Practicing NP non-trad introduction and advice needed.

[brookynp]

Hello all, its nice to be a part of this awesome forum! I am a 30 year old male who has worked as a RN in the ER for about 3 years and then became a NP. Been working as a NP in the ER and some urgent care for about 2 years now. Needless to say, I have been really considering going back to med school. Many of my supervising doctors have encouraged it.

I believe I will be a competitive applicant. I have a BS in biology with a 3.6 gpa, BSN 3.7 gpa and my masters which is a 3.9. Overall science GPA is going to be around a 3.6. I haven't took the MCAT yet. I took my pre-reqs like 7 years ago and in all honesty, I have basically forgotten most of chemistry, physics, and ochem. Surprisingly, I still have a good grasp on biology. First question is, what MCAT review material is best for those of us that need to almost relearn everything? I have heard good things about the TPR from searching. Some of the DO programs I am interested in have average scores of 25-26, so that's about what I am shooting for. Time frame for taking it would be in October.

Second question is this: Is it going to be worth going back? I am comfortably making about $130k a year right now and if I go back, that's going to be 7 years of a $130k salary gone compounded by the debt medical school is going to bring. I am interested in ER medicine, so once I am done I can expect that salary to double if not more. But that brings another tax bracket and all the other expenses that come along with an increased salary. Looking at this from a financial standpoint, I am just torn between it being worthwhile. Thoughts?

I also worry what the future for mid-levels is seeing that a huge influx of them will be graduating, especially NPs, in the near future. I believe the job market is going to become a whole lot tougher for us and am also concerned salaries will decrease. As far as my actual situation, I have a stable and secure position for the time being, but that could change once administration sees that they can hire multiple other mid levels for 40k cheaper a year than what I am making now. I want to think that my competence and clinical decision skills would offset this, but when it comes down to it, its all about money unfortunately.

Thanks for reading my post, any help or insight is much appreciated.

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[QofQuimica]

If you were still an RN asking whether to do NP vs. DO/MD, then I think a fair argument could be had. For an emergency NP to become an EP....just no. Totally not worth it. I have no idea why your physician colleagues are encouraging you to give up an excellent career with a good income and good stability to become an indebted medical trainee for now the third time, all so that you can basically do the same job you're already doing, along with spending the next 1-2 decades paying back all that unnecessary debt. But as one of your virtual physician colleagues, I will tell you that it is absolutely not worth it in your case, not financially, and not for any other reason except sheer sentiment that it's somehow "better" to be a physician than to play any other role on the health care team. If you want to go flush a quarter million dollars and ten years of your life down the drain, feel free to send them to me. I'm sure I'd find a way to make good use of both.

 

[Aelius]

From a financial standpoint, it is pretty much never worth going into medicine as a doctor.

Like you said, you will lose at least 7 years of 130k+ salary plus incur at least 250k of debt. If finances are some sort of motivating factor, you are better off saving money during those 7 years and investing it.

 

[2Pints]

Hello all, its nice to be a part of this awesome forum! I am a 30 year old male who has worked as a RN in the ER for about 3 years and then became a NP. Been working as a NP in the ER and some urgent care for about 2 years now. Needless to say, I have been really considering going back to med school. Many of my supervising doctors have encouraged it.

I believe I will be a competitive applicant. I have a BS in biology with a 3.6 gpa, BSN 3.7 gpa and my masters which is a 3.9. Overall science GPA is going to be around a 3.6. I haven't took the MCAT yet. I took my pre-reqs like 7 years ago and in all honesty, I have basically forgotten most of chemistry, physics, and ochem. Surprisingly, I still have a good grasp on biology. First question is, what MCAT review material is best for those of us that need to almost relearn everything? I have heard good things about the TPR from searching. Some of the DO programs I am interested in have average scores of 25-26, so that's about what I am shooting for. Time frame for taking it would be in October.

Second question is this: Is it going to be worth going back? I am comfortably making about $130k a year right now and if I go back, that's going to be 7 years of a $130k salary gone compounded by the debt medical school is going to bring. I am interested in ER medicine, so once I am done I can expect that salary to double if not more. But that brings another tax bracket and all the other expenses that come along with an increased salary. Looking at this from a financial standpoint, I am just torn between it being worthwhile. Thoughts?

I also worry what the future for mid-levels is seeing that a huge influx of them will be graduating, especially NPs, in the near future. I believe the job market is going to become a whole lot tougher for us and am also concerned salaries will decrease. As far as my actual situation, I have a stable and secure position for the time being, but that could change once administration sees that they can hire multiple other mid levels for 40k cheaper a year than what I am making now. I want to think that my competence and clinical decision skills would offset this, but when it comes down to it, its all about money unfortunately.

Thanks for reading my post, any help or insight is much appreciated.

Before looking into MCAT prep courses, I'd really look into WHY. Do you feel limited as an NP right now in your practice and background? If you are fulfilled and enjoy being an NP then stay because financially going to medical school, acquiring the debt from a DO school and losing out on that salary is not worth it. Who have you talked to about the job market predictions? If that's your driving force to go to medical school then I would talk to more people that would be able to better predict the job market for NPs.

Your pre-reqs will come back faster than you think. My practice tests started out in the average range you are looking for without a major content review and I'm about 9 years out from my pre-reqs. I think getting review materials for different sections from different resources seems like the best idea. Maybe take a free practice MCAT to see how far you are out of range?

 

[FutureDrB]

OP, you've probably run these numbers already, but I kind of wanted to see the equation myself.

You're 30 years old. So let's say you remain working as an NP, earning $140K a year (gave you an extra $10K for inflation) for the next 35 years = $4.9 million

Or, you go back to school for 8 years, losing that salary ($1.1 million), plus incurring $250K in debt from school.

You become an attending EP at 38 and work another 27 years (probably more) at $230K a year = $6.2 million.

Now subtract the 8 years of lost income and med school debt and you're back to $4.9 million... so you're pretty much breaking even.

With all that said, these figures are all hypothetical and I have a strong feeling you're in the medial field for much more than the money.

I actually debated becoming an NP (I couldn't care less about my salary) since I'm interested in primary care and I'd be curious to hear too why you would now choose to go the physician route?

 

[brookynp]

If you were still an RN asking whether to do NP vs. DO/MD, then I think a fair argument could be had. For an emergency NP to become an EP....just no. Totally not worth it. I have no idea why your physician colleagues are encouraging you to give up an excellent career with a good income and good stability to become an indebted medical trainee for now the third time, all so that you can basically do the same job you're already doing, along with spending the next 1-2 decades paying back all that unnecessary debt. But as one of your virtual physician colleagues, I will tell you that it is absolutely not worth it in your case, not financially, and not for any other reason except sheer sentiment that it's somehow "better" to be a physician than to play any other role on the health care team. If you want to go flush a quarter million dollars and ten years of your life down the drain, feel free to send them to me. I'm sure I'd find a way to make good use of both.

Haha, thanks for your opinion. I think the physician colleagues are encouraging it because I am a damn good mid level that exceeds the performance of some physicians. I think they want me to fully realize my potential. But you make a good point. Financially it doesn't make a whole lot of sense and as far as being "better" to be a physician, well technically it is as far as independence, autonomy, and pay.

From a financial standpoint, it is pretty much never worth going into medicine as a doctor.

Like you said, you will lose at least 7 years of 130k+ salary plus incur at least 250k of debt. If finances are some sort of motivating factor, you are better off saving money during those 7 years and investing it.

Ya, investing heavily is my goal, but I am trying to pay down the $60k of debt I already owe first... Thanks for your opinion.

Before looking into MCAT prep courses, I'd really look into WHY. Do you feel limited as an NP right now in your practice and background? If you are fulfilled and enjoy being an NP then stay because financially going to medical school, acquiring the debt from a DO school and losing out on that salary is not worth it. Who have you talked to about the job market predictions? If that's your driving force to go to medical school then I would talk to more people that would be able to better predict the job market for NPs.

Your pre-reqs will come back faster than you think. My practice tests started out in the average range you are looking for without a major content review and I'm about 9 years out from my pre-reqs. I think getting review materials for different sections from different resources seems like the best idea. Maybe take a free practice MCAT to see how far you are out of range?

You hit the nail on the head, I feel limited. If I want to change positions and move somewhere else, its hard to convince another future employer that I am a very competent provider. I am always stuck into the "mid-level" category, and unfortunately there are a lot of stereotypes associated with it. It will be hard to increase my salary other than matching inflation and I feel that in 5 years I will be stuck as far as career advancement goes unless I move into administration. As far as the job market goes, its just speculation because of the ever increasing number of NP graduates who are total idiots. I fear this is going to give us a bad name in all honesty.

OP, you've probably run these numbers already, but I kind of wanted to see the equation myself.

You're 30 years old. So let's say you remain working as an NP, earning $140K a year (gave you an extra $10K for inflation) for the next 35 years = $4.9 million

Or, you go back to school for 8 years, losing that salary ($1.1 million), plus incurring $250K in debt from school.

You become an attending EP at 38 and work another 27 years (probably more) at $230K a year = $6.2 million.

Now subtract the 8 years of lost income and med school debt and you're back to $4.9 million... so you're pretty much breaking even.

With all that said, these figures are all hypothetical and I have a strong feeling you're in the medial field for much more than the money.

I actually debated becoming an NP (I couldn't care less about my salary) since I'm interested in primary care and I'd be curious to hear too why you would now choose to go the physician route?

I ran the numbers and got similar results, but I gave myself a EP salary of more like 300k, which is what most of the EPs I work with make. So actually I came out closer to a million ahead. Basically, is the time worth an additional million in income over my working life? I am tending to think probably not. Again, I haven't completed medical school so I can't answer that.

The reason I am thinking about choosing the physician route is the independence, autonomy, and they are generally more marketable and sought after because of this. Its more difficult for me to find another position with a comparable salary if I so choose to move to the beach for example. Where I work right now, I cannot pick up an extra shift at the urgent care and be the sole provider for the day, even though I am capable of doing it, because I am a mid level. I have to have a supervising physician there. Its things like this that are annoying and I feel held back by it.

 

[FutureDrB]

The reason I am thinking about choosing the physician route is the independence, autonomy, and they are generally more marketable and sought after because of this. Its more difficult for me to find another position with a comparable salary if I so choose to move to the beach for example. Where I work right now, I cannot pick up an extra shift at the urgent care and be the sole provider for the day, even though I am capable of doing it, because I am a mid level. I have to have a supervising physician there. Its things like this that are annoying and I feel held back by it.

Same reasons I chose the physician route instead. Although some states allow NPs to practice on their own, I don't want to be limited. Good luck in your pursuit whatever you decide.

 

[primadonna22274]

I will be one of the few to tell you to go for it. I just graduated as a DO and have been a practicing PA in FM and EM for 14 yr. Just started residency (FM, my first choice) and not quite used to being called Doctor yet.
I know all the reasons you have for going back. For me it had to be an emotional decision more than a financial one--surely the smart financial move would have been to stay put and learn to be a happy PA, but I just never could (I also never made more than $105k and I worked insane hours, 2-3 jobs, to hit that!) I wanted to know what I didn't know and to not be limited in my practice. I'm happy with my choice overall.
I will tell you the most difficult part of medical school was to be so frickin' poor that last year--so anything you can do to bank money will help you. I did work quite a bit through M1-2 and a little bit in M3 but it's hard to commit to EM schedules a month or two ahead when your own student schedule changes every 4 wk. I was in an accelerated 3-yr program so didn't have to suffer through a 4th year but I did have a pretty insane final year. I survived.
Good luck!

 

[Aelius]

I ran the numbers and got similar results, but I gave myself a EP salary of more like 300k, which is what most of the EPs I work with make. So actually I came out closer to a million ahead. Basically, is the time worth an additional million in income over my working life? I am tending to think probably not. Again, I haven't completed medical school so I can't answer that.

The reason I am thinking about choosing the physician route is the independence, autonomy, and they are generally more marketable and sought after because of this. Its more difficult for me to find another position with a comparable salary if I so choose to move to the beach for example. Where I work right now, I cannot pick up an extra shift at the urgent care and be the sole provider for the day, even though I am capable of doing it, because I am a mid level. I have to have a supervising physician there. Its things like this that are annoying and I feel held back by it.

You also have to consider that being the physician will be a more stressful job and also open you up to lawsuits and such. There is just more responsibility, which goes back to the point that if you are making your decision based practicality and perceived financial rewards, then you should not pursue being a physician. On the flip side, what if you did the math, and staying a NP makes you come out a million ahead? If that makes you want to stay an NP, then I would say your desire to being a physician isn't strong enough.

But if you have this burning desire to be at the top of the food chain and cannot make peace otherwise, you have to go for it regardless if it is a financially a good or bad deal.

That's my two cents. I hope you can make a decision that makes you fulfilled.

 

[2Pints]

Haha, thanks for your opinion. I think the physician colleagues are encouraging it because I am a damn good mid level that exceeds the performance of some physicians. I think they want me to fully realize my potential. But you make a good point. Financially it doesn't make a whole lot of sense and as far as being "better" to be a physician, well technically it is as far as independence, autonomy, and pay.

Ya, investing heavily is my goal, but I am trying to pay down the $60k of debt I already owe first... Thanks for your opinion.

Have you looked into NP to MD programs? I'm meeting with a friend of one of my former nursing professors next week that just made the jump from being an ED NP to MD. She's in her residency now. The program was in Miami. I believe she was able to work during some of it.

 

[Plecopotamus]

Have you looked into NP to MD programs? I'm meeting with a friend of one of my former nursing professors next week that just made the jump from being an ED NP to MD. She's in her residency now. The program was in Miami. I believe she was able to work during some of it.

Have I missed the existence or advent of NP to MD bridge programs? I can't find any with google. I'm well aware of the PA to DO bridges, but my understanding was that NP education was fundamentally too different in its approach to lend to bridging.

There are definitely NP to physician programs off shore (which actually don't seem to shave off time, but allow some distance learning unlike regular MD programs)...and I think some of their in person or clinical portions might be based in FL. I absolutely would not recommend that path to anybody for all the reasons that have been hashed out on numerous other threads in this forum and others.

Maybe i'm way behind the times. If I am, sorry, and please educate me.

 

[primadonna22274]

I looked when I read that post. Only thing I saw was Oceania.

 

[2Pints]

I messaged my friend since I didn't realize this program wasn't common. She went to Oceania which is based in Samoa. I know she took her courses in the US. Positive is you can work some while in school. They accept a lot of the NP/PA Masters classes. Downside is you will be considered a foreign student. But she finished in 2.5 years and is in her second year of residency.

So not the ideal solution but it's an option. Sorry I didn't so a better fact check before posting.

 

[Plecopotamus]

I messaged my friend since I didn't realize this program wasn't common. She went to Oceania which is based in Samoa. I know she took her courses in the US. Positive is you can work some while in school. They accept a lot of the NP/PA Masters classes. Downside is you will be considered a foreign student. But she finished in 2.5 years and is in her second year of residency.

So not the ideal solution but it's an option. Sorry I didn't so a better fact check before posting.

Unless Oceania is extremely cheap, this is an incredible gamble, and she's very lucky she got a residency (and a fair chance she didn't get any clout in her choice, SOAPed, and/or is at a place that doesn't offer good training).

 

[2Pints]

Unless Oceania is extremely cheap, this is an incredible gamble, and she's very lucky she got a residency (and a fair chance she didn't get any clout in her choice, SOAPed, and/or is at a place that doesn't offer good training).

I'm not sure how expensive the program is but I am meeting with her this weekend. More so because I want to ask questions about transitioning from a nurse to MD and why being an NP wasn't enough for her. Since I haven't gone to graduate school, the "traditional" route is a better bet for me regardless. As for the OP, good luck with deciding! And if you decide to make the leap, good luck with studying for the MCAT while working full-time. I'm jealous of my former schedule 8 years ago when I could have made MCAT my main priority in life.

 

[Jewels86]

I too am a nurse and after reading and gleaning wisdom from SDN plus my physicians, the majority lean towards NP. The consensus states it's not worth it anymore, mostly financially speaking. In addition, NP's can do a lot but it all depends on the state you're in. I just want to treat the patient, prescribe what I believe is best at that time and re-evaluate that patient in a month or two, depending, teaching then and reteaching them about their illnesses and helping them on their journey to healthy living.
And...I really want to be in rural Texas; where cowboy boots are the expected norm

IDK...OP, if you're already an NP, perhaps you are searching for the autonomy that perhaps another region of the country would give to you. Or you seek the knowledge base, which is very important as well. Personally, I think you're in a great field that's expected to grow exponentially!! But...only you know what's best for you.

 

[amberlynnp13]

I will be one of the few to tell you to go for it. I just graduated as a DO and have been a practicing PA in FM and EM for 14 yr. Just started residency (FM, my first choice) and not quite used to being called Doctor yet.
I know all the reasons you have for going back. For me it had to be an emotional decision more than a financial one--surely the smart financial move would have been to stay put and learn to be a happy PA, but I just never could (I also never made more than $105k and I worked insane hours, 2-3 jobs, to hit that!) I wanted to know what I didn't know and to not be limited in my practice. I'm happy with my choice overall.
I will tell you the most difficult part of medical school was to be so frickin' poor that last year--so anything you can do to bank money will help you. I did work quite a bit through M1-2 and a little bit in M3 but it's hard to commit to EM schedules a month or two ahead when your own student schedule changes every 4 wk. I was in an accelerated 3-yr program so didn't have to suffer through a 4th year but I did have a pretty insane final year. I survived.
Good luck!

Where did you go to school

 

[primadonna22274]

LECOM in Erie, PA. First class of the Accelerated Physician Assistant Pathway--3 years for PA-Cs to become DOs. Track is only for PAs at this time as PA education is much more standardized than NP.
If you're interested in primary care they do have a 3-year primary care scholars pathway also. There are a handful of similar 3-yr pathways for MD at a few other schools--I think Mercer in Savannah and somewhere in Texas.
If you want a competitive specialty I think you're better off in a 4-yr traditional track as there just isn't enough time for audition rotations and "making friends and influencing people" in an accelerated track with only 13-15 mos of rotations.