minor ochem, biochem, etc in the beginning but that is just review with very little new knowledge from everyone I've talked to if you actually paid attention when previously taking the courses (referring to people who coming from undergrad). In regards to PhDs, yes they differ by school in rigor just like MD, undergrad and every other program.

Wut??? This isn't adding up. If you aren't in medical school, how are you comparing NP to MD lol? That is like comparing virtual reality boxing with real boxing. They may look similar, but if I get punched in the mouth, my perception changes.

 

[Little Green Mensch]

This statement makes it pretty clear that you have not been involved with a PhD program in any capacity. It is a very ignorant statement. Never mind the fact that there is no hand holding (in MD, I was informed by many individuals that there's a large amount of directed learning), the hours you put in as a PhD candidate are atrocious and stressful. You are not only working on your original research, you are also collaborating on countless other original research from other researchers. By the time you earn your degree, you understand your field on the most intimate level. It is all critical thinking. Not directed learning. It is literally the opposite of MD school in which you are using previously discovered knowledge to solve known problems with known solutions. That said, after med school, some MDs eventually get to the point where they begin to contribute but that's not the point. We are talking about the credentials after obtaining a degree not after years of experience. A master of engineering, after obtaining much experience, can produce papers and research and have a level of knowledge and understanding that reaches a doctor (PhD). We are talking about the level of the individual after obtaining their degree.

Eh. I worked with a couple Ph.D. students when I was an undergrad. One of them came in around 8AM every day (and usually left by 4PM); the other came in at 11AM and left around 7PM or so. Both ended up with very good post-doctoral fellowships. Admittedly, there were many days when they worked longer hours, usually if there was a protein to be purified or experiments to be done before resubmitting a paper.

As for research being harder than memorizing and synthesizing the vast corpus of medical knowledge, I think they're very different tasks, and there are relatively few people who have the temperament and ability to be excellent at both.

With respect to honorifics, unfortunately "Doctor" has become synonymous with "physician" for most people in the U.S. That's not the case in Europe, as I understand it. The problem with DNPs calling themselves "Doctor" is that patients may mistake the NPs for physicians.

 

[Cryc_to_the_point]

Not sure I agree. All the UK physicians I've see. Had name tags with "DOCTOR" on it.

 

[Gurby]

Lol, sorry, I didn't mean to get preachy there. Just trying to throw some further information out there. I don't think many people here understand, let alone acknowledges, their biases

I have to say that Qualifying Exams do sound like they are probably more stressful than anything we do as medical students... Spend 2+ years in your PhD program, then go take all-day written tests and get orally grilled by leaders of your field, and then if your program doesn't have enough funding maybe 1/3 of your cohort fails out and basically just wasted 2 years of their lives. At least as a US MD student if you bomb the boards exams you still get to become a doctor, just maybe not a neurosurgeon.

 

[curbsideconsult]

There might not be as much animosity between the professions if nurses treated medical students better during our training.

Oh how true this is. I understand the need for battle-hardened nurses to put a bratty, whiny, know-it-all, holier-than-thou med student in his/her place, but why be crusty to the whole lot of us? I bend over backwards to be nice to all the nurses, social workers, phlebotomists, scrub techs, etc. etc. and still some nurses go out of their way to make snide remarks towards me or not help me out in any way or just constantly give me the death stare for quite literally just trying not to be an obstacle while they're working. I swear to whatever-god-you-pray-to that a nurse went out of her way the other day to convince a patient NOT to let med students into her room. Seriously?! I PAY to get this education! The only upside to this is that this sort of behavior makes the nice nurses stand out. I have a ton of respect for those nurses and they end up helping me out a lot.

 

[VA Hopeful Dr]

Physicians have been calling themselves doctors since 1912 and ironically it was simply due to wanting greater stature because they lamented the stature of PhDs. So no, it wouldn't be fraud for the title to be used properly.

This could not be more false.

 

[dadaddadaBATMAN]

Am I the only one who sees the irony of an honorary degree title complaining about someone else using that title? I'm guessing most of the people in this post don't realize that MDs were granted the ability to use the title by the department of education (and other foreign nations) as a courtesy and that they are not officially recognized as Doctors except for in the honorary use of the title. Every government which allows MDs to use the title doctor is pretty clear about this. You can go to the DoE page and read the memo. A medical degree is considered a professional degree and does not meet the requirements for the usage of the term doctor since they are not required to perform original independent research and contribute to their field which is the sign of truly understanding a field and being a doctor of that field. Ironically, DNPs or Doctor of Nurse Practitioning, while considered a professional degree, it does meet the criteria without a honorific waiver. So the irony here is that they are actually real doctors in the eyes of the government. The proper, and only accepted term that is considered earned, is physician for those with MDs. It involves coursework and on the job training. It is no different than any other post graduate professional degree other than the type of material being learned.

Many medical schools do have a research requirement (mine did), and if you take a look through the nrmp stats published every year there are many fields where 90% of applicants have published multiple peer reviewed studies.

If you think there’s a universal difficulty to all PhD programs, and you’re a current PhD candidate, you’re either insane or purposely obtuse. People trying to break into tenure track academics at a Harvard physics program face a different level of difficulty than those obtaining a PhD in edu so they can get promoted to school superintendent in suburbia. Both are accomplishments, but they’re on a different scale.

As for your “the coursework looks similar comment” I would consider the following:

1. Medical school is one of the more challenging progressional schools to get into, with 40-50% of self-selected applicants making it into any program in a given year.

2. Np as a degree can be obtained online, with the seeming requirements being a bsn, a pulse and a checkbook (pulse optional at some locations). Some np schools are more rigorous, but I don’t think employers pay much attention to degree as much as experience for nps

3. For a more competitive applicant pool, it takes 4 years of 50-80 hr weeks of studying and on the job training to complete medical school. By comparison an np is completed in two years with significantly less hours while working full time. You can argue whether or not the breath of knowledge an md is expected to learn is necessary for the job, but there’s no question it’s a higher volume.

4. Objectively speaking, >90% of nps have failed a watered down version of our easiest and most directly clinical licensing exam when it was studied, and these were students hand picked and Prep’d to pass the exam, which most mds do without studying during intern year.

As a side note, every time I think this topic has been hacked to death a new zombie rises. Expect no further responses from me, I already wasted too much time on this.

 

[SouthernGent]

Lol, sorry, I didn't mean to get preachy there.

I find this hard to believe.

 

[jbax42]

Many medical schools do have a research requirement (mine did), and if you take a look through the nrmp stats published every year there are many fields where 90% of applicants have published multiple peer reviewed studies.

If you think there’s a universal difficulty to all PhD programs, and you’re a current PhD candidate, you’re either insane or purposely obtuse. People trying to break into tenure track academics at a Harvard physics program face a different level of difficulty than those obtaining a PhD in edu so they can get promoted to school superintendent in suburbia. Both are accomplishments, but they’re on a different scale.

As for your “the coursework looks similar comment” I would consider the following:

1. Medical school is one of the more challenging progressional schools to get into, with 40-50% of self-selected applicants making it into any program in a given year.

2. Np as a degree can be obtained online, with the seeming requirements being a bsn, a pulse and a checkbook (pulse optional at some locations). Some np schools are more rigorous, but I don’t think employers pay much attention to degree as much as experience for nps

3. For a more competitive applicant pool, it takes 4 years of 50-80 hr weeks of studying and on the job training to complete medical school. By comparison an np is completed in two years with significantly less hours while working full time. You can argue whether or not the breath of knowledge an md is expected to learn is necessary for the job, but there’s no question it’s a higher volume.

4. Objectively speaking, >90% of nps have failed a watered down version of our easiest and most directly clinical licensing exam when it was studied, and these were students hand picked and Prep’d to pass the exam, which most mds do without studying during intern year.

As a side note, every time I think this topic has been hacked to death a new zombie rises. Expect no further responses from me, I already wasted too much time on this.

To respond do your message by point.

1. Medical schools are far less selective than a good PhD program. That said, it is more selective than other PhD programs so I won't argue this point since it is a fallacia non causae ut causae.

2. To pretend as though MD coursework cant be learned online is a bit nearsighted. I happen to know for a fact that there are already programs looking into this. Any coursework can be translated to an online equivalent (some may require conditions). It is a problem of systems and processes, not necessity. Medical school programs (a system) are older and rigid and will take time to adapt to this new way of learning. As an example, mechanical and electrical engineering for example (one of my undergrad degrees was in EE). While newer programs are able to build around new technologies and systems (I am using system in a broad sense here so not just technological). So this point is rather null. There have been many studies done on this point and have found that online programs offer no disadvantage in regards to learning if done properly. NP programs, to my knowledge, require you to be on campus when necessary but the classes that are capable of being done online are online without diminished returns. An example is the Advanced Pathophysiology in most programs I looked into while comparing the two focuses which requires in person lectures periodically and exams. There seems to be some differences in the requirements for admittance though although most seem to require at least 2 years experience a nurse, a BSN and at least a GPA of 3.0 from previous studies with the GPA being competitive after that point which is pretty standard for most post graduate degrees. I agree with you that the rigor varies greatly but that is said of every school in existence. I have been told not to apply to certain Med schools for this very reason.

3. I'm not sure what your point is here? Maybe I need you to elaborate a bit further? On the job training is just that... on the job training. You can get it in school or you can get it...on the job... This is just a matter of organization. Correct me if I am wrong but, as an MD student, you get experience in a wide variety of jobs during your rotations. A NPs experience during their rotations are very specific. You do clerkships in, Internal medicine, Obstetrics-gynecology, General surgery, Pediatrics, Psychiatry, Family medicine and/or neurology. So... I don't understand your argument. If you were to take out and only do one of those clerkships then your hours would be similar to theirs. This makes an MD more well rounded in their experience and capable of performing more jobs but keep in mind that those are all different jobs. When performing a single job (like almost all MDs do), the actual on the job experience is similar. This is simply a matter of mathematics and looking at the situation objectively. The fact that the program takes so long is because you have to study multiple jobs instead of just one. That said, the MDs I have talked to have all said that most of that knowledge goes over time except the job you decide to do. You have to relearn the rest again but that's how all knowledge works. This all said, I am not seeing the advantage you are speaking of when the math is said and done. I simply see a difference in organization of the programs but when performing the exact same job, studies have consistently shown the knowledgebase and patient outcome was similar with MDs being slightly greater in some studies and NP being slightly greater in others. I chose MD over NP only because of the money.

4. I would need to know what information you are referencing to discuss this point. I didn't find this anywhere in my researching the two or talking with people and colleagues from both. I don't think your statistic is objective or accurate because it sounds extremely unlikely that anyone who studied any graduate program would have a failure rate that high of a licensing exam. That program would have been restructured. Sounds like BS to be honest.

 

[762513]

To respond do your message by point.

1. Medical schools are far less selective than a good PhD program. That said, it is more selective than other PhD programs so I won't argue this point since it is a fallacia non causae ut causae.

2. To pretend as though MD coursework cant be learned online is a bit nearsighted. I happen to know for a fact that there are already programs looking into this. Any coursework can be translated to an online equivalent (some may require conditions). It is a problem of systems and processes, not necessity. Medical school programs (a system) are older and rigid and will take time to adapt to this new way of learning. As an example, mechanical and electrical engineering for example (one of my undergrad degrees was in EE). While newer programs are able to build around new technologies and systems (I am using system in a broad sense here so not just technological). So this point is rather null. There have been many studies done on this point and have found that online programs offer no disadvantage in regards to learning if done properly. NP programs, to my knowledge, require you to be on campus when necessary but the classes that are capable of being done online are online without diminished returns. An example is the Advanced Pathophysiology in most programs I looked into while comparing the two focuses which requires in person lectures periodically and exams. There seems to be some differences in the requirements for admittance though although most seem to require at least 2 years experience a nurse, a BSN and at least a GPA of 3.0 from previous studies with the GPA being competitive after that point which is pretty standard for most post graduate degrees. I agree with you that the rigor varies greatly but that is said of every school in existence. I have been told not to apply to certain Med schools for this very reason.

3. I'm not sure what your point is here? Maybe I need you to elaborate a bit further? On the job training is just that... on the job training. You can get it in school or you can get it...on the job... This is just a matter of organization. Correct me if I am wrong but, as an MD student, you get experience in a wide variety of jobs during your rotations. A NPs experience during their rotations are very specific. You do clerkships in, Internal medicine, Obstetrics-gynecology, General surgery, Pediatrics, Psychiatry, Family medicine and/or neurology. So... I don't understand your argument. If you were to take out and only do one of those clerkships then your hours would be similar to theirs. This makes an MD more well rounded in their experience and capable of performing more jobs but keep in mind that those are all different jobs. When performing a single job (like almost all MDs do), the actual on the job experience is similar. This is simply a matter of mathematics and looking at the situation objectively. The fact that the program takes so long is because you have to study multiple jobs instead of just one. That said, the MDs I have talked to have all said that most of that knowledge goes over time except the job you decide to do. You have to relearn the rest again but that's how all knowledge works. This all said, I am not seeing the advantage you are speaking of when the math is said and done. I simply see a difference in organization of the programs but when performing the exact same job, studies have consistently shown the knowledgebase and patient outcome was similar with MDs being slightly greater in some studies and NP being slightly greater in others. I chose MD over NP only because of the money.

4. I would need to know what information you are referencing to discuss this point. I didn't find this anywhere in my researching the two or talking with people and colleagues from both. I don't think your statistic is objective or accurate because it sounds extremely unlikely that anyone who studied any graduate program would have a failure rate that high of a licensing exam. That program would have been restructured. Sounds like BS to be honest.

4) There was apparently an experiment from many years ago when NP students took the step 3 exam that physicians take (interns). The student doctors on this website never link that study yet use it as proof that all NP's across the country are unable to pass this exam. Having a NP student take an exam that makes no difference to their future or their career is not really a fair comparison to physicians who's chance at fellowship and future rests with how they do on their steps. It's really one of the worst arguments these student doctors try to bring up.

 

[jbax42]

I find this hard to believe.

That's because you are biased and think that everyone who says anything critical is against you. In reality, I have no bone in the NP vs MD argument. I think it's silly and based fully in ego on both sides. My experience with both found little differences in their knowledgebase on their specific jobs (family doctor, pediatrics, etc.) and I know a few NPs who teach and train med students just like I know MDs who teach and train NPs. I know NPs who are leading research into treating and caring for HIV patients. I know doctors who are leading research into various things. These are typically very experienced people, PhD/MDs, or DNPs. TBH, I really don't care. In my explanations above, I made it clear that all my knowledge is based on me researching the two (talking to people, looking into programs, salary, etc.) to choose one for myself.

My only bone in this whole conversation has always been about the use of the term doctor. MDs do not own that term and have not officially earned that title so to try to take ownership is absurd. If they have earned the title and are recognized as doctors then they can use the title. Anything argument otherwise has no merit unless you can definitively prove that their research was not up to par with expected research out of a professional doctoral student. If you truly want to complain, at least go do original research and an earn an actual doctorate degree.

So, my goal isn't to sound preachy. It's to hopefully point out the bias I see here and silliness of complaining about the title 'doctor' being used by anyone given the honor of using it whether it is honorary or earned.

******* Keep in mind I'm not referring to completely honorary degrees like the actors or people who get honorary degrees for being popular. MD isn't an honorary degree. Only the title doctor is honorary. The degree is terminal professional degree and is well earned.

 

[Disciple of Sattar]

Huh? No, I'm a researcher which means I understand bias and identifying bias. Unfortunately, we are not paid like MDs even though we do, and in many cases head, a lot of research with MDs. So, it makes sense to get MD.

I chose MD over NP only because of the money.

Hahahahahahahahahaha

That's because you are biased and think that everyone who says anything critical is against you. In reality, I have no bone in the NP vs MD argument. I think it's silly and based fully in ego on both sides. My experience with both found little differences in their knowledgebase on their specific jobs (family doctor, pediatrics, etc.) and I know a few NPs who teach and train med students just like I know MDs who teach and train NPs. I know NPs who are leading research into treating and caring for HIV patients. I know doctors who are leading research into various things. These are typically very experienced people, PhD/MDs, or DNPs. TBH, I really don't care. In my explanations above, I made it clear that all my knowledge is based on me researching the two (talking to people, looking into programs, salary, etc.) to choose one for myself.

My only bone in this whole conversation has always been about the use of the term doctor. MDs do not own that term and have not officially earned that title so to try to take ownership is absurd. If they have earned the title and are recognized as doctors then they can use the title. Anything argument otherwise has no merit unless you can definitively prove that their research was not up to par with expected research out of a professional doctoral student. If you truly want to complain, at least go do original research and an earn an actual doctorate degree.

So, my goal isn't to sound preachy. It's to hopefully point out the bias I see here and silliness of complaining about the title 'doctor' being used by anyone given the honor of using it whether it is honorary or earned.

******* Keep in mind I'm not referring to completely honorary degrees like the actors or people who get honorary degrees for being popular. MD isn't an honorary degree. Only the title doctor is honorary. The degree is terminal professional degree and is well earned.

Again, you are completely missing the point.

 

[Disciple of Sattar]

4) There was apparently an experiment from many years ago when NP students took the step 3 exam that physicians take (interns). The student doctors on this website never link that study yet use it as proof that all NP's across the country are unable to pass this exam. Having a NP student take an exam that makes no difference to their future or their career is not really a fair comparison to physicians who's chance at fellowship and future rests with how they do on their steps. It's really one of the worst arguments these student doctors try to bring up.

You mean the exam that is used to show that you are competent to independently treat patients?

 

[Psai]

As a doctor, I also go on websites for electrical engineering to debate the finer points concerning the education of electrical engineers vs that of pastry chefs.

 

[762513]

You mean the exam that is used to show that you are competent to independently treat patients?

Why don’t you link the article and then we can see what’s what.

 

[Gurby]

4) There was apparently an experiment from many years ago when NP students took the step 3 exam that physicians take (interns). The student doctors on this website never link that study yet use it as proof that all NP's across the country are unable to pass this exam. Having a NP student take an exam that makes no difference to their future or their career is not really a fair comparison to physicians who's chance at fellowship and future rests with how they do on their steps. It's really one of the worst arguments these student doctors try to bring up.

I just wasted way too much time Googling about this, and as far as I can tell, there was no study, and there was no experiment. What seems to have happened is this:

In 2008, the NBME joined forces with the Council for the Advancement of Comprehensive Care (CACC) - apparently now defunct - to create a series of DNP licensing exams similar to the one physicians take. Theoretically this test was going to use old Step 3 questions, but ultimately it was designed to be pretty different from the USMLE. I wasn't able to find actual results about DNP pass rates, just random people on forums claiming the pass rates were low on this test that wasn't even a USMLE test... Seems like this initiative must have eventually fizzled out at some point around 2011.

Here is a nice synopsis of the situation:
NBME Development of a Certifying Examination for Doctors of Nursing Practice - PDF

Here is an allnurses thread where people are talking and citing numbers and giving links, but all of the links are dead because this transpired 10 years ago:
DNP's failing the test????

 

[762513]

I just wasted way too much time Googling about this, and as far as I can tell, there was no study, and there was no experiment. What seems to have happened is this:

In 2008, the NBME joined forces with the Council for the Advancement of Comprehensive Care (CACC) - apparently now defunct - to create a series of DNP licensing exams similar to the one physicians take. Theoretically this test was going to use old Step 3 questions, but ultimately it was designed to be pretty different from the USMLE. I wasn't able to find actual results about DNP pass rates, just random people on forums claiming the pass rates were low on this test that wasn't even a USMLE test... Seems like this initiative must have eventually fizzled out at some point around 2011.

Here is a nice synopsis of the situation:
NBME Development of a Certifying Examination for Doctors of Nursing Practice - PDF

Here is an allnurses thread where people are talking and citing numbers and giving links, but all of the links are dead because this transpired 10 years ago:
DNP's failing the test????

Thank you for taking the time to do this research. I’m reading it all now.

 

[Ho0v-man]

To respond do your message by point.

1. Medical schools are far less selective than a good PhD program. That said, it is more selective than other PhD programs so I won't argue this point since it is a fallacia non causae ut causae.

2. To pretend as though MD coursework cant be learned online is a bit nearsighted. I happen to know for a fact that there are already programs looking into this. Any coursework can be translated to an online equivalent (some may require conditions). It is a problem of systems and processes, not necessity. Medical school programs (a system) are older and rigid and will take time to adapt to this new way of learning. As an example, mechanical and electrical engineering for example (one of my undergrad degrees was in EE). While newer programs are able to build around new technologies and systems (I am using system in a broad sense here so not just technological). So this point is rather null. There have been many studies done on this point and have found that online programs offer no disadvantage in regards to learning if done properly. NP programs, to my knowledge, require you to be on campus when necessary but the classes that are capable of being done online are online without diminished returns. An example is the Advanced Pathophysiology in most programs I looked into while comparing the two focuses which requires in person lectures periodically and exams. There seems to be some differences in the requirements for admittance though although most seem to require at least 2 years experience a nurse, a BSN and at least a GPA of 3.0 from previous studies with the GPA being competitive after that point which is pretty standard for most post graduate degrees. I agree with you that the rigor varies greatly but that is said of every school in existence. I have been told not to apply to certain Med schools for this very reason.

3. I'm not sure what your point is here? Maybe I need you to elaborate a bit further? On the job training is just that... on the job training. You can get it in school or you can get it...on the job... This is just a matter of organization. Correct me if I am wrong but, as an MD student, you get experience in a wide variety of jobs during your rotations. A NPs experience during their rotations are very specific. You do clerkships in, Internal medicine, Obstetrics-gynecology, General surgery, Pediatrics, Psychiatry, Family medicine and/or neurology. So... I don't understand your argument. If you were to take out and only do one of those clerkships then your hours would be similar to theirs. This makes an MD more well rounded in their experience and capable of performing more jobs but keep in mind that those are all different jobs. When performing a single job (like almost all MDs do), the actual on the job experience is similar. This is simply a matter of mathematics and looking at the situation objectively. The fact that the program takes so long is because you have to study multiple jobs instead of just one. That said, the MDs I have talked to have all said that most of that knowledge goes over time except the job you decide to do. You have to relearn the rest again but that's how all knowledge works. This all said, I am not seeing the advantage you are speaking of when the math is said and done. I simply see a difference in organization of the programs but when performing the exact same job, studies have consistently shown the knowledgebase and patient outcome was similar with MDs being slightly greater in some studies and NP being slightly greater in others. I chose MD over NP only because of the money.

4. I would need to know what information you are referencing to discuss this point. I didn't find this anywhere in my researching the two or talking with people and colleagues from both. I don't think your statistic is objective or accurate because it sounds extremely unlikely that anyone who studied any graduate program would have a failure rate that high of a licensing exam. That program would have been restructured. Sounds like BS to be honest.

1) I’ve never applied to a PhD program so I’m not sure if this is incorrect or correct. I won’t comment on things I have no knowledge of as others in this thread seem to have a monopoly on that.

2) some stuff in medical school can and is incorporated into online coursework. But all it really has lead to in my n=1 experience is a way to give me more crap to do when the school is closed. Furthermore, the fact that you don’t seem to realize that most medical schools have multiple labs , case presentations and skill evaluations essentially every week shows that you don’t really know what you’re talking about. We’re constantly assessed in person because if we weren’t, some would fall too far behind as it’s easy to do. This is much more rigorous than any online NP program with a few mandatory physical exam labs. I’ve met multiple who’ve never even sutured but have practicing for years. Not to imply this is the end all be all skill of being a physician, just using it as an example everyone can understand.

3) of course a family med doc wouldn’t be able to take out a gallbladder bc they did a surgery rotation 10 years ago in med school. But because of that training they’re more familiar with what goes into taking care of a post op patient and looking for complications. They’ve also spent more time managing an acute abdomen for example. Experience in the care of complex ob patients or those undergoing complications of chemo therapy for example is part of what makes a physician a physician. Yeah, you probably can’t manage those problems by yourself all the time. But you will be prepared to recognize red flags of pathology that an NP doesn’t know exists.

Perhaps I’m confusing you with another poster, but didn’t you claim to have a research background? Any undergrad who’s taken an introductory research methods class could tell you those “studies” are severely flawed with an obvious bias. Unless I’m mixed up about which poster is which, it really calls your background into question.

4) I couldn’t find it either. I remember reading about it when it came out. The above poster was correct about it but iirc only about 50% failed it. But it was still an easier version of a test for which most MDs don’t even bother to prepare.