PreMed to RN to NP or MD?

[Hazelapril94]

I have a career dilemma that has been growing heavier and heavier on my mind. As far back as I remember I’ve wanted to be a physician, I come from a very medical family, my mother is an NP while my father is an MD. In college I pursued pre-med, had plenty of shadowing, research projects, volunteer work, leadership etc and graduated with a 3.51 GPA in biomedical sciences degree. I took the MCAT the first year it switched over to the newer scoring system and totally bombed it with 488, I had applied anyway and had an interview but no acceptance. Basically repeated this same process for three application cycles with poor scores, 493 and 495, but a lot of delusional hope. I kept getting more and more test anxiety despite how hard I was studying and how well I knew the material and continued to test poorly. Anyway, it didn’t pan out obviously, and I became severely depressed about it, feeling like my dream was a total wash.

My mom advised me to use my science background and pivot into nursing, encouraging me that I could still work in healthcare and make a difference. I took her advice and did a direct entry MSN program, graduated with a 3.89 and passed the NCLEX. So I’ve been working as an RN for a few years now but I still constantly want more. I’m appreciative of all that I have learned at the bedside and the amazing clinical experiences I’ve gleamed, but it just cemented for me how much I want to go further. I assumed the most logical next step would be to transition to an NP role. I have a devout passion for women’s health and obstetrics, my interest is in the disparity gap pertaining to pregnant black women, it was the cornerstone of my masters thesis. So now I’m enrolled in a DNP program with dual specialties in midwifery and women’s health NP, focusing my research on maternal disparities in POC communities. I’m doing very well in it, currently 4.0 GPA, but even still, I can’t help but think that even when I finish this program, I’ll still be left wanting. I know that I will always be thinking of the career I could have had as an OBGYN and the impact I could make on closing the disparity gap of maternal mortality amount black women. It’s something so personal to me and I feel like I won’t be able to do as much as I want even with a terminal nursing degree.

For the past few years I’ve been telling myself to just let my medicine dreams go and find happiness in the nursing path and focus on what I can do as a midwife and NP. But no matter what, I can’t seem to let go of it, and I keep circling back to the idea of retackling the MCAT. I’m 27 now and I feel like I have grown so far from the naïve 21 year old pre-med student I once was. Although I always had the dream of medicine, for the first time I have an actual direction towards the impact I want to make on the world and the change that needs to be made.

My question is: Do you think I’ve done too much damage to my chances of medicine with my prior applications? Although there is a gap, it would be my fourth time applying if I decided to pursue. Also would my prerequisites in my biomed degree still be viable? I graduated college in 2016, applied for matriculation cycles starting 2015, 2016, 2017. Also would the experiences I gained in college, shadowing, research etc, be obsolete by now? I have new experiences from the nursing world, but I’m not sure what is applicable.

I know that I can nail the MCAT this time around, my study methods have evolved and I’m far more focused and matured than I once was. I have this determination inside me to succeed and I feel like I won’t be able to rest until I finally reach my goals. I just don’t know if it’s too late or not.

I appreciate any and all advice you have to give!

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[RZRZ]

I think it's highly dependent on your MCAT score. If you can make a significant jump, say to a 50X at least I think you could reasonably consider yourself back in the game. You'd probably need to do a post bacc or SMP since you've been out of school for a while to demonstrate that you can handle a rigorous courseload (someone correct me if I'm wrong, I'm not sure how med schools view DNP curriculum), as well as for letters of rec. I think your nursing experiences would make for a strong application, but really you'd need to crush the MCAT first and then assess from there.

 

[sylvanthus]

Just go DNP, medicine is a hot mess and being a physician is steadily becoming not worth it.

 

[Sn00pygrrl]

Seems to me that the major issue with your previous applications was your MCAT score. Focus on pulling that up before you investigate the rest. Without a competitive score, your application will get screened out, unfortunately.

 

[wysdoc]

What about pursuing CRNA degree? Many of the ones I know do largely OB, with spinals, epidurals, or general anesthesia and work in concert with MD anesthesiologists. It would be a shorter more direct route to more responsibility and you would be with your target patient population

 

[gramnegative]

I'm an M1 and former RN. If you could get your MCAT up and reasonably explain why you want to make the transition, you probably have a shot. However, if you are interested in affecting disparities in maternal health, you could also work toward a MPH/MPA or skip the degree and work directly in PH/policy w/o going through all the hoops and have more of an impact than the marginal difference of going to medical school.

 

[Medisaint]

These are extremely important questions you are asking yourself and your decisions will have enormous impact on your family/financial/social/professional life's trajectory. If I can just say, with all due respect, your story does carry an undercurrent of not looking before your leap. I also came from a medicine/nursing family and was surprised that you decided to go into nursing after not getting into medical school. I feel very strongly that one should never treat nursing as a silver medal. Medicine and nursing are two completely separate professions. Personally, if I couldn't be a doctor I would do something outside of clinical work altogether. As such, from my perspective, this statement does not make much sense to me:

I assumed the most logical next step would be to transition to an NP role.

It seems like you are also questioning the logic of this move because as a DNP you'll never have the full training and autonomy of an MD/DO. Now if your goal is to help reduce pregnancy-associated mortality among black mothers then it may be the case that you don't actually need the MD. This is where you need to be really really thoughtful about what you need to be fulfilled. Why? because of this:

I’m 27 now and I feel like I have grown so far from the naïve 21 year old pre-med student I once was.

You're not that old but you're also not 21 anymore. Just realize that medicine--which already guts a young person's personal life and finances--may require even more sacrifice from you. If you apply to med school this year and get in, you'll finish med school at age 32, and OBGYN residency at age 36. Again, 36 isn't old per se but wiping out 8 years of NP salary in your 20's early 30's in order to take on $100Ks of debt can become a problem--especially if you have preexisting educational loans. It will harm your ability to save for retirement (which you should be thinking about now) and potentially limit the kind of lifestyle you might want to live. I didn't have any idea what it took to pay off a loan at age 21 but by age 27 you really need to. Similarly, dating/marriage/kids/family time may suffer if you're pulling 80 hour work weeks.

I am definitely not trying to be negative because it could be that medicine is still the best option for you. I just think you owe it to yourself to make a best-guess projection of where you want to be in 5/10/15 years and honestly consider which path is most likely to get you there.

I know that I can nail the MCAT this time around, my study methods have evolved and I’m far more focused and matured than I once was.

You may get different feedback from others but I think the MCAT should be the least of your worries. You scored close to the mean 6 years ago--to borrow a quote from the 2019 Chernobyl miniseries, "not great but not terrible". Now let's say you retake the MCAT and get a competitive score in the 80% percentile. Ask yourself 'why would a med school want to take me over a fresh grad who scored equally well after their first attempt?' My point is that you may need to retake the MCAT to apply (and if you do make sure you are very prepared for it) but don't count on a good score to get you in. I suspect anyone looking at your application would be MUCH more interested in what you've done with your life over the last 5 years than how much physics you recall from undergrad. If you are able to draw from your work/extracurricular/leadership/academic experiences to demonstrate a strong and consistent focus on minority women's health issue then you leverage that into a very strong application. What experiences as a nurse lead you to want to pursue medicine? How has working as a nurse for 4 years made you more sensitive to minority women's issues? How will your prior nursing inform your future as an OBGYN? Etc.

Lastly:
-If you apply, apply broadly to many centers.
-Make sure to include DO schools as well.
-I would not recommend going to a Caribbean school for many reasons. You'll get it but you run the serious risk of being unable to match after taking on $200-300K+ in debt