RN looking for advice: NP vs MD (Or, 'Beating a Dead Horse' )

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Looking for personalized advice- NP vs MD (I know it's been done before...)
I know this may seem like it is beating a (very) dead horse, but I am looking for advice for my personal/unique situation..


I am an RN in my late 20s who has practiced only in mental health, in various settings (inpatient, outpatient). I recently took a position working as a psych case manager in a well known teaching hospital w/a teaching service comprised mainly of residents and fellows, and this has renewed my "MD envy" and interest in going back to med school/getting an advanced degree.

I started out pre-med, took a year off due to medical illness, and transferred to a local community college, where I obtained my ADN/RN. I didn't enjoy med/surg clinicals and for many reasons was disenchanted with my nursing program (and nursing as I saw it in the community hospitals I rotated through), so I applied to transfer to a 4-year school and entered with a major in biology the fall after finishing nursing school. I ended up working during winter break as a psych nurse, switching my major to psychology, graduating with a BA in psych, and taking a full time psych nursing job after graduation; this is what I've been doing since.

Trust me, this is an abbreviated version...


This summer I started working at a large teaching hospital w/a teaching service/group of psychiatry fellows and residents, and have started to think about med school again. I have also thought about NP school (as it would be cheaper, an easier transition, and require a lot less courses-- I have taken some of the prereqs for med school but most are at least 5 yrs old and I haven't taken physics or orgo, which I would enjoy the least), but have been thinking of med school for a few reasons:

1. I like the idea of the deeper & broader training that med students get through med school & residency. I am leaning towards psychiatry (that's another discussion, as I'm not 100% sure...) and feel that my lack of background in med surg would put me at a disadvantage as an NP, as psych pts are so medically complex these days. With med school, I'd get a solid background in basic medicine. Also there is more clinical training through residency, as NP residencies aren't widely offered.

2. Med school allows for rotations-- I have always wanted to work in the ED and am not 100% sure I want to do psych forever (vs. medicine or ED) so this would give me a chance to rotate through all specialties

3. An MD opens more doors in the sense of positions of authority at teaching hospitals, like the one I am at.

4. There is more "prestige" associated with the MD and I have always wanted some of that, although I don't like to admit it..

5. Although I like the holistic part of the nursing model, I really didn't enjoy the nursing theory portions of nursing school and felt like a lot of it was fluff -- I don't want to take out loans and spend 2 years doing NP school to be frustrated & dissatisfied w/my education (this is what happened after my experience at community college)

6. I hear a lot about NPs not making any more than RNs despite more education, which is disheartening



There are also a lot of reasons why an NP would make more sense:


1. It would build on my RN degree and would not require a crazy amount of hard science prereqs that I would not enjoy

2. It is generally a shorter, less expensive route, and I'd be more likely to get scholarships -- I am ~$30k in debt from undergrad , along w/some credit card debt. Avg. med school debt is ~200k PLUS I would have to take ~2yrs of prereqs, which would put me *another* $25-50k in debt if I went to a post bacc program with a solid advising/linkage program... I would make more $$ In the long run with an MD, although that's not the top priority

3. It would be easier to get in (no MCAT stress)

4. Less stress than med school-- less intensive science courses, less volume of information, less competitive classmates, etc. I tend to get competitive and stress about my grades, even though I am a strong student, and this has lead me to unnecessary anxiety in the past

5. I feel like I would be taking a step backward in my career (clinically) to have to devote 2 years to studying/memorizing chem, orgo, physics when I am already able to work with patients, assess, have worked in a leadership position in an outpatient program where I directed treatment plans (not medication, but still)

I am wondering if anyone has advice/thoughts.. I know I obviously have to make my own decision, but I wanted to solicit feedback from the experienced and accomplished folks in here who have been (or are) in a similar position.


Thanks in advance--

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Looking for personalized advice- NP vs MD (I know it's been done before...)
I know this may seem like it is beating a (very) dead horse, but I am looking for advice for my personal/unique situation..


I am an RN in my late 20s who has practiced only in mental health, in various settings (inpatient, outpatient). I recently took a position working as a psych case manager in a well known teaching hospital w/a teaching service comprised mainly of residents and fellows, and this has renewed my "MD envy" and interest in going back to med school/getting an advanced degree.

I started out pre-med, took a year off due to medical illness, and transferred to a local community college, where I obtained my ADN/RN. I didn't enjoy med/surg clinicals and for many reasons was disenchanted with my nursing program (and nursing as I saw it in the community hospitals I rotated through), so I applied to transfer to a 4-year school and entered with a major in biology the fall after finishing nursing school. I ended up working during winter break as a psych nurse, switching my major to psychology, graduating with a BA in psych, and taking a full time psych nursing job after graduation; this is what I've been doing since.

Trust me, this is an abbreviated version...


This summer I started working at a large teaching hospital w/a teaching service/group of psychiatry fellows and residents, and have started to think about med school again. I have also thought about NP school (as it would be cheaper, an easier transition, and require a lot less courses-- I have taken some of the prereqs for med school but most are at least 5 yrs old and I haven't taken physics or orgo, which I would enjoy the least), but have been thinking of med school for a few reasons:

1. I like the idea of the deeper & broader training that med students get through med school & residency. I am leaning towards psychiatry (that's another discussion, as I'm not 100% sure...) and feel that my lack of background in med surg would put me at a disadvantage as an NP, as psych pts are so medically complex these days. With med school, I'd get a solid background in basic medicine. Also there is more clinical training through residency, as NP residencies aren't widely offered.

2. Med school allows for rotations-- I have always wanted to work in the ED and am not 100% sure I want to do psych forever (vs. medicine or ED) so this would give me a chance to rotate through all specialties

3. An MD opens more doors in the sense of positions of authority at teaching hospitals, like the one I am at.

4. There is more "prestige" associated with the MD and I have always wanted some of that, although I don't like to admit it..

5. Although I like the holistic part of the nursing model, I really didn't enjoy the nursing theory portions of nursing school and felt like a lot of it was fluff -- I don't want to take out loans and spend 2 years doing NP school to be frustrated & dissatisfied w/my education (this is what happened after my experience at community college)

6. I hear a lot about NPs not making any more than RNs despite more education, which is disheartening



There are also a lot of reasons why an NP would make more sense:


1. It would build on my RN degree and would not require a crazy amount of hard science prereqs that I would not enjoy

2. It is generally a shorter, less expensive route, and I'd be more likely to get scholarships -- I am ~$30k in debt from undergrad , along w/some credit card debt. Avg. med school debt is ~200k PLUS I would have to take ~2yrs of prereqs, which would put me *another* $25-50k in debt if I went to a post bacc program with a solid advising/linkage program... I would make more $$ In the long run with an MD, although that's not the top priority

3. It would be easier to get in (no MCAT stress)

4. Less stress than med school-- less intensive science courses, less volume of information, less competitive classmates, etc. I tend to get competitive and stress about my grades, even though I am a strong student, and this has lead me to unnecessary anxiety in the past

5. I feel like I would be taking a step backward in my career (clinically) to have to devote 2 years to studying/memorizing chem, orgo, physics when I am already able to work with patients, assess, have worked in a leadership position in an outpatient program where I directed treatment plans (not medication, but still)

I am wondering if anyone has advice/thoughts.. I know I obviously have to make my own decision, but I wanted to solicit feedback from the experienced and accomplished folks in here who have been (or are) in a similar position.


Thanks in advance--

Sounds like all the pros of the NP are shorter term, and the pros of MD/DO are longer term or permanent. Is the lack of standing/status/prestige, lower pay, less authority and understanding of medical problems/conditions, less exposure to various specialties worth the lower debt and quicker path to becoming an NP? How much do you look at doctors now and think "that could have been/should be me" right now? Do you think that will go away if you choose the NP path, or do you think you will be here saying "I am an NP in my mid thirties dissatisfied with my scope of practice, is it too late to pursue med school at this point?"

Obviously, I am biased toward becoming a doctor, but you don't seem to have any really compelling reasons to choose the NP path over the MD path, and some of the motivation you have to become an MD/DO seems to be the type of things that will keep you from ever being satisfied with the "lesser" degree. On the other hand, given the ACA and the stagnant number of residency slots, NP scope of practice is only going to increase, at least for the short term. I guess you just have to ask yourself how much this "step backward" will bother you, vs how much NOT being a doctor will bother you. For me, I would take a temporary setback for a long term gain every time, but it is obviously your choice. :luck:
 
sounds like all the pros of the np are shorter term, and the pros of md/do are longer term or permanent. Is the lack of standing/status/prestige, lower pay, less authority and understanding of medical problems/conditions, less exposure to various specialties worth the lower debt and quicker path to becoming an np? How much do you look at doctors now and think "that could have been/should be me" right now? Do you think that will go away if you choose the np path, or do you think you will be here saying "i am an np in my mid thirties dissatisfied with my scope of practice, is it too late to pursue med school at this point?"

obviously, i am biased toward becoming a doctor, but you don't seem to have any really compelling reasons to choose the np path over the md path, and some of the motivation you have to become an md/do seems to be the type of things that will keep you from ever being satisfied with the "lesser" degree. On the other hand, given the aca and the stagnant number of residency slots, np scope of practice is only going to increase, at least for the short term. I guess you just have to ask yourself how much this "step backward" will bother you, vs how much not being a doctor will bother you. For me, i would take a temporary setback for a long term gain every time, but it is obviously your choice. :luck:

+1
 
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would not require a crazy amount of hard science prereqs that I would not enjoy

So I completely get this . . . there are times when I remember the days of 4.0, no studying, easy poli-sci/philosophy/history and later nursing classes. The sciences are like a foreign language to me sometimes. I work hard for my A minuses and am incredibly overwhelmed with envy of those bell curve breaking prodigies (whomever they may be) in my science classes. So one day I'm whining about how I can get a 3.7 in sciences, but it's like going to school in a foreign university where all the classes are in a non-native tongue and one of the doctors at work said, very briskly "So what do you think you are doing trying to go to medical school? What do you think medicine is?"

There are certainly many other components, but we have to recognize that the education, and the career, is a hands on managment of daily scientific issues taking place in human lives.

And so I decided to change my attitude about the sciences and decided I would enjoy them, enjoy learning them, enjoy grasping the nuances and the application of them, or I would go back to nursing and just concentrate on the less scientifically rigorous patient care aspects.

Good luck with your choice.
 
If you want to do em do pa, not np, as pa's have most of the market in emergency medicine and are the "non-physician provider of choice in emergency medicine" per the american college of emergency physicians.
if you want to do psych defitely go np as they own that market. if you are unsure of your future specialty, pa is a better background as it provides rotations in multiple specialties while np tends to focus on one specialty area.
good luck whatever you decide.
 
If you want to do em do pa, not np, as pa's have most of the market in emergency medicine and are the "non-physician provider of choice in emergency medicine" per the american college of emergency physicians.
if you want to do psych defitely go np as they own that market. if you are unsure of your future specialty, pa is a better background as it provides rotations in multiple specialties while np tends to focus on one specialty area.
good luck whatever you decide.

What does that mean? Honest question.
 
What does that mean? Honest question.

The vast majority of "midlevel" positions in em are looking for/advertising for pa's.
there are probably 10 pa positions in em for every np position out there. the reverse is true looking at psych/ob/peds.
 
I'm going to argue in favor of doing the NP. First off, spending all that extra time and money to get an MD just because of a little misplaced prestige envy when you can accomplish your career goals with an NP is foolish. Being a physician is not nearly as prestigious as many premeds think it is. Second, you didn't take into account that you'd have to do a minimum three years of residency after medical school, which you would not have to do as an NP, and which greatly adds to your debt burden and time requirements. Third, I'd argue that you greatly overestimate both the authority/autonomy of physicians, and the extent of the IM training of most psychiatrists. Yes, there are some who do IM/psych combined residencies, but a psychiatry residency is geared toward preparing people to practice as psychiatrists, not as combined psychiatrist-internists. With as specialized as medicine has become, most psychiatrists will transfer medically complex patients to medical services, or at least consult a hospitalist to help them manage those patients. Fourth, you greatly overestimate how much what you learn in medical school prepares you for practice. There's a reason why medical school is considered to be an "undergraduate" education by the ACGME; you don't really start learning how to practice medicine until you're a resident.

Finally, there is the personal toll of medical training. It can stress yourself and your relationships with loved ones tremendously, sometimes to the point of breaking. Be very, very sure that your perceived notions of greater prestige are really going to be worth the extra sacrifices you're going to have to make, because there ain't no easy exits off this highway once you're a few years in and you already have six figure debt.
 
I've considered and (mostly) dismissed NP. But, my reasons for medicine are very different. I don't care about the money or the prestige. Regarding money, I already make a lot (probably more than quite a few family docs here in CA). Regarding prestige, I think most pre-meds overestimate the degree of prestige being a doctor carries.

I wrote off NP, b/c I'd like to learn medicine to the greatest degree possible (I know between medical school and a residency, I'll understand both the science background and learn to practice). I think I'd get less science in an NP program.

While I have a gf (who happens to be a resident), I'm not too worried about rushing to have a family or balancing work-life. I'm going all in so to speak and am ready to dedicate my life to medicine. I'm actually looking forward to it.

I've embraced the pre-med requirements. Yes, I feel that I could have gotten to see patients quicker in many other paths. But, I'm in it for the long haul. I understand there is a wedding out process. I understand that I need to do well on the MCAT (my practice tests thus far have been embarrassingly low, but they'll get better). I kind of like this. The MCAT and pre-med classes exist to HELP pre-med students.

I can't really speak to the debt. I plan to pay for half of it out of pocket from savings, and take loans for the other half. I'd imagine as an RN you can save up at least a years worth of tuition in a year or two to make you feel more comfortable (each person has their own circumstances and threshold for debt).

I'm not advising you one way or the other. I know for me, I'd always feel what if, if I went the NP route. I think it's right for some, but will you live to wish you had done more?
 
OP - I'm someone who chose to go the NP route (I'm doing psych, so PA wasn't really much of a consideration), and I am really happy I decided to go this way. I do not envy docs at all, but that's a personal consideration. I am very excited about my job prospects, scope of practice, ability to start working faster, etc. One important thing to note is that if you do decide to go the NP route, get into the best school you can (one with a solid reputation at a true university, affiliated or part of a larger medical institution, etc.) since NP training is not nearly as uniform as PA training or medical training.
 
Honestly, Q's response is pretty straightforward, and there's no fluff there. It's pragmatic and true--I say this only from what I have seen as a RN of many years in critical care. So, no, I am at this time neither a med student nor resident physician.

What compells me to go physician over NP is, well, a genuine interest in medicine. This has always been a sticking point for me in nursing, and there can be a lot of medicine to think on--or at least someone is talking about it around you in terms of the patient/s and requiring you to somehow be involved in it to some degree--well, you'd have to be deaf, ditsy, or completely uncaring about it to miss the great medical considerations in critical care nursing. What I mean is that it's hard to avoid the medical thinking processes in this area of nursing and how many things fit or don't fit in the puzzle-- that is, the mystery solving angles and the need to constantly balance and find the right "recipe" for the particular critical care patient at any particular moment, which can change dramatically from seconds to minutes to hours to days. So then you get interested and want to know and explore more, only to have to be pulled away by other nursing things. Nursing must interface with so many disciplines and involves a lot of making others happy in order to get what the patient/s need and to keep nursing administration happy. Yes some of that kind of juggling goes on in medicine too--probably more than most docs would like, but, in general, it is still pretty much from a medicine-focused approach.

Also, looking down the road, my long-term goals are different in terms of the population of patients I want to serve. This will require a good deal of autonomy, b/c I'm looking at more remote populations.

Time will tell, but I think the decision has to be made based on your overall interest in the medical sciences, medical practice, and your long-term goals.

For one thing, I am not at the point where I am just starting a family. That is a serious issue in my view. Yes, people can do med school and residency as well as start a family, but having and raising children can be hard, and, at least in my view, requires a lot of devotion and attention w/o med school or residency. So, I'm at a different place in my life, and I am approaching a sense of greater freedom in terms of children and some satisfaction that I was pretty much there a lot to do a better than decent job at parenting and guiding my children, as compared with just starting out and taking on the heavy load of medical school and onward. Right now, my biggest issue will be how well my spouse will deal with any acceptances that may come, which may be out of our general area.

To me, medical school, especially as a non-trad, is so personal in terms of where you are in your life and what your long-term goals are. Also, I truly believe you have to have a love for learning science and medicine. Without that love and curiosity, even through the massive amount of things that require more rote memorization, etc, it's going to be tortuous. So many people that I have talked with that are in or have been through medical school have felt that there was little to like about medical school. It's amazing how many have encountered depression and frustration, even through residency. Seems like for a number of folks, however, when they get to the latter end of residency and/or fellowship, it gets better for them.

These kinds of questions are just so tough to answer, b/c choosing medicine requires a ton of inner questioning and searching and weighing of factors that greatly impact one's personal life or goals. Also, the financial burden cannot be ignored, and neither can anyone ignore the great many changes that have occurred and are forcoming in healthcare. It's all really a lot to consider.
 
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Arrgh, I had written a long response and then SDN ate it... Anyway, the short version is that PMHNP is one of the best (including best-paid!) areas of advanced practice nursing, you have a lot of autonomy, you can surely find an MSN program with minimal fluff, and the prestige issue will probably fade as you start your 9-5, six-figure job seeing patients independently, as your would-be colleagues who started medical school at the time you would have are toiling away, sleepless, broke, and miserable. (And if you find that you really want to be called Dr., you can get a DNP, or I guess possibly a PsyD if you feel like it.)

Also, QofQuimica tends to give really good advice, so after reading this, you should scroll back up and read her/his post again.

Zelia, this is very true. Being a PMHNP seems to be a pretty fantastic gig, from my research. If I wasn't doing PMHNP I very well would have pursued MD/DO (or maybe PA) instead.
 
Sounds like all the pros of the NP are shorter term, and the pros of MD/DO are longer term or permanent. Is the lack of standing/status/prestige, lower pay, less authority and understanding of medical problems/conditions, less exposure to various specialties worth the lower debt and quicker path to becoming an NP? How much do you look at doctors now and think "that could have been/should be me" right now? Do you think that will go away if you choose the NP path, or do you think you will be here saying "I am an NP in my mid thirties dissatisfied with my scope of practice, is it too late to pursue med school at this point?"

Obviously, I am biased toward becoming a doctor, but you don't seem to have any really compelling reasons to choose the NP path over the MD path, and some of the motivation you have to become an MD/DO seems to be the type of things that will keep you from ever being satisfied with the "lesser" degree. On the other hand, given the ACA and the stagnant number of residency slots, NP scope of practice is only going to increase, at least for the short term. I guess you just have to ask yourself how much this "step backward" will bother you, vs how much NOT being a doctor will bother you. For me, I would take a temporary setback for a long term gain every time, but it is obviously your choice. :luck:

:thumbup::thumbup::thumbup:

Your in your late 20's right? So you have to do some hard sciences, and mcat prep, and 4 years of med school, and lets say 3 years residency. So you are looking at close to 9 or 10 years to complete your physician training, which would put you into your late 30s by the time your done.

So imagine yourself working as an NP for the next decade. When you are in your late 30s, will you wish you went the MD/DO route?
 
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So imagine yourself working as an NP for the next decade. When you are in your late 30s, will you wish you went the MD/DO route?
It's disingenuously easy to say something like that. "Oh, I could have been a doctor by now." As if you just have to wait around and eventually you become a doctor. QofQuimica hit it on the head, and I could have picked out her post as the only one by a resident in this thread without even knowing it was her. This road is hard, and it takes a really, really long time. I joined this forum 8 years ago, when I was already two years into pre-med, and I've got another 2-3 years before I finish residency/fellowship.

If you're going to ask yourself "Should I have gone the MD route?" when you're 38, make sure you ask yourself "Do I really feel like being the junior resident on call when I'm 36?" and "Do I want to be 47 years old before my student loans are paid off, and I can start putting a meaningful amount of money toward retirement?"

I work with someone who went the NP route....and then went on to go to med school after that. I admire the resolve, but know that it takes a serious toll. I look forward to the day when I can be done with the endless number of steps and hoops to get there.
 
It's disingenuously easy to say something like that. "Oh, I could have been a doctor by now." As if you just have to wait around and eventually you become a doctor. QofQuimica hit it on the head, and I could have picked out her post as the only one by a resident in this thread without even knowing it was her. This road is hard, and it takes a really, really long time. I joined this forum 8 years ago, when I was already two years into pre-med, and I've got another 2-3 years before I finish residency/fellowship.

If you're going to ask yourself "Should I have gone the MD route?" when you're 38, make sure you ask yourself "Do I really feel like being the junior resident on call when I'm 36?" and "Do I want to be 47 years old before my student loans are paid off, and I can start putting a meaningful amount of money toward retirement?"

I work with someone who went the NP route....and then went on to go to med school after that. I admire the resolve, but know that it takes a serious toll. I look forward to the day when I can be done with the endless number of steps and hoops to get there.

It's not disingenuous. It's a legitimate question. I can choose A or B. If I choose A and not B, will I wish I chose B? I wasn't implying that you can just wait around and become a physician. I apologize for the misunderstanding.
 
I was an NP and went back to school for my MD because I felt limited by my degree because of the field I was in (ortho). I helped my patients for weeks/months and if they could not find relief, I handed them off to a surgeon at our practice. I didn't like handing them off to someone else after building a relationship with them.

I don't know if that would be the case with psych as an NP. Would you feel limited in your care for the patients? It seems to me that aside from consulting a doctor yourself, you would be able to care for your patients all along the spectrum of care (in most cases).

I liked being an NP and if it were not for that one little thing, I would still be one. It was actually a pretty sweet gig.
 
I was an NP and went back to school for my MD because I felt limited by my degree because of the field I was in (ortho). I helped my patients for weeks/months and if they could not find relief, I handed them off to a surgeon at our practice. I didn't like handing them off to someone else after building a relationship with them.

I don't know if that would be the case with psych as an NP. Would you feel limited in your care for the patients? It seems to me that aside from consulting a doctor yourself, you would be able to care for your patients all along the spectrum of care (in most cases).

I liked being an NP and if it were not for that one little thing, I would still be one. It was actually a pretty sweet gig.

As far as I can tell, the psych NPs that I knew functioned just like the psychiatrists. There weren't limitations in the field that NPs faced, other than doing ECT, I suppose. Granted, this was in an independent practice state.

To the OP - I think the whole issue is quite complicated and depends on your specific career goals, specialty, age, priorities in life, etc. I don't really think there's a wrong approach, since the need for docs, PAs, and NPs is only going to increase in the future. Good luck with your decision!
 
It's disingenuously easy to say something like that. "Oh, I could have been a doctor by now." As if you just have to wait around and eventually you become a doctor. QofQuimica hit it on the head, and I could have picked out her post as the only one by a resident in this thread without even knowing it was her. This road is hard, and it takes a really, really long time. I joined this forum 8 years ago, when I was already two years into pre-med, and I've got another 2-3 years before I finish residency/fellowship.

If you're going to ask yourself "Should I have gone the MD route?" when you're 38, make sure you ask yourself "Do I really feel like being the junior resident on call when I'm 36?" and "Do I want to be 47 years old before my student loans are paid off, and I can start putting a meaningful amount of money toward retirement?"

I work with someone who went the NP route....and then went on to go to med school after that. I admire the resolve, but know that it takes a serious toll. I look forward to the day when I can be done with the endless number of steps and hoops to get there.


You're almost done with that part of jumping hoops. There's a light at the end of the tunnel, even if the future of medicine looks dubious in many ways right now. Congratulations to you, and hang in there.
 
It's not disingenuous. It's a legitimate question. I can choose A or B. If I choose A and not B, will I wish I chose B? I wasn't implying that you can just wait around and become a physician. I apologize for the misunderstanding.
His point though is that you really can't go back and play that "what if" game, because life isn't a controlled experiment. All you can do at each stage in your life is make the decision that seems most reasonable/logical at that time. You can't have the benefit of hindsight, and you can't redo the decision and watch your life play out in some other direction if you decide later that you made the wrong decision. You get to make one choice at each fork in the road, and then you have to keep going forward no matter what. You'll never know what would have happened had you picked the other option. And there are a lot more possibilities out there besides being an NP who wishes s/he were an MD. You might become an NP and be very happy, and still, who knows if you'd have been even happier had you been an MD? Or conversely, if you did an MD and were miserable, would you be lamenting that you didn't stick to the NP when you already had it so good? There are plenty of days when I regret having quit chemistry, but who knows how I'd be feeling right now had I been working as a chemist for the past six years? What I can tell you for sure is that I would *not* be happy if I had to spend the rest of my career as a resident. :hungover:

Personally, I don't think the OP has a good reason for pursuing an MD. If you look through his/her reasons for getting an MD, it comes down to some combination of desire for prestige and a mistaken understanding about what it's like to be a physician. Whereas, s/he has a very short road to becoming an NP with very few disadvantages and most of the same benefits that s/he hopes to gain by becoming an MD. As far as I'm concerned, it's a no-brainer.
 
His point though is that you really can't go back and play that "what if" game, because life isn't a controlled experiment. All you can do at each stage in your life is make the decision that seems most reasonable/logical at that time. You can't have the benefit of hindsight, and you can't redo the decision and watch your life play out in some other direction if you decide later that you made the wrong decision. You get to make one choice at each fork in the road, and then you have to keep going forward no matter what. You'll never know what would have happened had you picked the other option. And there are a lot more possibilities out there besides being an NP who wishes s/he were an MD. You might become an NP and be very happy, and still, who knows if you'd have been even happier had you been an MD? Or conversely, if you did an MD and were miserable, would you be lamenting that you didn't stick to the NP when you already had it so good? There are plenty of days when I regret having quit chemistry, but who knows how I'd be feeling right now had I been working as a chemist for the past six years? What I can tell you for sure is that I would *not* be happy if I had to spend the rest of my career as a resident. :hungover:

Personally, I don't think the OP has a good reason for pursuing an MD. If you look through his/her reasons for getting an MD, it comes down to some combination of desire for prestige and a mistaken understanding about what it's like to be a physician. Whereas, s/he has a very short road to becoming an NP with very few disadvantages and most of the same benefits that s/he hopes to gain by becoming an MD. As far as I'm concerned, it's a no-brainer.

It's still a question the OP has to answer and factor into her ultimate decision. Choosing NP and still having a lingering desire to be a physician can be psychologically burdensome. We have to make predictions about are future in spite of how inaccurate our forecasts are, and base our present day decisions on those predictions. It sucks, but that's the way it is.

I didn't get the impression that prestige was a huge factor in her considerations for pursuing an MD. She mentioned it, and also mentioned that she doesn't like to admit it. This was for the sake of full disclosure.

I'm also not convinced that she should rule out MD because of her expressed interest in clinical rotations and medicine in general. She said she wasn't 100% committed to psychiatry. She also mentioned that the reasons she listed were not exhaustive, so there's more to these competing paths than what is presented here.

I'm not trying to be disrespectful or challenge the knowledge and wisdom of any of the residents that have commented on this board. I have to say that because I think your stickies rock :love:

I just believe that in spite of the imperfect fact set she can present herself with, she still has to determine for herself whether she'd be happier in the long run as an NP or as a physician, and that determination still has to be based on her crappy fact set.
 
It's still a question the OP has to answer and factor into her ultimate decision. Choosing NP and still having a lingering desire to be a physician can be psychologically burdensome. We have to make predictions about are future in spite of how inaccurate our forecasts are, and base our present day decisions on those predictions. It sucks, but that's the way it is.

I didn't get the impression that prestige was a huge factor in her considerations for pursuing an MD. She mentioned it, and also mentioned that she doesn't like to admit it. This was for the sake of full disclosure.

I'm also not convinced that she should rule out MD because of her expressed interest in clinical rotations and medicine in general. She said she wasn't 100% committed to psychiatry. She also mentioned that the reasons she listed were not exhaustive, so there's more to these competing paths than what is presented here.

I'm not trying to be disrespectful or challenge the knowledge and wisdom of any of the residents that have commented on this board. I have to say that because I think your stickies rock :love:

I just believe that in spite of the imperfect fact set she can present herself with, she still has to determine for herself whether she'd be happier in the long run as an NP or as a physician, and that determination still has to be based on her crappy fact set.
I don't presume to make decisions for other people; it's hard enough making them for myself. However, I also don't subscribe to the idea that if someone asks my opinion, I shouldn't give it to them (and sometimes even when they don't ask, if I think they're doing something especially foolish). I tell patients/families what I think they should do every day; I have more specialized medical knowledge than they do, and that's part of my job. Ditto for the OP, as again, I am coming from a position of more specialized experience and s/he asked. But I don't at all take it personally if people decide not to take my advice. I also don't take it personally if premeds disagree with me. I think the OP is wrong, and I think you're wrong, but there's no law against that. And if you reach your residency and you still think you're right, and if you're still around on SDN, feel free to come back and debate about it some more. Of course, I'll be an attending then and still outrank you, so.....:D

That being said, you are correct that this forum's stickies are by far the most superior on SDN, and anyone who says otherwise is very wrong. :p
 
I don't presume to make decisions for other people; it's hard enough making them for myself. However, I also don't subscribe to the idea that if someone asks my opinion, I shouldn't give it to them (and sometimes even when they don't ask, if I think they're doing something especially foolish). I tell patients/families what I think they should do every day; I have more specialized medical knowledge than they do, and that's part of my job. Ditto for the OP, as again, I am coming from a position of more specialized experience and s/he asked. But I don't at all take it personally if people decide not to take my advice. I also don't take it personally if premeds disagree with me. I think the OP is wrong, and I think you're wrong, but there's no law against that. And if you reach your residency and you still think you're right, and if you're still around on SDN, feel free to come back and debate about it some more. Of course, I'll be an attending then and still outrank you, so.....:D

That being said, you are correct that this forum's stickies are by far the most superior on SDN, and anyone who says otherwise is very wrong. :p

I'll drink to this

:p
 
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His point though is that you really can't go back and play that "what if" game, because life isn't a controlled experiment. All you can do at each stage in your life is make the decision that seems most reasonable/logical at that time. You can't have the benefit of hindsight, and you can't redo the decision and watch your life play out in some other direction if you decide later that you made the wrong decision. You get to make one choice at each fork in the road, and then you have to keep going forward no matter what. You'll never know what would have happened had you picked the other option. And there are a lot more possibilities out there besides being an NP who wishes s/he were an MD. You might become an NP and be very happy, and still, who knows if you'd have been even happier had you been an MD? Or conversely, if you did an MD and were miserable, would you be lamenting that you didn't stick to the NP when you already had it so good? There are plenty of days when I regret having quit chemistry, but who knows how I'd be feeling right now had I been working as a chemist for the past six years? What I can tell you for sure is that I would *not* be happy if I had to spend the rest of my career as a resident. :hungover:

Personally, I don't think the OP has a good reason for pursuing an MD. If you look through his/her reasons for getting an MD, it comes down to some combination of desire for prestige and a mistaken understanding about what it's like to be a physician. Whereas, s/he has a very short road to becoming an NP with very few disadvantages and most of the same benefits that s/he hopes to gain by becoming an MD. As far as I'm concerned, it's a no-brainer.

I agree with Q. It's a no-brainer. It makes no sense to give up 10+ years to start from scratch when you can build on a previous degree in many fewer years and reach an almost equivalent place. It seems your reasons to pursue MD are impractical and a bit superficial (at least you are admitting them tho). It might be time to sit and have an honest conversation with yourself about what you really want and what is truly important to you. To me it seems that you regret not having pursued medicine before and are trying to remake your choice now. You have dedicated a lot of time, energy and money and to start over doesn't really make sense, when you are doing something so similar. People change to medicine later in life, but it's usually from something like law or business, which are very different.

If you NEED an MD to do what you want to do, and it's worth it to spend 10+ MORE years doing it, then that is the right choice. If you really feel you will not be satisfied in your life without the training and more in-depth science background, it might be the right choice. Other than that, the reasons you give above are not going to be enough motivation to get you through 10 years.
 
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