Nursing vs. MD

[geewiz]

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I have always wanted to be a doctor, however I am now considering following the path of a NP or a DrNP as an alternative career choice because it seems as an "easier" career path to juggle a family with and will allow me to be with my husband (I will explain in the paragraph below).

My Medical School choice right now is St George's in Grenada (scholarship opportunity...already in the interviewing process) so I would be separated from my new husband (got married only last year) for 2 yrs while I am at school (he is himself finishing up school here in the US).

Nursing seems to be a good alternative that would allow me to fulfill my passion to help others plus I would not have to go away and leave my husband but I am just not sure if I would be fulfilled. I want to make the best choice for myself and my marriage but I'm just not sure what path best fits the bill. Any ideas/suggestions?

 

[2008orbust]

I do think that the odds of your new marriage surviving two years apart is slim. Not that you couldn't make it work, I am sure others have. BUt medical school breaks up lots of marriages even when they could still lived together.

IF you are really only going MD to "help people" (which is noble) and you could be happy with the nursing career and happy knowing you made the sacrifice for your family then there is your answer. IF, in the long run, you would resent your husband for keeping you from your dreams, then there is your alltogether different answer.

As I am sure you know, getting matched after going off-schore can be very tricky. Will your husband be able to pick up and move if you can only match in Utah or something? (there are lots of threads about matching after off-shore)

I wish you much luck! James

 

[PT2MD]

I do think that the odds of your new marriage surviving two years apart is slim. Not that you couldn't make it work, I am sure others have. BUt medical school breaks up lots of marriages even when they could still lived together.

IF you are really only going MD to "help people" (which is noble) and you could be happy with the nursing career and happy knowing you made the sacrifice for your family then there is your answer. IF, in the long run, you would resent your husband for keeping you from your dreams, then there is your alltogether different answer.

As I am sure you know, getting matched after going off-schore can be very tricky. Will your husband be able to pick up and move if you can only match in Utah or something? (there are lots of threads about matching after off-shore)

I wish you much luck! James

I agree with 50% of that. I've had several friends with spouses in medical school and some have had extended periods away from each other. If the relationship is strong, nothing will tear you apart. That may sound hokey, but it's a cold fact.

I do agree that IMG clerkship and match issues may make life even tougher though. I'd have no problem with AUC and St. Georges apart from the fact that I'd be going from Grenada et al to many areas distant to my home for my 3rd and 4th year rotations. We could do it, but if there is a more reasonable and cheaper alternative, that has to be considered. I am fortunate in Texas to have many cheap options within 5 hours of my home town. I would imagine it might be tougher living in more remote areas. Either way, best of luck to you.

 

[Wackie]

The difference between an MD and NP is the MD gets to practice medicine the way they want to. As an NP, you practice as your supervising MD wants you to.
Some MD's are pretty lax and then some MD's watch over your shoulder. It's something you need to be okay with if you want to go the NP route.

 

[2008orbust]

Just for an example of a job with a lot of autonomy. I am an NP in an ortho office and most days I do not see an MD unless I track one down for a second opinion ( or the other way around-yes that really does happen). I am given as much autonomy as the law allows and never feel watched or anything. I know that is not always the case, but I have a few NP friends that also are allowed to work "on their own".

 

[NewHope]

The difference between an MD and NP is the MD gets to practice medicine the way they want to. As an NP, you practice as your supervising MD wants you to.
Some MD's are pretty lax and then some MD's watch over your shoulder. It's something you need to be okay with if you want to go the NP route.

Both of these statements are not true at all. These days, unless you are independently wealthy, how you get to practice medicine will be determined by many various factors, Insurance, policy of the institution, malpractice and liability concers, cash flow, if in private practice just to name a few. NPs for the most part do not have any supervising physician. They have collabarative ageements. What it usually mean meeting with a doc for a lunch every 3 months or so to "discuss" some cases. If NP works in a group setting then s/he would be a subject to some corporate rules, just like an MD would, assuming the NP is not an owner of the practice....lol. Many ppl overlook the fact that docs could be hired just like any other employee, and tend eo idealize medicine to what it is absolutely not.

To the OP: There are soooooooo many students with families in Grenada, There are many spouse / SO organizations. Ppl even bring their kids along. Also ppl go back and forth to U.S after the exams, mid semester etc. And don't forget that SGU does not use trimester system. They only start im September and January. Which means you have the whole summer to yourselves, and even could work if you cared to. I know ppl caution you about off-shore, but in the case of SGU I'd say fear not. Just look at their matches. It's on par with most D.O schools, and low to mid tier U.S allopathic schools. If you can get a scholorship, then grab it and go. If you rally want to be a doc do not settle for anything less. There plenty of NPs, RNs, CRNAs, Chiro, PAs etc in med schools today, including SGU, who wished they;ve done it first. Myself included. Think long and hard before you commit to any of the options.

Good Luck

 

[GreyBlueEyes]

frankly, the way that medical care is changing, I think people who want patient care should do NP or PA. They're getting hired more & more for primary care. MD seems to be more for people fascinated by how the body works & problem solving.

that's quite a simplification, but just my two cents 🙂

 

[Wackie]

Both of these statements are not true at all. These days, unless you are independently wealthy, how you get to practice medicine will be determined by many various factors, Insurance, policy of the institution, malpractice and liability concers, cash flow, if in private practice just to name a few. NPs for the most part do not have any supervising physician. They have collabarative ageements. What it usually mean meeting with a doc for a lunch every 3 months or so to "discuss" some cases. If NP works in a group setting then s/he would be a subject to some corporate rules, just like an MD would, assuming the NP is not an owner of the practice....lol. Many ppl overlook the fact that docs could be hired just like any other employee, and tend eo idealize medicine to what it is absolutely not.

Well, I got it from 2 NP's and 3 PA's that I work with.
At one hospital, all of the docs pretty much let the PA's and NP's do as they want. At another hospital, there are a few docs who are constantly over their shoulders, even examining the patient's after they have (why they'd have an NP or PA if they're going to examine everyone, I don't know), and going over what they have prescribed.

I looked into the PA or NP route seriously and have been able to talk to both as well as doctors. While it's not exactly a free for all for the doctors, they certainly have much more autonomity...especially if you end up working under an overbearing ass.
Consider that a PA or NP practices as an extension of the MD's or DO's license so some doctors WILL tell you what their rules are. It all depends on who you work for.

It's just something I would very seriously consider. Some people can work like that. Some can't. I'd hate for that to be a surprise to anyone after graduating.

 

[NewHope]

Well, I got it from 2 NP's and 3 PA's that I work with.
At one hospital, all of the docs pretty much let the PA's and NP's do as they want. At another hospital, there are a few docs who are constantly over their shoulders, even examining the patient's after they have (why they'd have an NP or PA if they're going to examine everyone, I don't know), and going over what they have prescribed.

I looked into the PA or NP route seriously and have been able to talk to both as well as doctors. While it's not exactly a free for all for the doctors, they certainly have much more autonomity...especially if you end up working under an overbearing ass.
Consider that a PA or NP practices as an extension of the MD's or DO's license so some doctors WILL tell you what their rules are. It all depends on who you work for.

It's just something I would very seriously consider. Some people can work like that. Some can't. I'd hate for that to be a surprise to anyone after graduating.

Well, I couldn't agree with you more. It's quite possible that individual problems like that do happen. But it also would be a big mistake to believe that doctors "own" medicine, and do whatever they want. I guess my point was that having an MD/D.O degree does no automatically protects you from all the crap ppl have to take at their work places. Basically, many doctors, if not self-employed, are treated as any other employee by the corporations, and sometimes even worse. That's because that many little, mean, and narrow-minded ppl, who otherwise never amont to anything in life, somehow manage to get into position of power. And that's their "golden chance" to get back at the world who treated them ohh, "so unfairly."
I hope you get my drift. Sure, it's gotta be more gratifying exp for one to be a physician. But....at what cost? Both financial and human factor? Unfortunately, these days medicine, regardless of the specialty does not guarantee respect doctors once enjoyed, being a "final authority" figure if you will, but it does guarantee huge debt, and loooooooooooooong hours.
Also, I do not want to go into differences of PA vs NP, there are countless threads on that. But generally speaking PAs function under supervision by a doc not by factb but by law. Also they practice medicine, while NPs can't at least legally, claim that. They practic advanced practice nursing, and cannot be regulated by medicine by law, but I guess in real life could be in fact. I've been an RN for a good 16 (soon to be 17 years). I sure debated with myself and others med school vs (fill in the blank). There is no real substitute if your heart is set on medicine. Nothing else will do, even if it seems like a similar or even the same thing as far as practicing is concerned. But I'm really for going into it (med school) with your eyes wide open. It is painful to watch how some of these premeds have deluded themselves while in basic science, and in premed years. They come on the wards with this stinkig thinkig attitudes, and as you immagine are up for a very, and I mean very rude awakening.

Sorry, I went on here waaay tooooo looooong. But the take home message is: buyer beware! Those days of "Doctor is the G-D" or "Do as I say" are long gone. It may still exist somewhere in the old boys club, but new medical graduates, unless really independently wealthy, are not likely to enjoy any of that good ole' glory, IMHO.

Good Luck

 

[deleted6669]

"But generally speaking PAs function under supervision by a doc not by factb but by law."

Keep in mind that this "supervision" can be indirect via chart review or conferences every few months. at one of my jobs I staff a small emergency department by myself and see whatever comes in the door. 10% of my charts as chosen by me are reviewed within 1 month. supervisory requirements vary by state. some states allow pa's to own their own practices with very minimal( q 6 month meeting) oversight.
for more pa info see www.aapa.org and www.physicianassistant.net

 

[NewHope]

emedpa to the rescue 😀

I know, I know. I'm not implying the doc just always watces over your shoulder. And that's what the phrase you quoted me on describes. Most PAs I know function independently to some extent. I only wanted to advise folks that PA vs NP is really pracice of medicine vs advanced nursing (which is medicine in fact but not by law). The very old like the World itself is "De Facto" vs "De Jure". BTW I'm no legal scholar either 😉. If someone wants a great career in medicine with a certain degree of flexibility of changing fields I'd say go PA. Well I'm an RN already so NP probably is more viable. But despite all the things I know, I'll drug myself through medical school. Nothing else will do. I've tried to quit that idea many, many times. It doesn't go away, and the years are creeping up on me...lol

"But generally speaking PAs function under supervision by a doc not by factb but by law."

Keep in mind that this "supervision" can be indirect via chart review or conferences every few months. at one of my jobs I staff a small emergency department by myself and see whatever comes in the door. 10% of my charts as chosen by me are reviewed within 1 month. supervisory requirements vary by state. some states allow pa's to own their own practices with very minimal( q 6 month meeting) oversight.
for more pa info see www.aapa.org and www.physicianassistant.net

 

[deleted6669]

emedpa to the rescue 😀

I know, I know. I'm not implying the doc just always watces over your shoulder. And that's what the phrase you quoted me on describes. Most PAs I know function independently to some extent. I only wanted to advise folks that PA vs NP is really pracice of medicine vs advanced nursing (which is medicine in fact but not by law). The very old like the World itself is "De Facto" vs "De Jure". BTW I'm no legal scholar either 😉. If someone wants a great career in medicine with a certain degree of flexibility of changing fields I'd say go PA. Well I'm an RN already so NP probably is more viable. But despite all the things I know, I'll drug myself through medical school. Nothing else will do. I've tried to quit that idea many, many times. It doesn't go away, and the years are creeping up on me...lol

hey, lots of pa's are former rn's. the stat used to be 30% of pa's were previously rn's. I'm sure that's lower now with the influx of younger students but being an rn is a great prep for pa school nonetheless. something to think about.....mmmm come to the dark side.....

 

[NewHope]

hey, lots of pa's are former rn's. the stat used to be 30% of pa's were previously rn's. I'm sure that's lower now with the influx of younger students but being an rn is a great prep for pa school nonetheless. something to think about.....mmmm come to the dark side.....

Thanks man!
It;s actually easier for me to apply PA than NP. I don't have BSN b/c I'm FNG with diploma in nursing. But I did my undergrad at the University that has boh PA and medical school. So we'll see how that goes with an app. Hey, may be heck with all the "helping people" field I'll just do my MBA and go into business. I did health care / home care administration already for many years. I see lots of folks crossing over from that World to the health field. I wonder if anyone did the other way around? I just hate putting all eggs in one basket.

Hey emedpa! What do PAs do in a field of PM&R, neurology etc? I'm interested in spinal blocks. Tr. point injection, b/c I do bodywork. I'm licensed in Acupuncture as well. I know many ppl will "boooooo" me on here, but I don't care. I've been working with ppl for a while to figure what works and what doesn't, at least within my scope of practice.

Thanks

 

[deleted6669]

there are quite a few pain med and neurology pa folks who post regularly over at www.physicianassistant.net
I would ask over there. I know lots of them do fairly full scope stuff with regards to procedures, etc

 

[soonereng]

Consider that a PA or NP practices as an extension of the MD's or DO's license so some doctors WILL tell you what their rules are.

This is state and midlevel dependent. For my state (and quite a few others), NPs practice under their own license, not that of the physician, while PAs do practice under the license of the physician.

I'm in med school and my wife has been an NP for several years. I think that PA or NP is definitely the best "bang for your buck" medical training around, with the advantage probably going to the PA route as they seem to have higher average salaries for whatever reason (but this is again state and region dependent).

I went the MD route specifically because I wanted to have the most freedom in where and how I can practice when I get finished.

 

[foreverLaur]

When I shadowed an orthopaedic surgeon, the PA was right next to the surgeon in the OR doing as much, if not more, than the surgeon's PGY-4 resident.

 

[CrazyPremed]

For the OP, I would consider the NP/PA route. Obviously, your new marriage and your life away from your career is very important to you right now. Going the NP/PA route would give you more freedom than going overseas to medical school. Based upon the tone of your post, I would say give NP a shot.

CrazyPremed

 

[geewiz]

A million thanks to all of you for taking the time to post a response...a lot to think but I am better informed thanks to all of you. Still haven't made a final decision but will take it one step at a time. Good luck to me on my interview tomorrow!😀