PA or Nurse Practitioner

[poppj]

Hello,

Advice..here is the situation. As an undergraduate I earned a degree as a Spanish major and Psychyology minor. I wasn't very sure what to do with that mix, so I began translating in a gynecology office and a clinic. The experience was wonderful, so much that I went to work as a research assistant in prostate cancer..to gain more experience in medicine. Then..I went back to school for a post-bac pre-med program. ..and after this year of courses and mcat ..I've come to a better understanding of myself and the role I would like in medicine. I am looking towards PA programs or Nurse Practitioner.

I am not sure where to go. I would love to continue to use Spanish and keep the door open for working in other countries. I am also wondering how many more years of training is needed and if there are any scholarship program of PA/Nurse Practitioners. Please be frank, candid, blunt, honest..!! I feel very lost at this point. Once I thought I had a direction to become a doctor, and now everything is turning around.

All my best, poppj

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[Monika]

Hello poppj,

I can offer some links that will get you plenty of information about the PA profession.

The American Academy of Physician Assistants

The Student Academy of the American Academy of Physician Assistants

The PA Forum

Best of luck!

 

[zenman]

Hello,
I am not sure where to go. I would love to continue to use Spanish and keep the door open for working in other countries.

I don't know anything about PAs in other countries, but there are NPs in Africa, Fiji, Australia, Canada, New Zealand, Taiwan, Thailand and the role is being developed in others. Did you want to live in a foreign country or just visit for awhile? For NP, you'd have to go to school to be an RN first though, so PA route might be quicker.

 

[deleted6669]

keep in mind that since you already have a ba degree you could do a direct entry np program in 3 yrs. yr 1=rn, yr 2/3= np. there are several of these programs now.
pa's work overseas in many different countries for charitable organizations, the peace corps, the state dept(staff embassies as THE medical provider), the us govt(military or civilian contract at military bases), as well as private corporations. check out the international page at www.aapa.org for more info
the pa concept is expanding internationally fairly rapidly. there are programs in holland, england, and canada now with austalia and other nations considering the concept.your experience background is a little light for admission to a pa program as many schools would not count translating or research as clinical experience. you probably have many of the prereqs done if you did a postbac but these vary by pa program so I would check to be sure as many programs require microbiology, a+p, etc not typically taken by premeds.
the major difference between a pa and np eduaction is the amount of clinical time spent on rotations. the typical pa program requires around 2200 hrs and the yr is very similar in composition to the 3rd yr of medical school with typical rotations in fp, im, psych, peds, ob, surgery, em, and other primary care settings. np's do similar rotations but usually do no more than 800 hrs of total clinical time with some programs as short as 500 clinical hrs. if you do an np program yuou have to pick a focus(peds, womens health, psych, family, adult) and work within that specialty with very little flexibility. fnp is probably thge most flexible np cert. as it allows some mobility among the primary care fields. a peds np for example can not see adults. an adult np can't see kids. a psych np can't work in primary care, etc
pa is a generalist degree and allows one to work in any field they desire and change as often as they like. a peds np who decides they want to work at a womens clinic has to go back to school for an additional cert while a pa just applies for the job.

 

[poppj]

thank you for the links and details of contrasting PA/Nurse Practitioner. I like the idea that a PA has the flexibility to change areas of practice. It seems that it might take me about 3 years for either program. I am hoping to meet with a counselor about the PA program at Duquesne University in Pittsburgh, PA (where I did the post-bac. program). Yea, I still need microbology (I had cell and molecular bio), a+p, and most likely other core requirments.

Internationaly, I am interested in Australia. It seems that PA is starting to gain acceptance. Is this true?

Could anyone tell me why they made the decision to become a PA? Did anyone enter into a PA program as a career change?

cheers

 

[deleted6669]

"Did anyone enter into a PA program as a career change?"

for most pa's it is a second medical career after years as a paramedic, rn, resp.therapist or other medical professional. I was an er tech for 5 yrs and a paramedic for 5 yrs before I became a pa.

 

[quicksilverhere]

Where are these 3 direct entry NP programs for people with BA/BS?

 

[quicksilverhere]

Does anybody know if there are direct entry Psych NP programs out there?

Also, I've been trying to find out what the typical/average salary of a Psych NP is? Anybody know where I can find this info. I've tried salary.com but all they show on there is for regular vanilla NPs.

 

[sunnyjohn]

Does anybody know if there are direct entry Psych NP programs out there?

Also, I've been trying to find out what the typical/average salary of a Psych NP is? Anybody know where I can find this info. I've tried salary.com but all they show on there is for regular vanilla NPs.

You might try asking this question on this site. I am sure one of the nurses there would know the answer.
www.allnurses.com

 

[mshheaddoc]

Where are these 3 direct entry NP programs for people with BA/BS?

I know philly and new york had a couple. I looked into Jefferson's BSN/NP program a few years ago. The combined programs were a chunk of change I noticed. But that is what happens when you go to a private institution. The community college have a 2 year wait now but are alot cheaper.

I suggest you go over to allnurses.com and check it out. Look around because I know there are PLENTY of threads on that. And more information b/c people who would know frequent it more often.

 

[billydoc]

keep in mind that since you already have a ba degree you could do a direct entry np program in 3 yrs. yr 1=rn, yr 2/3= np. there are several of these programs now.
pa's work overseas in many different countries for charitable organizations, the peace corps, the state dept(staff embassies as THE medical provider), the us govt(military or civilian contract at military bases), as well as private corporations. check out the international page at www.aapa.org for more info
the pa concept is expanding internationally fairly rapidly. there are programs in holland, england, and canada now with austalia and other nations considering the concept.your experience background is a little light for admission to a pa program as many schools would not count translating or research as clinical experience. you probably have many of the prereqs done if you did a postbac but these vary by pa program so I would check to be sure as many programs require microbiology, a+p, etc not typically taken by premeds.
the major difference between a pa and np eduaction is the amount of clinical time spent on rotations. the typical pa program requires around 2200 hrs and the yr is very similar in composition to the 3rd yr of medical school with typical rotations in fp, im, psych, peds, ob, surgery, em, and other primary care settings. np's do similar rotations but usually do no more than 800 hrs of total clinical time with some programs as short as 500 clinical hrs. if you do an np program yuou have to pick a focus(peds, womens health, psych, family, adult) and work within that specialty with very little flexibility. fnp is probably thge most flexible np cert. as it allows some mobility among the primary care fields. a peds np for example can not see adults. an adult np can't see kids. a psych np can't work in primary care, etc
pa is a generalist degree and allows one to work in any field they desire and change as often as they like. a peds np who decides they want to work at a womens clinic has to go back to school for an additional cert while a pa just applies for the job.

FNP (Family) could treat all age groups from birth to death. No limitations.

 

[billydoc]

Does anybody know if there are direct entry Psych NP programs out there?

Also, I've been trying to find out what the typical/average salary of a Psych NP is? Anybody know where I can find this info. I've tried salary.com but all they show on there is for regular vanilla NPs.

Hi there!
Check out these sites:

www.allnurses.com
www.allnursingschools.com

Good Luck

 

[Izzygal]

Here is a link to all the Accelerated Bachlors and Masters Programs in the US, which includes Direct Entry Masters in Nursing Programs (also called MEPN = Masters Entry Programs in Nursing) to become a Nurse Practitioner in three years.

Good luck!
Izzy

 

[lawguil]

FNP (Family) could treat all age groups from birth to death. No limitations.

If you're already an RN, and want less training, less time in the classroom and less flexibility as a provider - become a Nurse Practitioner. If you're an RN and want superior training, have the pre-reqs., and can commit to full-time schooling - become a physician's assistant. If you are not an RN - the NP route is probably not for you unless you have unusual reasons. That’s what I usually tell students who are interested in the mid-level professions.

 

[billydoc]

If you're already an RN, and want less training, less time in the classroom and less flexibility as a provider - become a Nurse Practitioner. If you're an RN and want superior training, have the pre-reqs., and can commit to full-time schooling - become a physician's assistant. If you are not an RN - the NP route is probably not for you unless you have unusual reasons. That’s what I usually tell students who are interested in the mid-level professions.

I would agree with you that generally PA programs have more clinical hours, it's not necessarily "better" If someone is an RN, and probably makes some nice buck already...starting another profession from scratch (PA) is not very practical.Remember that all NPs and CRNAs are the RNs first. These professions are just an advacement of the RN. I hate to look at it form this angle, but the political climate is quite ugly ot there today.As a profession nursing is better represented politically, than a PA. I'm not applousing that, just observing the fact. But if someone was not an RN yet...no arguement here:go PA all the way. However, thinking that if you had a PA vs NP after your name will somehow increase your flexibility as a provider...think again. Most jobs, if you want to work for some corporation, advertise "PA/NP" or "NP/PA" same $$ for the same job. Other factors depend on the State where you want to practice.
Anyway, just my $0.02

 

[chicoborja]

If you're already an RN, and want less training, less time in the classroom and less flexibility as a provider - become a Nurse Practitioner. If you're an RN and want superior training, have the pre-reqs., and can commit to full-time schooling - become a physician's assistant. If you are not an RN - the NP route is probably not for you unless you have unusual reasons. That’s what I usually tell students who are interested in the mid-level professions.

I agree with billydoc about some of his points that he elaborated on in regards to the mid-level discussion; however, I wanted to comment on lawguil's recommendations/observations. I believe that he is correct in stating that the PA education is superior to that of an NP's, generally speaking. My opinion beyond that may diverge from his. As billydoc mentioned, NPs/RNs have better political backing. This plays out in some areas as increased autonomy for NPs and possibly increased employment opportunities. Some states require that the supervising physician be physically present for PAs to practice. In rural areas, this may not be feasible. Legislative issues should be strongly factored into the equation if one is hoping to practice in a particular locale.

Additionally, CRNA and CNM-type positions would generally not be available to PAs. I am aware that there are AAs if one would like to go the anesthesia route but these providers are restricted to the geographic areas they can work in and legally require more physician supervision. Although legally, PAs may work in anesthesia I don't know why a physician would prefer to hire them over an AA or CRNA due to the cost of re-training (I would prefer not to hear a trite arguement about PAs being well-rounded and having a more complete knowledge of the human body, etc.).

The flip side of the coin is that PAs, on average, net higher salaries. This is a large plus in their favor. Regardless of whether this is due to physician preference, superior training, less female dominated field, or other factors is less relevant. The fact that PAs make more than NPs but have less autonomy does strike me as odd though.

I don't believe it is always a cut and dry scenario. In addition to the previous reasons (and those mentioned by lawguil) for deciding which is a better choice for a given person, I believe that personality type may also be a factor. Certain personality types such as the analytical engineer type may prefer the cut and dry science and precision of PA training. A contrasting personality type such as the protector may prefer the nursing route that addresses the psychosocial aspects of patient healthcare. There are exceptions to every generalization so please no andecdotal objections. This is just my two cents so I hope no one takes it too seriously.

 

[hospPA]

I agree with billydoc about some of his points that he elaborated on in regards to the mid-level discussion; however, I wanted to comment on lawguil's recommendations/observations. I believe that he is correct in stating that the PA education is superior to that of an NP's, generally speaking. My opinion beyond that may diverge from his. As billydoc mentioned, NPs/RNs have better political backing. This plays out in some areas as increased autonomy for NPs and possibly increased employment opportunities. Some states require that the supervising physician be physically present for PAs to practice. In rural areas, this may not be feasible. Legislative issues should be strongly factored into the equation if one is hoping to practice in a particular locale.

Additionally, CRNA and CNM-type positions would generally not be available to PAs. I am aware that there are AAs if one would like to go the anesthesia route but these providers are restricted to the geographic areas they can work in and legally require more physician supervision. Although legally, PAs may work in anesthesia I don't know why a physician would prefer to hire them over an AA or CRNA due to the cost of re-training (I would prefer not to hear a trite arguement about PAs being well-rounded and having a more complete knowledge of the human body, etc.).

The flip side of the coin is that PAs, on average, net higher salaries. This is a large plus in their favor. Regardless of whether this is due to physician preference, superior training, less female dominated field, or other factors is less relevant. The fact that PAs make more than NPs but have less autonomy does strike me as odd though.

I don't believe it is always a cut and dry scenario. In addition to the previous reasons (and those mentioned by lawguil) for deciding which is a better choice for a given person, I believe that personality type may also be a factor. Certain personality types such as the analytical engineer type may prefer the cut and dry science and precision of PA training. A contrasting personality type such as the protector may prefer the nursing route that addresses the psychosocial aspects of patient healthcare. There are exceptions to every generalization so please no andecdotal objections. This is just my two cents so I hope no one takes it too seriously.

I agree with these statements in general. One issue I do want to make clear is that the strong political backing NP's have often results in less backing and in some cases, even adversarial relationships with physicians. Generally, physicians appreciate partnerships with midlevel providers, not folks who are inferiorly trained trying to become independent from them.

How I see the politics (not individual clinicians) is this: PA's are colleagueal, NP's are adversarial. This pseudo-independence thing being pushed by the nursing lobby will keep it this way. That is very unfortunate for practicing NP's, as all the one's I kinow don't even support it.

Pat, RN, PA-C, MPAS

 

[billydoc]

I agree with these statements in general. One issue I do want to make clear is that the strong political backing NP's have often results in less backing and in some cases, even adversarial relationships with physicians. Generally, physicians appreciate partnerships with midlevel providers, not folks who are inferiorly trained trying to become independent from them.

How I see the politics (not individual clinicians) is this: PA's are colleagueal, NP's are adversarial. This pseudo-independence thing being pushed by the nursing lobby will keep it this way. That is very unfortunate for practicing NP's, as all the one's I kinow don't even support it.

Pat, RN, PA-C, MPAS

I can only speak from personal experience. But by observation I noticed that ppl who have more difficulty establishing and maintaining their practices on both sides both (docs and NPs) bring this issue up. Many other disciplines
are allowed to practice independently of doctors. I, for one, otside of being RN have a license to practice acupuncture and orienta medicine. Laugh all you want, but I don't need any orders and or referrals from MD/DO. However, I get lots, and lots of referrals from ortho, neuro, PMR, and just general practitioners, including NPs and PAs, whose business I really, really appreciate. I don't remember any of these truely great professionals bringing up the terms such as mid-levels, upper/lower, or sideline levels. Ppl do what they they do because they chose any given profession, hopefully. All these professions bring something different to the table Tx form the prospectives of their expertise. No one approach is "better" or "right" more than the other. No matter how qualified the MD/DO/CRNA/RN one realizes his/her limitations, and absolutely must refer out. There sure are some nut cases in every profession, who think that they know it all, and their overinflated ego shaddows the patient' s need. If only all practitioners could say to themselves "it ain't about you, stupid". Once we all, as health care providers, learn to understand our limitations, and the importance of INTERDENDANCE vs DEPENDENCE, and dictatorial control over each other, our patients will benefit from it the most,IMHO.

Anyway, just one man's opinion

 

[hospPA]

I can only speak from personal experience. But by observation I noticed that ppl who have more difficulty establishing and maintaining their practices on both sides both (docs and NPs) bring this issue up. Many other disciplines
are allowed to practice independently of doctors. I, for one, otside of being RN have a license to practice acupuncture and orienta medicine. Laugh all you want, but I don't need any orders and or referrals from MD/DO. However, I get lots, and lots of referrals from ortho, neuro, PMR, and just general practitioners, including NPs and PAs, whose business I really, really appreciate. I don't remember any of these truely great professionals bringing up the terms such as mid-levels, upper/lower, or sideline levels. Ppl do what they they do because they chose any given profession, hopefully. All these professions bring something different to the table Tx form the prospectives of their expertise. No one approach is "better" or "right" more than the other. No matter how qualified the MD/DO/CRNA/RN one realizes his/her limitations, and absolutely must refer out. There sure are some nut cases in every profession, who think that they know it all, and their overinflated ego shaddows the patient' s need. If only all practitioners could say to themselves "it ain't about you, stupid". Once we all, as health care providers, learn to understand our limitations, and the importance of INTERDENDANCE vs DEPENDENCE, and dictatorial control over each other, our patients will benefit from it the most,IMHO.

Anyway, just one man's opinion

I agree. I was just making my point about the potential pitfalls of a profession's "hard-line" stance on certain issues. Of course, different folks take different levels of issue with it. Most of us don't care.

Pat

 

[billydoc]

I agree. I was just making my point about the potential pitfalls of a profession's "hard-line" stance on certain issues. Of course, different folks take different levels of issue with it. Most of us don't care.

Pat

Amen to that,Pat!
Have a good one

 

[AlexCCRN]

If you're already an RN, and want less training, less time in the classroom and less flexibility as a provider - become a Nurse Practitioner. If you're an RN and want superior training, have the pre-reqs., and can commit to full-time schooling - become a physician's assistant. If you are not an RN - the NP route is probably not for you unless you have unusual reasons. That’s what I usually tell students who are interested in the mid-level professions.

Two thoughts: autonomy and employment. Presently, PAs don't enjoy as much autonomy as NPs and as an RN... you can always find work. PAs are at the mercy of MDs.

 

[AlexCCRN]

I agree with billydoc about some of his points that he elaborated on in regards to the mid-level discussion; however, I wanted to comment on lawguil's recommendations/observations. I believe that he is correct in stating that the PA education is superior to that of an NP's, generally speaking. My opinion beyond that may diverge from his. As billydoc mentioned, NPs/RNs have better political backing. This plays out in some areas as increased autonomy for NPs and possibly increased employment opportunities. Some states require that the supervising physician be physically present for PAs to practice. In rural areas, this may not be feasible. Legislative issues should be strongly factored into the equation if one is hoping to practice in a particular locale.

Additionally, CRNA and CNM-type positions would generally not be available to PAs. I am aware that there are AAs if one would like to go the anesthesia route but these providers are restricted to the geographic areas they can work in and legally require more physician supervision. Although legally, PAs may work in anesthesia I don't know why a physician would prefer to hire them over an AA or CRNA due to the cost of re-training (I would prefer not to hear a trite arguement about PAs being well-rounded and having a more complete knowledge of the human body, etc.).
...

I still ponder why anesthesia isn't available to PAs. Seems like a fantastic specialty to which PAs are well suited. What's the politics?

 

[deleted6669]

I still ponder why anesthesia isn't available to PAs. Seems like a fantastic specialty to which PAs are well suited. What's the politics?

CRNA'S AND AA'S (ANESTHESIOLOGY ASSISTANTS) HAVE THE MIDLEVEL ANESTHESIA MARKET PRETTY MUCH LOCKED UP.

 

[thirtysomething]

[COLOR=RoyalBlue]Having worked in healthcare for 20 years, the one question to ask yourself is this: Do you want to go through your professional career as an assistant to some other profession or be a practitioner of your own? Things to consider.
Best of luck. Dr. John B.[/COLOR]

Hello,

Advice..here is the situation. As an undergraduate I earned a degree as a Spanish major and Psychyology minor. I wasn't very sure what to do with that mix, so I began translating in a gynecology office and a clinic. The experience was wonderful, so much that I went to work as a research assistant in prostate cancer..to gain more experience in medicine. Then..I went back to school for a post-bac pre-med program. ..and after this year of courses and mcat ..I've come to a better understanding of myself and the role I would like in medicine. I am looking towards PA programs or Nurse Practitioner.

I am not sure where to go. I would love to continue to use Spanish and keep the door open for working in other countries. I am also wondering how many more years of training is needed and if there are any scholarship program of PA/Nurse Practitioners. Please be frank, candid, blunt, honest..!! I feel very lost at this point. Once I thought I had a direction to become a doctor, and now everything is turning around.

All my best, poppj

 

[Febrifuge]

Do you want to go through your professional career as an assistant to some other profession or be a practitioner of your own?

Yeah, but as someone with 20 years experience, surely you recognize that PA's are not "assistants to" physicians in, say, the same way that an executive assistant in the business world is an assistant to an executive. It's important to not let the misconceptions stand, sometimes.

My understanding is that PA's "assist" the docs they work with in the sense that they do pretty much the same job -- on many days, it might be exactly the same work -- and this helps the practice, the department, the group, etc. There are other folks in the clinic or department who are more traditionally "assistants to" people (like in my ER Tech role, I'm a nursing assistant and sometimes a medical assistant). PA's are practitioners. Certainly they're 'midlevel' providers, but they're directly providing the healthcare just like docs are... only within some guidelines that MD's and DO's don't have.

If I'm wrong about that, someone should tell me before I go to PA school.

 

[hospPA]

[COLOR=RoyalBlue]Having worked in healthcare for 20 years, the one question to ask yourself is this: Do you want to go through your professional career as an assistant to some other profession or be a practitioner of your own? Things to consider.
Best of luck. Dr. John B.[/COLOR]

20 years of experience and still clueless

The "assist" is in name only, unless you are referring to the work done by PA's in the OR.

Pat

 

[lawguil]

Two thoughts: autonomy and employment. Presently, PAs don't enjoy as much autonomy as NPs and as an RN... you can always find work. PAs are at the mercy of MDs.

Could you elaborate on this comment! Also, have you seen the 10 year forecast of PA employment predictions?

 

[Bandit]

RN???? how did that sneak in there. laughable really.

 

[lawguil]

RN???? how did that sneak in there. laughable really.

Could you elaborate on how NP's have more autonomy than a PA?