Transgender Health-Care Goals - NP or MD/DO Route?

[RavenHealer]

Hi all! Trying to figure out which path to walk to get to where I want to go. I guess I wanted secondary opinions on a public forum just to see if anyone has additional opinions/thoughts/resources. I appreciate ANY feedback - so let it rip!

[GOALS] I’m a 22 year old trans-woman. My interest lies in LGBTQ health – particularly with transgender/queer populations. My –dream- would be to practice at a queer center offering primary care and hormone replacement therapy. Additionally, I’d like to consult with hospitals and clinicians about how to provide better care for transgender patients (making hospital stays more comfortable/less stressful; ensuring WPATH is implemented well). Finally, I’d love to research long-term life-cycles of the LGTBQ population and health monitoring.

[WHERE IM AT NOW] Currently I have completed B.S. lower-level requirements. I’m in a position to graduate within two years with a Bachelors of Science in General Science with a minor in Queer Studies. I own a business which provides me with a stable income. I have no kids, no spouses, etc. I’d like to stay in my current city for a couple more years – mainly because of the financial stability that my business is providing me.

I’ve got a GPA of around 3.0. I know I’ll need to ace all of my science classes; last time I was in school I began transitioning so I definitely wasn’t able to concentrate on academics/starting a business.

[WHERE TO GO] I’m thinking with my goals I would want to end up as a nurse practitioner or a physician. I’m leaning more towards the NP route because nursing seems to be more person-centric than disease-centric. Especially with transgender healthcare, I feel like the social/emotional needs of a patient kind of end up being more important than the ‘disease-process’ of gender-dysphoria (esp. since disease process sounds really weird in this context). I live in a state where I would be able to practice independently as an NP. On the other hand, I’ve always dreamed/desired to go to medical school and this may logistically be a more sound option – and eventually financially more viable. I don’t feel like I’d want to pursue the PA route because I want the autonomy to run my own practice as I see fit.

[TIME-LINES]

Nursing: Earliest to start nursing school would be Fall 2017. I would Graduate Summer 2019 with an RN, and probably receive my bachelors within a year after that by 2020. I’d have a BSN at 27 years old and start practicing nursing. Then start working/going to school to become a nurse practitioner – maybe take a year or two to work and save money, start practitioner school and probably end up practicing as a NP by 2023/2024/2025.

Medicine: I’d finish my pre-requisites and take the MCAT Spring 2017. Apply to medical school Fall 2017, graduate with a BS in Spring 2018 and (fingers crossed) attend Medical school Fall 2019. I’d graduate medical school by Spring 2023 at the age of 30.

[CONCERNS] Working with a specific community might not be lucrative. Medical school would be way more expensive and I wouldn’t be able to work during that time – whereas I might be able to hold down nursing and NP school. I feel like I’m mostly interested in primary care. I guess I just have second-guesses because it would take me longer to go the nursing route, and I could learn more about how to treat patients by receiving an MD. Idk! Seems like NP might be less stressful and more balanced of a route than MD... And I'm kind of leaning towards the NP route through writing this post.

What are your thoughts on my situation? Any words of advice/questions that might help me figure out what I want? Thank you for reading <3

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[Goro]

Stay away from LUCOM, and if you live in GA, avoid MCG. My pal Aero can fill you in on the latter.

NP or MD/DO? Follow your heart.

Hi all! Trying to figure out which path to walk to get to where I want to go. I guess I wanted secondary opinions on a public forum just to see if anyone has additional opinions/thoughts/resources. I appreciate ANY feedback - so let it rip!

[GOALS] I’m a 22 year old trans-woman. My interest lies in LGBTQ health – particularly with transgender/queer populations. My –dream- would be to practice at a queer center offering primary care and hormone replacement therapy. Additionally, I’d like to consult with hospitals and clinicians about how to provide better care for transgender patients (making hospital stays more comfortable/less stressful; ensuring WPATH is implemented well). Finally, I’d love to research long-term life-cycles of the LGTBQ population and health monitoring.

[WHERE IM AT NOW] Currently I have completed B.S. lower-level requirements. I’m in a position to graduate within two years with a Bachelors of Science in General Science with a minor in Queer Studies. I own a business which provides me with a stable income. I have no kids, no spouses, etc. I’d like to stay in my current city for a couple more years – mainly because of the financial stability that my business is providing me.

I’ve got a GPA of around 3.0. I know I’ll need to ace all of my science classes; last time I was in school I began transitioning so I definitely wasn’t able to concentrate on academics/starting a business.

[WHERE TO GO] I’m thinking with my goals I would want to end up as a nurse practitioner or a physician. I’m leaning more towards the NP route because nursing seems to be more person-centric than disease-centric. Especially with transgender healthcare, I feel like the social/emotional needs of a patient kind of end up being more important than the ‘disease-process’ of gender-dysphoria (esp. since disease process sounds really weird in this context). I live in a state where I would be able to practice independently as an NP. On the other hand, I’ve always dreamed/desired to go to medical school and this may logistically be a more sound option – and eventually financially more viable. I don’t feel like I’d want to pursue the PA route because I want the autonomy to run my own practice as I see fit.

[TIME-LINES]

Nursing: Earliest to start nursing school would be Fall 2017. I would Graduate Summer 2019 with an RN, and probably receive my bachelors within a year after that by 2020. I’d have a BSN at 27 years old and start practicing nursing. Then start working/going to school to become a nurse practitioner – maybe take a year or two to work and save money, start practitioner school and probably end up practicing as a NP by 2023/2024/2025.

Medicine: I’d finish my pre-requisites and take the MCAT Spring 2017. Apply to medical school Fall 2017, graduate with a BS in Spring 2018 and (fingers crossed) attend Medical school Fall 2019. I’d graduate medical school by Spring 2023 at the age of 30.

[CONCERNS] Working with a specific community might not be lucrative. Medical school would be way more expensive and I wouldn’t be able to work during that time – whereas I might be able to hold down nursing and NP school. I feel like I’m mostly interested in primary care. I guess I just have second-guesses because it would take me longer to go the nursing route, and I could learn more about how to treat patients by receiving an MD. Idk! Seems like NP might be less stressful and more balanced of a route than MD... And I'm kind of leaning towards the NP route through writing this post.

What are your thoughts on my situation? Any words of advice/questions that might help me figure out what I want? Thank you for reading <3

 

[familyaerospace]

Either one would be helpful. I think it depends on what your goals are and how much direct responsibility you want. You might also want to consider an MPH regardless.

I would say also in general just be careful about who you are out to. Don't be out if you can help it especially not in the south. MCG is a good spot to learn about LGBT health provided you are not out as trans yourself. One specific person really hates it because I think she thinks I am challenging her and has been making my life a living hell. My classmates are ok. Most (all?) faculty are ok. One staff member. One. That is all I have to say because l-rd knows she is probably on SDN watching me or something.

 

[LizzyM]

Your academic record is going to dictate which paths remain open to you after you've completed your coursework. You do need to pick up the pace now if you are going to reach your desired goal, whatever that may be.

As with some other applicants who come in with a very specific interest, we are going to ask whether you are interested enough in what does not interest you do to well in all of the areas of medicine that you will be expected to learn.

 

[Krupke]

You should do what you want, but my vote would be NP. The best thing to do would be to ask yourself "why MD?" Is there something that you want to do that requires a MD or would your career be completely fulfilling as a NP?

It seems to me like you can accomplish all your goals as a NP + it is easy to finish a NP with very little debt if you go to a state school program.

Edit: And the nursing route won't be longer because you also have to do a residency if you go MD

 

[mvenus929]

I'd be cautious about the idea of setting up a clinic as an NP. Granted, my experience is limited, but I feel like in the states where NPs can practice independently, they are still employees of a larger organization, not running a practice themselves. Also, I think your interests are so specialized that if you went MD, you'd likely have to do a fellowship of some sort to do hormone therapy (and not be at higher risk of malpractice). That's generally outside the scope of a PCP. If you just want to do basic primary care, then by all means, go for the NP, but anything more advanced and your patients will be better served by the larger depth of an MD.

But that's just my $0.02

 

[Henry101]

wow. I actually have a similar goals as yours. I want to start a family practice that caters to gay male adolescents/young adults in Silver Lake/Castro/West Hollywood/Chelseaish area.
I had a similar dilemma my sophomore year in college and I am now applying to medical school. One of the main reasons, for me, was that I was really interested in pre-exposure prophylaxis and I knew I couldn't prescribe drugs as a nurse. I am also passionate about gay male health advocacy and knew I could have a larger audience and impact as a physician.

 

[Psai]

GPA of around 3.0 will preclude you from most medical schools, even with a great mcat. If you want to provide the best care for your patients, be a doctor. If you want to do high quality research that other people will take seriously, be a doctor. If you want a deep understanding of how the hormones actually work to change human physiology, be a doctor.

Getting into nursing school is easy. Getting into np school is easy. Working as an RN while in np school is easy. It's faster and cheaper. "Person-centric" is a load of crock. It's used as an excuse for people who don't know as much about physiology and pathology by pretending that they have other strengths which don't actually exist.

 

[TBV]

"Person-centric" what a ton of BS quit drinking the cool aid and put down the nursing propaganda. What they mean to say is "poorer training".

 

[hiphopcrates]

Hey! I'm a 27 year old trans guy who returned to school to finish my prerequisites and just (finally!) got into medical school.

It is a long, hard road - but, to be honest, I believe you'd have more impact as an MD. Do you like school? Are you willing to buckle down and sacrifice a lot for academic success? If the answer is 'yes,' your best bet might be to complete a special post-bacc program at a school with direct linkage or strong affiliations to a medical school.

I would also like to mirror what @LizzyM said: it is unlikely that you will only have trans people as a patient population, and important (for your own happiness, really) that you enjoy aspects of medicine 'as a whole.' That being said, just being a trans woman in a medical field is going to increase our visibility, advocacy, and collective clout. I'm rooting for you. Best of luck.

 

[Lawpy]

Stay away from LUCOM

Staying away from LUCOM is the default answer for anyone applying but i understood the context and emphasis

 

[occams_razor]

IMO your patients will be better served having their HRT managed by someone with the background and training provided by a MD/DO degree than NP.

you said you will be 30 by the time you graduate med school if all goes as planned - that's still young. MD/DO training is tougher and more stressful than nursing - can't argue that. and yes, med school will be more expensive, but you will also earn more as an MD/DO than NP, even if you go into a non-lucrative specialty.

 

[Annabell Lee]

As someone who has considered NP before, I think there are serious issues you have to consider with that route considering scope of practice as well as training. I don't think there is any form of NP training that would let you do what you discussed. Even if you could, once you graduated you wouldn't be able to move without considering the changes in your scope of practice.

I'm going to have to jump in on the band wagon with the "person centric" thing too. There is nothing stopping you from being a person centric MD or DO. There are NPs who are person centric and those who are not. That has way more to do with who you are as a person and what you choose to focus on than it does with your training.

You need to work on you GPA which you already acknowledged. You should also work on ECs and making yourself a better candidate all around. A specific reason for wanting to be a doctor is great, but like LizzyM said, don't be too specific. Maybe get some clinical experience o you can earnestly discuss what you find compelling about the practice of medicine outside of the specific specialty you have in mind.