PhD and PA/NP/others?

[ToAspire]

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Hi folks,

I'm starting a clinical PhD this fall in a relatively research-intensive program. I chose the PhD over an MD for many reasons and it is something I thought extensively about. I'm interested in doing executive consulting, I like research, I'm interested in the philosophical underpinnings of psychopathology and human flourishing, and I simply have no interest in examining toe fungus or cadavers as done in medical school. My passion is psychology and I don't want to spend 4-5 years waiting to get started.

All that being said, I do want to be able to prescribe psychotropics for financial reasons but also primarily to be the most effective and comprehensive practioner possible.

My plan was to pursue an NP after my doctorate in an accelerated 2 year program but I learned recently that in 2015 you'll need a doctorate in nursing to earn prescription rights and there is no chance I'll want to do a second PhD. So the only option left it seems is a physicians assistant but it is unclear to me if this is a viable option. I know each state has its own regulations, but in terms of reaching as much autonomy as possible, does a PA make any sense? Can anyone speak to this? Are there any other degrees apart from an NP and a PA that allow one to prescribe? Does the RxP for Clinical Psychologists have any shot of spreading to new states?

Thank you all for your time.

 

[medium rare]

Hi folks,

I'm starting a clinical PhD this fall in a relatively research-intensive program. I chose the PhD over an MD for many reasons and it is something I thought extensively about. I'm interested in doing executive consulting, I like research, I'm interested in the philosophical underpinnings of psychopathology and human flourishing, and I simply have no interest in examining toe fungus or cadavers as done in medical school. My passion is psychology and I don't want to spend 4-5 years waiting to get started.

All that being said, I do want to be able to prescribe psychotropics for financial reasons but also primarily to be the most effective and comprehensive practioner possible.

My plan was to pursue an NP after my doctorate in an accelerated 2 year program but I learned recently that in 2015 you'll need a doctorate in nursing to earn prescription rights and there is no chance I'll want to do a second PhD. So the only option left it seems is a physicians assistant but it is unclear to me if this is a viable option. I know each state has its own regulations, but in terms of reaching as much autonomy as possible, does a PA make any sense? Can anyone speak to this? Are there any other degrees apart from an NP and a PA that allow one to prescribe? Does the RxP for Clinical Psychologists have any shot of spreading to new states?

Thank you all for your time.

The recommendation for the DNP to be the entry-level degree for NP practice by 2015 is just that - a recommendation. You will still be able to earn the NP credential with a MSN, there will just not be as many institutions offering the MSN as there are now, but they will still exist. If you want Rx authority after your clinical psych doctorate, psych NP training is the best route to pursue.

 

[ToAspire]

The recommendation for the DNP to be the entry-level degree for NP practice by 2015 is just that - a recommendation. You will still be able to earn the NP credential with a MSN, there will just not be as many institutions offering the MSN as there are now, but they will still exist. If you want Rx authority after your clinical psych doctorate, psych NP training is the best route to pursue.

So there isn't a regulating body that will only recognize DNPs with script authority? I read somewhere that those with NPs before 2015 will be grandfathered in, suggesting some hard cut off is made, no?

 

[edieb]

So there isn't a regulating body that will only recognize DNPs with script authority? I read somewhere that those with NPs before 2015 will be grandfathered in, suggesting some hard cut off is made, no?

Just in case you do not know, you can also earn a post-doctoral master's degree in psychopharmacology and prescribe in 2 states, the IHS and DOD as a psychologist. I just recently earned my Ph.D. in clinical psychology and myself, along with my colleagues, kick ourselves for not going to medical school or NP school. Your future is very, very limited as a clinical psychologist without prescribing rights..

 

[medium rare]

So there isn't a regulating body that will only recognize DNPs with script authority? I read somewhere that those with NPs before 2015 will be grandfathered in, suggesting some hard cut off is made, no?

No. There is no single regulating body that governs scope of practice for NPs. This is decided by each state's Nurse Practice Act and varies by state.

The American Association of Colleges of Nursing (AACN) has called for the DNP to be adopted by 2015, but this has no legal baring on NPs' scope of practice in any way. What you will see (and this is already occurring) is more and more nursing schools transitioning to the DNP degree over the MSN. But it is each state's law that stipulates the requirements for practice.

For this to change, each state will have to open its Nurse Practice Act to change regulations. This is not likely to happen with regard to the DNP, because when you open a practice act, it becomes open to any and all possible changes by any outside group, not just nurses and not just pertaining to the intended legal changes. This could result is extreme changes to current scope of practice in particular state - something most nursing groups will be clearly opposed to.

 

[edieb]

While I'm not convinced of the "limited" thing and, I generally am against dumbing down education, optometrists prescribe, nurses prescribe, and physician's assistants have a limited prescription right. None of those fields have particularly steep or difficult requirements, especially compared with psychology. A formal postdoctoral program geared at prescription priv to me seems like it should be on par or better than those fields in terms of background when combined with the level of depth of a PhD program in clinical psych. I personally have little interest in prescribing medications at this point. Though I do acknowledge that financially, it might be a boon. At present, I am content, clinically, with recommending various medications, against medications, and generally suggesting consideration of various things of that nature. I don't really have the time or the inclination to spend the money to go back to school or do a postdoctoral program for prescription priv. Though, a pharmacy program of some sort could be interesting, I suppose.


Limited = little money not in the amount of things one can do with their degree. The average PhD/PsyD psychologist makes $50K.
As far as limits . . . my current job consists of research and clinical work. I use imaging techniques, psychophysiology, and other various behavioral methods in my research. I consult for physicians on statistics and research design. I supervise residents, fellows, and undergrads in conducting research projects.

Primary research for me = writing my own grants, writing papers, data analyses, helping other people write grants and papers and analyze data.

Also, I attend a few conferences a year, some I am "faculty" on and help plan content.

I do neuropsychological assessments on several different populations, directing a specialty service in my department.

Overall, I can work as many hours a week as I wish. Meaning, I have a lot I have to say no to. Income isn't that far off of a neurologist or other similar physicians and I have no debt, no call, and no expectation that I have to work 60+ hours a week (though I often do). I have a lot of freedom. If I wanted to make more money, I have avenues to do that: start a weekend private practice (say one or two saturdays a month), do more forensic work (my specialty areas are very nice for this). But, money isn't my biggest consideration. I want to have fun working and I want to have fun outside of work. That's my priority. Now, do I want to be rich? Sure. But, to me, there isn't a big difference between making 120,000 or 150,000, or even 200,000 in income (depending on the hours) with respect to being rich. To me, rich is income off of interest conservatively invested of at least 6 figures. I'm not going to get there quickly without starting a business (and succeeding).

In any case, my job doesn't feel limited to me.

Limited = make very little money for the amount of time you spend in school. According to the APA, the average PhD psychologist earns $50K.

 

[hopefuldoc97239]

Hi folks,

I'm starting a clinical PhD this fall in a relatively research-intensive program. I chose the PhD over an MD for many reasons and it is something I thought extensively about. I'm interested in doing executive consulting, I like research, I'm interested in the philosophical underpinnings of psychopathology and human flourishing, and I simply have no interest in examining toe fungus or cadavers as done in medical school. My passion is psychology and I don't want to spend 4-5 years waiting to get started.

All that being said, I do want to be able to prescribe psychotropics for financial reasons but also primarily to be the most effective and comprehensive practioner possible.

My plan was to pursue an NP after my doctorate in an accelerated 2 year program but I learned recently that in 2015 you'll need a doctorate in nursing to earn prescription rights and there is no chance I'll want to do a second PhD. So the only option left it seems is a physicians assistant but it is unclear to me if this is a viable option. I know each state has its own regulations, but in terms of reaching as much autonomy as possible, does a PA make any sense? Can anyone speak to this? Are there any other degrees apart from an NP and a PA that allow one to prescribe? Does the RxP for Clinical Psychologists have any shot of spreading to new states?

Thank you all for your time.

I'm less concerned about the practicing rights issue than your prediction of how much time this will all take you...

A master's level NP program will take you two years after you become bachelor's-level registered nurse, which will take at least one year. If you don't have all the right pre-requisites for the BS in Nursing, then it will take longer. I don't know of any nurse practitioner programs that allow you to skip the Registered Nurse step, and I'd be astonished if they ever made one. The NP training is not meant to be entry-level training!

Physician's assistant programs are probably not going to be much easier for you. They typically take two years, but still you need the right pre-reqs. A typical psychology major will not have hardly any of the biology/chemistry requirements. On top of this, applicants are usually required to have 2,000-3,000 hours of healthcare experience, and the type of setting is important (some programs might not think your clinical psychology experience counts as strongly as someone who has worked as an EMT).

Either way, the NP or PA route could take a total of four years starting from the time you begin doing pre-requisites, then getting appropriate healthcare experience, and the actual training. Your PhD will be a great extra-curricular to help you beat out the competition for admissions, but only after you've satisfied the other requirements. It won't exempt you from any requirements.

All that said, combining clinical psychology with NP or PA would be a great degree combination. I knew a PsyD/PMHNP, and having that dual-training helped her to become the director of the psych-NP program at a major university.

Here in Oregon, PAs and NPs have liberal prescribing authority. PAs need only minimal supervision from physicians, and NPs are completely autonomous--they don't need a physician partner at all. Yet prescription privileges for psychologists was recently struck down in the legislature.

Except for post-doctoral psychopharmacology programs for psychologists, all of the other prescribing roles take a substantial amount of time to complete. For someone who has already completed the psych doctorate route, the post-doc psychopharm route makes sense if you're in the right state. But for someone like you who hasn't even started the PhD, I question whether it doesn't make more sense just to go to med school, or nursing school, if you know that you want to prescribe as part of your practice.

 

[ToAspire]

I'm less concerned about the practicing rights issue than your prediction of how much time this will all take you...

A master's level NP program will take you two years after you become bachelor's-level registered nurse, which will take at least one year. If you don't have all the right pre-requisites for the BS in Nursing, then it will take longer. I don't know of any nurse practitioner programs that allow you to skip the Registered Nurse step, and I'd be astonished if they ever made one. The NP training is not meant to be entry-level training!

Physician's assistant programs are probably not going to be much easier for you. They typically take two years, but still you need the right pre-reqs. A typical psychology major will not have hardly any of the biology/chemistry requirements. On top of this, applicants are usually required to have 2,000-3,000 hours of healthcare experience, and the type of setting is important (some programs might not think your clinical psychology experience counts as strongly as someone who has worked as an EMT).

Either way, the NP or PA route could take a total of four years starting from the time you begin doing pre-requisites, then getting appropriate healthcare experience, and the actual training. Your PhD will be a great extra-curricular to help you beat out the competition for admissions, but only after you've satisfied the other requirements. It won't exempt you from any requirements.

All that said, combining clinical psychology with NP or PA would be a great degree combination. I knew a PsyD/PMHNP, and having that dual-training helped her to become the director of the psych-NP program at a major university.

Here in Oregon, PAs and NPs have liberal prescribing authority. PAs need only minimal supervision from physicians, and NPs are completely autonomous--they don't need a physician partner at all. Yet prescription privileges for psychologists was recently struck down in the legislature.

Except for post-doctoral psychopharmacology programs for psychologists, all of the other prescribing roles take a substantial amount of time to complete. For someone who has already completed the psych doctorate route, the post-doc psychopharm route makes sense if you're in the right state. But for someone like you who hasn't even started the PhD, I question whether it doesn't make more sense just to go to med school, or nursing school, if you know that you want to prescribe as part of your practice.

Here's an example: http://www.bc.edu/schools/son/programs/masters/masters-entry.html

I know that MGH has one as well.

 

[hopefuldoc97239]

Here's an example: http://www.bc.edu/schools/son/programs/masters/masters-entry.html

I know that MGH has one as well.

Okay, well... that's amazing... Don't show this to the kids in the pre-allo forum or they'll have a hategasm about the newly lowered nursing standards.

Point still stands: Do you have all the pre-reqs for this program? Anatomy and Physiology, chemistry, microbiology? If you don't have all of that, it's unlikely to get all the way through in less than three years.

 

[ClinicalPHD5]

How do you plan on paying for your PhD and then NP/PA program? It seems like it could take you 8 years of school total and i'm not sure it would justify the additional income since making more money is a concern for you. Plus, these are years where you are not earning income and investing your money (i'm focusing on $ because you mentioned you would like additional income).

You mentioned an interest in organizational/executive consulting. Organizational psychologists are one of the most highly paid in the field (above clinical psychology). Why not focus on this instead of getting an additional graduate degree? I would focus on what you can do with your degree instead of adding additional years of education.

 

[ClinicalPHD5]

Plus, after you finish a clinical Phd program, i doubt you will be up for additional schooling. You haven't even started your program so thinking about post-PhD graduate programs is too soon.