Advertisement - Members don't see this ad
you can do this with just a JD.
Nurse Practioners encroaching upon Physician territory?
Started by icevermin
Get help with your application
Use all the free resources available to you from SDN: articles, guides, expert advising, forums discussions, and school research.
you can do this with just a JD.
I'm well aware. I actually seriously considered this. Then I realized I was about to move to Austin and spend roughly 54K a year in tuition alone for 3 years..
and that I would be leaving the clinical aspect of medicine behind. forever.
Obviously the docs figured they could rely on the rock solid pharmacological knowledge of the nursing staff to catch any oversights 🙄
Advertisement - Members don't see this ad
I have yet to meet a practicing lawyer with an MD who still does anything remotely 'clinical'
You're missing the point.
It was probably pharmacy's job anyway. 😛
bummer.
perhaps it's the pharmacy's job, but it does bear noting it's the nurse's job to double check before administration
Hoody, a couple of things:
1. If I compare a lawyer and a doctor and say that the lawyer has inadequate training to practice medicine, is it a true statement? Yes. If I say that the physician has a significantly greater medical knowledge/foundation than the lawyer, is it a true statement? Absolutely. However, does me saying that imply that the lawyer is dumb? No. Does what I say imply that the lawyer is worth less as a person? No (although some would argue yes 😀). So don't get offended or think people are calling nurses dumb when they say that NP/DNP training is not equivalent to that of physicians. It's absolutely true that physicians have a greater medical knowledge base compared to NPs/DNPs and it's also true that the length of training/intensity of training is longer/more rigorous for physicians. However, me believing this does not mean I think nurses are dumb. Does that make sense?
2. I have looked at the NP/DNP curricula for several schools and I have to agree with what Instatewaiter has posted. I have also looked at the curricula for various PA schools and it seems that PA training much more closely parallels physician training than NP/DNP training does. If you find NP/DNP curricula that's widely utlized and that contradicts what Instatewaiter has said, please cite it and give us a link.
3. I still do not understand how you can say nursing experience is equivalent to experience practicing medicine. They're two separate things that require different ways of thinking. I'm sure years and years of nursing experience will help a bit in the transition to practicing medicine but I just cannot see how you can say all those clinical hours as a nurse compensate for the lack of clinical hours practicing medicine. And as several people, including me, have mentioned, there are several direct-entry NP programs where you require no prior healthcare experience at all and can get an NP within a few years. It's scary to think that someone without any prior clinical experience who graduates with about 1000 clinical hours practicing medicine can practice independently. I still stand firmly by my assertion that the amount of time spent being a nurse doesn't really translate equally to the amount of time spent practicing medicine or thinking in a medical manner until someone can provide evidence that nurses think like doctors and thus, their clinical hours should count as practicing medicine.
4. Regarding the fact that you've taken phys/pathophys/biochem in your pursuit of a BSN, I have also taken many upper level classes such as immunology, physiology (where a good chunk of our notes said M1 physio on them and the class was taught by med school professors), biochem, genetics, etc. (I'm an MCB major). The only classes I haven't taken are pathophys and pharmacology. Does this mean I should be allowed to skip a number of years of training and should just take path/pharm instead before jumping into clinicals? No. I doubt that the depth of my classes was similar to that of med school courses and even if they were similar, these classes did not have a medical focus (ie. how what we learn can be applied in a clinical setting). So, because you've taken a few basic science courses at either a lower level of depth or with a not-so-clinical focus as med school courses doesn't mean that they compensate for a lack of a strong basic science foundation. No one's saying that nurses have no scientific foundation at all; I have no idea where you're getting this from. However, what people are saying is that the foundation you do have is inadequate compared to the foundation physicians have.
I can't think of anything else to add right now, but anyways, it is exactly because of the lack of an adequate amount of training that I don't like the idea of NPs/DNPs practicing without physician supervision. I know that they're already allowed to practice independently in several states but that doesn't mean I approve of it. There's also an active push towards calling DNPs equal to physicians, which is a very misleading and false thing to do. This vocal group is pushing for equivalency to physicians and equal reimbursement as physicians, so I can't see people arguing that NPs/DNPs save money either. If anything, they might increase costs due to more referrals to specialists.
1. If I compare a lawyer and a doctor and say that the lawyer has inadequate training to practice medicine, is it a true statement? Yes. If I say that the physician has a significantly greater medical knowledge/foundation than the lawyer, is it a true statement? Absolutely. However, does me saying that imply that the lawyer is dumb? No. Does what I say imply that the lawyer is worth less as a person? No (although some would argue yes 😀). So don't get offended or think people are calling nurses dumb when they say that NP/DNP training is not equivalent to that of physicians. It's absolutely true that physicians have a greater medical knowledge base compared to NPs/DNPs and it's also true that the length of training/intensity of training is longer/more rigorous for physicians. However, me believing this does not mean I think nurses are dumb. Does that make sense?
2. I have looked at the NP/DNP curricula for several schools and I have to agree with what Instatewaiter has posted. I have also looked at the curricula for various PA schools and it seems that PA training much more closely parallels physician training than NP/DNP training does. If you find NP/DNP curricula that's widely utlized and that contradicts what Instatewaiter has said, please cite it and give us a link.
3. I still do not understand how you can say nursing experience is equivalent to experience practicing medicine. They're two separate things that require different ways of thinking. I'm sure years and years of nursing experience will help a bit in the transition to practicing medicine but I just cannot see how you can say all those clinical hours as a nurse compensate for the lack of clinical hours practicing medicine. And as several people, including me, have mentioned, there are several direct-entry NP programs where you require no prior healthcare experience at all and can get an NP within a few years. It's scary to think that someone without any prior clinical experience who graduates with about 1000 clinical hours practicing medicine can practice independently. I still stand firmly by my assertion that the amount of time spent being a nurse doesn't really translate equally to the amount of time spent practicing medicine or thinking in a medical manner until someone can provide evidence that nurses think like doctors and thus, their clinical hours should count as practicing medicine.
4. Regarding the fact that you've taken phys/pathophys/biochem in your pursuit of a BSN, I have also taken many upper level classes such as immunology, physiology (where a good chunk of our notes said M1 physio on them and the class was taught by med school professors), biochem, genetics, etc. (I'm an MCB major). The only classes I haven't taken are pathophys and pharmacology. Does this mean I should be allowed to skip a number of years of training and should just take path/pharm instead before jumping into clinicals? No. I doubt that the depth of my classes was similar to that of med school courses and even if they were similar, these classes did not have a medical focus (ie. how what we learn can be applied in a clinical setting). So, because you've taken a few basic science courses at either a lower level of depth or with a not-so-clinical focus as med school courses doesn't mean that they compensate for a lack of a strong basic science foundation. No one's saying that nurses have no scientific foundation at all; I have no idea where you're getting this from. However, what people are saying is that the foundation you do have is inadequate compared to the foundation physicians have.
I can't think of anything else to add right now, but anyways, it is exactly because of the lack of an adequate amount of training that I don't like the idea of NPs/DNPs practicing without physician supervision. I know that they're already allowed to practice independently in several states but that doesn't mean I approve of it. There's also an active push towards calling DNPs equal to physicians, which is a very misleading and false thing to do. This vocal group is pushing for equivalency to physicians and equal reimbursement as physicians, so I can't see people arguing that NPs/DNPs save money either. If anything, they might increase costs due to more referrals to specialists.
In regards to the point that mid level providers are necessary to compensate for the "shortage" of primary care docs, I wonder if the shortage isn't necessarily a lack in number of physicians available to practice, but rather the number of trained physicians willing to practice. Many of the PCP I've worked with and talked to have stated that the numbers are there, it's just very hard to build and maintain a sustainable practice under the current reimbursement rates. Consider rural communities, many are uninsured, the majority have medicaid or medicare, which reimburse almost 50 cents on the dollar, and it takes anywhere from 3-6 months to be reimbursed for services. And even IF NPs/DNPs were allowed to operate autonomously, if they push for equal reimbursement they'll run into the same financial dilemma. On the other hand, if reimbursement is increased and compensation is adequate, there will be an increase in trained physicians willing to practice, so DNPs won't be needed.
And it is the doctor's job to get it right the first time. Period.
Even if the pt was allergic to penicillins (there is a 10% cross reactivity between allergies to cephalosporins and penicillins) that would be a big mistake. The fact that the pt was allergic specifically to that class of drugs is a huge no-no.
An anecdote: slightly off topic as this is about a PA, but to me it illustrates the effects of a less than thorough training, even at the PA level as opposed to NP. And experience isn't everything - this guy was at least 50 years old.
I visited a PA in my student health center with a bad sore throat. He told me I had mono (understandable). The test came back negative. He told me that he was sure I had mono and to come back in a week and take the test again. It was still negative. Then he told me "sorry, don't know what it is" and that was it. Um, what?
A woman in my lab happened to get the same PA when she went to the clinic unable to walk on her foot or move her toe.... he told her she had a bunion. She went to another doctor and it turned out to be a massively fractured bone in her foot. A bunion? Seriously?
Not necessarily dramatic, but I am for sure never seeing this guy again and I am still shy of seeing a PA let alone NPs.
I visited a PA in my student health center with a bad sore throat. He told me I had mono (understandable). The test came back negative. He told me that he was sure I had mono and to come back in a week and take the test again. It was still negative. Then he told me "sorry, don't know what it is" and that was it. Um, what?
A woman in my lab happened to get the same PA when she went to the clinic unable to walk on her foot or move her toe.... he told her she had a bunion. She went to another doctor and it turned out to be a massively fractured bone in her foot. A bunion? Seriously?
Not necessarily dramatic, but I am for sure never seeing this guy again and I am still shy of seeing a PA let alone NPs.
Sorry about your experience, but anecdotes don't really mean much. Everyone has anecdotes about great doctors, NPs, PAs, etc. and everyone also has anecdotes about horrible doctors, NPs, PAs, etc. I hope some sort of valid study regarding outcomes will be done (ie. not like the flawed studies that currently exist).
A patient outcome study would be awesome.
Regardless, NPs and PAs, etc, need to have a common board and I agree with the majority that if you are practicing medicine, you should be governed by the BOM. I really don't like that the mid level roles are so murkey and undefined. I will never believe that NP = MD and it should never be treated as such.
Does anyone know how the AMA looks at this? I suppose I should quit being lazy and look it up myself...
This is a moot, but the nurse did not administer. Patinet was initially triaged by a nurse in the ER for itching secondary to bug bites. He saw the Resident were he was prescribed the medicine and he was sent home. He picked up the medicine from a pharmacy.
I should note that the patient didn't help his situation by letting the reaction persist for a week while continuing to take the medicine and then basically overdosing on benedryl but my point was that even MDs can miss stuff...
...I'll just stick with blaming the pharmacy 😡😀
I'm glad that you think that. Unfortunately, there's a very vocal group that believes otherwise and is pushing for equal status and reimbursement as physicians.
There was recently an article on the AMA website where they accused the nursing organizations of falsely saying that they were taking exams that were equivalent to what physicians take (in actuality, what the DNPs took was a very diluted form of Step 3, which from what I gathered reading various posts on this forum, is the easiest Step exam to take): http://www.ama-assn.org/amednews/2009/06/08/prl10608.htm
What's really funny is Hoody brings up the issue of undergraduate years. The hilarious part of that is the SAME THING can be said about MDs. Actually not even the same thing because MDs have to really WORK THEIR BUTTS OFF to get to the top to even qualify for medical school! BSN students can relax much more often than your premed. Just my two cents. Sorry for the late replies.
Just on second page -_-
Just on second page -_-
Advertisement - Members don't see this ad
lolwut
u kidn? All the nursing kids here are out every night chilling. They don't have to work for a GPA above 3.5. Hell this nursing chick I know (who is very hot) has a 3.1 and she doesn't seem to be one bit worried!
because worry about gpa=stress & hard work?? talk about your premed fishbowl... don't know where you are, but from what i've seen,
engineering/architechture>>>>>>nursing>premed>>all else
I read this article, and found it interesting.
It poses an interesting question though - if a NP can take and pass all the step exams and the end of residency primary care exams, should s/he then be allowed to practice medicine?
There's a difference between passing multiple choice exams and being able to apply that knowledge clinically. No matter how well med students/physicians do on all 3 Steps, they still have to go through a significant amount of clinical training with attending oversight before they're allowed to practice independently. As has been repeatedly pointed out in this thread and in others, there is a very minimal amount of clinical training in the NP/DNP curriculum compared to the amount physicians put in.
Let's just get rid of all graduate/professional institutions and replace everything with a test. I'm sure that'll work out fine 🙄
Hi. I think Im very hot too. 😀
this bums me out. i completed my undergrad at a low tier state school and it was extremely competetive due to the nation wide nursing shortage. I was waitlisted when I originally applied with a 3.2 I had to spend a year retaking several courses that I got Bs in just to get As (imagine that toutre). I later accpeted with a 3.6. Something like the top 10-20% of the class get an invitation to an honor society thier senior year. The lowest GPA was I am aware of that recived an invitaiton was still > 3.5. Nurses tend to be type A and the competivness within the classes was high.
I see nothing wrong with this in principle...a test by definition is "A procedure for critical evaluation"
If you can meet the expectations of critical evaluation for a position, then I see nothing wrong with you holding that position.
But there is no national standard for clinical hours, is there? (I honestly don't know) I am fairly certain that some schools, like U Penn, remove months of clinical rotations for research (which I would argue are quite unrelated compared to clinical hours). Programs like BCM, however, have 1.5 years of classwork and 2.5 years of clinical rotation. There is a huge variance in these hours amongst the schools themselves. If DNPs were to beef up the clinical hours to that of the lowest required by medical schools, should nurses then be allowed to test to practice medicine?
(not necessarily agreeing with the idea of nurse physicians, just playing devil's advocate to your arguementation)
I knew people in college with GEDs that well outperformed people with HS diplomas. If our goal is a standardized level of care, who cares how you meet the standardized tests...as long as you meet them? If you're argument is that the test doesn't test enough, then I would argue that that is a mistake with the test, not the theory of standardized testing.
Honestly you don't really learn much in high school for its diploma to grant you any advantage over a GED holder
Besides, I knew lots of really smart kids who got the GED just so they could go to a CC when they were 16-17 then transfer to a UC, etc, etc.The whole point of clinical hours (which you get at your graduate/professional institution) is to hammer in things you've spent 4 years learning in med school. The idea that someone who crams for a standardized test (which is, by nature, predictable) has as much applicable knowledge in a field as someone who's done rotations/clinical hours is just wrong. This hold true for ALL fields. For example, if you're applying for a technology based position, work experience >>>>>>> GPA/GRE scores.
Life doesn't come in multiple choice format like the STEP 3 does. Just like the law example above, if I spent several years practicing JUST for the STEPs and was able to pass it, would you trust me as your family doctor?
No, residency is where physicians are trained by physicians to think like physicians and apply the rigorous sciences they learned in medical school to real life, clinical situations. "Nursing residency" would be when nurses learn to think like nurses and assist physicians in the delivery of health care.
Advertisement - Members don't see this ad
that is a fine point. It would create a lot of debate if people actually thought about the issue of standardized examinations and the whole theory behind them.
I'm still down with meeting standardized tests simply because it creates an organized system. On a interesting note, i remember reading a thread last year where we were discussing how several DNP (who claim they are equivalent to PCP MD standardized level of care) took the Step III and over 80% failed...
This whole issue reminds me this fu***g tool who participated in a 10K run I completed in High School- We all started the league race in 95 degree weather, then out of nowhere at the 9.5K mark, this fresh guy pops out from behind a tree and starts running in front of me. He sprinted the rest of the race and all I could do is watch as this guy finished 2 seconds before me. The guy was a lean, fit SOB who was not in the league (no doubt he could have finished the complete 10K race if he had wanted to) but still, it was unfair when the sport photographer took the school year picture for our X-country team and published it in our Yearbook. You see this A-hole running towards the finish line and me just behind him sweating like a hypoxic pig about to faint. ah, memories.
To even take the bar exam, you have to go to an ABA accreditied law school in every state except NY.
I do. I could pass step 3 right now. I can assure you though, that I am not fit to practice medicine.
Being able to pass step 1-3 is necessary but not sufficient to practice medicine. In addition to passing the USMLEs, you need to go through the training of residency because it is that that trains you to be a doctor.
Being able to answer a question when they give you all the lab data and the physical exam findings is one thing. Knowing what tests to order, being able to find those physical exam findings and knowing what to do next is a completely different beast when you have a new pt in front of you.
Interns (when you take step 3) generally dont study for step 3 because they dont have time. There is an addage: study 2 months for step 1, 2 weeks for step 2 and bring a number 2 pencil for step 3. Still ~95% of US students pass on their first attempt despite not studying.
Let's assume though, that passing all 3 steps is all that is needed (which it is not): DNP education clearly still doesnt make the grade.
The DNPs at columbia recently took an exam made by the same people who do the USMLE. Remember at Columbia (those who took the exam) they all were trained NPs and then did their "advanced" training at columbia to get the DNP. Thus they had far more "experience" than a nurse straight out of college doing a BSN to DNP route. COlumbia is also the place tha pioneered the DNP so you would expect it to be the Gold standard of DNP education.
So ABCC a political nursing organization run by Mary Mundinger (dean of columbia's nursing school) decided to get the NBME to make an exam that was a watered down version of step 3. Not only did they remove questions that are normally on step 3 that the DNPs wouldnt have to answer but they also lowered the score needed to pass. The results, only 50% passed- AND THEY HAD TIME TO STUDY!!
Compare that to the 95% pass rate of the interns who dont study and tell me the education is clearly the same- 'cause it's not.
That was kind of my point. If you want to practice law, go to law school. If you want to practice medicine, go to med school, not nursing and then prep for multiple choice questions
Well, getting a 3.5 isn't quite as difficult when you have re-takes and all courses are introductory level ^_^ (MD schools do no replace old grades with new ones). I even got an A at my local CC's Anatomy class (required for nurses, hygienists, etc and I had the "hard" teacher according to most) by cramming and doing the bulk of my study while my girlfriend drove me to school (50 min drive). I tried to do that with my first upper division physiology course and got a 35% of the first test. LOL. Rude awakening for me!
I'm not trying to be a jerk, but there is significant difference between the introductory level courses required for nurses and the full courses. E.g. girl in my Ochem class was an RN and wanted to become a doctor. She had already finished Intro Ochem and graduated top of her class at her nursing school. But, what happened when she signed up for the full year of Ochem at the University? Unfortunately, she got a 'D'. It was very disheartening to see. 🙁
Actually, I think there is a standard for clinical hours in residency (http://www.acgme.org/acwebsite/rrc_140/140_prindex.asp). A certain number of procedures, etc. are required I believe. You also have lectures, etc. that you have to attend. Plus, there's boards, which are, from what I understand, very, very difficult. The biggest differences in residency that I can think of off the top of my head is that the differences in patient profiles might lead to different frequencies in the pathologies encountered. Any med student/resident/attending can jump in if I'm wrong about this.
Edit: Also, in medical school, all students rotate in core clerkships, which are essentially the same at every US school. These are specialties like IM, surgery, Ob/Gyn, psychiatry, neurology, and I think one or two other areas that I can't think of right now. In addition, there are standardized shelf exams for each specialty (ie. the surgery shelf, the neurology shelf, etc.) that you take after each rotation. These may count for a significant portion of your clerkship grade or a not-so-significant part based on you school. Other than that, it appears to me that the clinical training in medical education is pretty standardized.
4
45408
Yeah, no. Nursing is not harder than typical pre-med coursework.
yea. you would know this how?
Nursing pre-req's are open to all students, and the pre-req courses are relatively easy. The nursing program itself is a lot of busy work with a few challenging courses, and in that regard is likely more stressful than what the average pre-med has on their plate.
http://allnurses.com/general-nursing-discussion/general-nursing-school-258764.html
Some anatomy and physiology classes, intro stats, some schools require a general chemistry class...
"SUNY Farmingdale - The 4 required classes are English 101, Psychology 101, A&P1, A&P2
Nassau Community - ENglish 101, Psychology 101, Any college math class, A&P 101
Queensborough - English 101, Psyhololgy 101, A&P1, Sociology 101"
No physics, no calculus, no O. Chem, no biochem...it's just a bunch of intros...
No average 3.7 GPA/32 MCAT...
I think it's a losing point to argue that nursing prep is more difficult or more competitive than M.D. prep.
(http://www.nursing.upenn.edu/stude...Mailing/BSN Sample Plan of Study 2009-10.pdf)"]Even at UPenn, the nursing curriculum is pretty similar, and quite simple, in terms of science courses.[/url] Not to mention, they can take all of their science courses at the nursing school.
Last edited:
I think this "which is harder" career debate is the underlying issue in the creation of these DNP programs.
Nurses are not trained to hold equivalent expertise in the scientific and clinical evaluation aspects of medicine...they are instead trained to educate patients, perform procedures in line with a physician's course of treatment (based on advanced analysis incorporating a huge array of scientific knowledge that is unique to the field), monitor patients, etc.
Physicians and nurses are both essential to providing efficient health care, but their duties are unique to their profession. When hybridization of these two different but necessary professions occurs, what results is a "jack-of-all-trades master of none" occupation that, in the best case scenario serves no real purpose and in the worst case lowers the quality of health care provided.
Nurses are not trained to hold equivalent expertise in the scientific and clinical evaluation aspects of medicine...they are instead trained to educate patients, perform procedures in line with a physician's course of treatment (based on advanced analysis incorporating a huge array of scientific knowledge that is unique to the field), monitor patients, etc.
Physicians and nurses are both essential to providing efficient health care, but their duties are unique to their profession. When hybridization of these two different but necessary professions occurs, what results is a "jack-of-all-trades master of none" occupation that, in the best case scenario serves no real purpose and in the worst case lowers the quality of health care provided.
i wasn't arguing nursing prep was more difficult than MD prep. i said the entire nursing program (i.e.BSN) is more difficult/stressful than premed.
my point exactly - though i don't think hours and hours of clinical rotations & writeups are just "busy work"
Fair enough. I was, perhaps incorrectly, using busywork to mean anything in the educational program that isn't academically intensive/challenging. Regardless, they work hard once they're in nursing school. Getting in, on the other hand, is an Apples to Oranges comparison when they want to start comparing GPA etc to Pre-Meds.
word. hence the noncomparison on my part
Advertisement - Members don't see this ad
DNP's are not physicians. They are not MDs. They do not have the same training as MDs. Why would they have the same results on the diluted step 3? DNPs and MDs take vastly different classes as you have pointed out before. Why would they be expected to preform the same on step 3? Why is this pointed out? Look the DNPs did bad on a diluted step 3! Call the president! Stop DNP progams! The sky is falling!
A DNP is not a physican. DNPs claiming to be such are wrong, and an embarasement. The DNP is a terminal degree NURSE, not physician.
It is awfully easy for people to critizize mid level care providers from their ivory towers. For the rest of us, in low income areas, university health clinics, and rural america, try getting MDs to practice. There is a reason why these areas are over represented by mid level providers. It often does not make economic sense for a PCP to practice medicine in these areas.
A DNP is an option for an over stressed health care system. given the option of no care at all, or a mid level provider, I'll take the mid level provider every time.
There is a ton of standardization. As you will learn when you get to med school, the LCME (board that accredits medical schools) runs a very tight ship. So the rotations are VERY standardized. Each school does at a minimum the core rotations: OB/GYN, Surgery, Internal Medicine, Family Medicine, Pediatrics and psychiatry. Most also require Neurology and Emergency medicine plus a host of electives in the field you are going to go into.
Considering they had to LIMIT the amount of clinical hours a medical student could do in a given week, I think it is safe to say that most schools were erring on the side of too many than too few hours.
Holy crap. Are you serious?! Nursing notes are completely worthless. I am not trying to be mean or condescending but it is worthless paperwork that keeps the nurse from doing his or her job and that no one reads. At the VA they do nothing except clog up the amount of real daily notes you can see in the computer system from other institutions. You get 50 notes when you do the remote connect through the VAs system. 45 of those end up being nursing notes leaving you to only get physician notes from the past 3 days at that institution instead of the last 3 weeks like if they left those out.
Here is a youtube video that supports my claim. It is a parody about how bad stuff is at outside hospitals compared to academic medical centers.
http://www.youtube.com/watch?v=xskFo75Wdhs
"[when we transfer a patient] We're not going to burden the doctors with meaningless copies of cath reports, echos, a transfer summary, we send only what's important. A big stack of nursing notes."
DNPs claim they are equal to MDs. They were/are attempting to use their results on 3 to prove this.
They can't pass the kindergarden test for MDs.
Ergo, DNPs need to shut it...
Except they have a political body that is ignoring this fact.
No you're right they're not. But their lobbying organization is trying to pass them off as the same. Obama is eating it up.
The motivation behind the name change- the addition of the title "doctor"- and the motivation behind getting the same organization that does step 3 to do an exam for the DNP was to pass DNPs off as equal to doctors.
Too bad 50% of the DNPs failed the watered down step 3. That kinda backfired on Mary Mundinger now didnt it.
This claim is supported by substantial evidence. "...the NBME stated that the scope of the DNP exam was "materially different" from physician testing"
"50% of candidates for a doctor of nursing practice degree received passing scores on the first-ever test." Not to mention, these DNP candidates were from a premiere institution, Columbia University. Step 3 of the USMLE is passed by well over 90% (approximately 95%) of MDs.
Still, I am quite convinced by some of the papers I've cited and read that it is likely that NPs may be better at managing some chronic conditions than MD/DOs. How could we incorporate this into collaborative practices?
Similar threads
