Was planning for BSN, but my grades this semester make me think pre-med?

[priorities2]

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Hi all. I'm a sophomore in college who was planning to go the BSN -> PMHNP route. I'm now not sure if I want PMHNP or pre-med/psychiatry.

There are three gen chem courses at my univ -- "Chem 1000," which is the prenursing req, and then beyond that gen chem 1 + 2, which are needed for med school admissions. There's also one bio course that is needed as the first intro for both nursing and med school. I got an A in both Chem 1000 and an A that first intro bio course this semester. I was expecting much lower grades but it was curved up at the end of the term. I therefore got straight A's this semester, and have actually gotten straight A's since I started college (though I was taking almost all non-math/science classes). I also have some non-A's from dual-enrollment type courses I took in HS, so my transcript GPA is more like a 3.79 rather than a 4.0.

Anyways, now I'm in a really tough situation of deciding between PMHNP and pre-med school/psychiatry. Since I'm leaning toward BSN->PMHNP, I'll write out the pros and cons of this path. Any feedback would be SO appreciated. Thank you!

Pros of BSN/PMHNP route:
- If, while attaining my BSN, I decide that therapy/psych med management is not what I want to do, I'd have lots of other options. I could get an MBA and do something in healthcare business or go to law school (I have a lot of lawyers in my family).
- If I get into the nursing major and graduate on time with a BSN then go straight to the PMHNP program, I could literally be done with school by age 23 or 24. I could avoid the stress of med school.
- Seems like this is a less stressful route in general, both in schooling and career (correct me if I'm wrong). While I'm a hard-working, career-oriented individual, work-life balance is REALLY important to me, especially because I am prone to becoming very anxious.
- Makes good money, and would start making money earlier. I could probably graduate and start earning 70k+, maxing out at 95k-130k depending on where I work.
- Less expectation of being an expert in both medical and psychiatric realms. From what I've heard from people in the field, PMHNPs (esp in outpatient) pretty much just take care of psychiatric concerns, and while they will need to make sure meds don't interact with non-psych meds, they don't necessarily deal with other medical problems. Correct me if I'm wrong.
- Just seems more comfortable at this point - I've been planning on nursing school so it seems like an easier/more natural option.
- More certain than med school
- Lots of healthcare admin jobs look for people with RN backgrounds

Cons of BSN/PMHNP route:
- Less income and prestige than med school.
- Less respect from family members compared to med school. Like I said, I have a lot of lawyers/upper middle class folks in my fam who don't necessarily consider nursing to be a prestigious field. I don't care about this that much, and will likely care less as I get older, but it's still a concern.
- I might look back when I'm middle aged and say, why didn't I spend a few more years to become a doctor? I might wish I did have all that extra money for whatever reason.
- Perhaps less respect from patients as an NP than as an MD? I'm not entirely aware on this issue.
- Less autonomy for NPs (but in my state, the autonomy for NPs is very high)

 

[400292]

Nursing and physician are very different careers and fields. You cannot judge your aptitude for one or the other because you happened to pull an 'A' out of your butt (as you didn't expect it). It was curved, so you cannot tell how well these courses have challenged you, or whether you actually 'get it'. Physician work requires high affinity and understanding of complex human science. No one can be sure if you college taught anything well (in your case, probably not since your curve saved you...you didn't actually earn it).

This is what the MCAT is for. If you fail this test, then my words stand true.

But, beyond this, medical school requires higher entrance stats than nursing programs. You'll need the extracurricular shadowing, academics, letters of reference, MCAT score, volunteering, etc. etc. I'd be a waste of time/life to try to aggregate all of these items, only to find you bomb the MCAT or upper level bio/chem courses (aka you actually don't understand science).

You need to wait until (1) you take advanced courses, more pre-reqs, and (2) you take a bunch of practice MCATs

 

[priorities2]

Chorosz, thanks for your reply. I go to a state school in the top ~65 univ's in the U.S. according to USNews, if that clarifies what an A means at all. But I agree that those A's could be a fluke.

I guess it's just too bad because I need to take more nursing prereqs next sem (anat, microbio, phys) if I want any chance of starting the nursing major next fall - so I don't have time to try more pre-med reqs. I suppose I could audit Physics 1 or something...

 

[Barcu]

Chorosz, thanks for your reply. I go to a state school in the top ~65 univ's in the U.S. according to USNews, if that clarifies what an A means at all. But I agree that those A's could be a fluke.

I guess it's just too bad because I need to take more nursing prereqs next sem (anat, microbio, phys) if I want any chance of starting the nursing major next fall - so I don't have time to try more pre-med reqs. I suppose I could audit Physics 1 or something...

Those grades don't necessarily need to be a fluke. But I would caution about getting too excited about a bio class and a prereq to the actual prereqs (chem 1 and 2). You still have a long way to go.

You really need to make a decision about which path you want to pursue because once you start down one, it may be hard to switch back to another. Afraid that you won't succeed is a bad reason to rule out med school, but you haven't really shown that you understand what being a physician entails either (getting A's shouldn't be a reason to pursue med school either). I would suggest either shadowing a physician or getting more clinical experience before you decide to go down one path or another.

 

[priorities2]

Thank you both for your insight. I will try to shadow a psychiatrist ASAP. Psychiatry is also a field you can enter from D.O. school, correct? This is a more secure path than MD (the entrance standards are lower)?

I have shadowed a psychiatric nurse and interviewed another psych nurse as well as a psych NP, and spoken with various therapists about their careers. I'm pretty sure I want to go into mental health/counseling but not sure I want to stay in it forever.

I suppose I should also set up an appointment with my advisor.

If anyone has any similar stories of deciding between BSN vs pre-med, pleeeease share them. Thank you =)

 

[Eon]

Thank you both for your insight. I will try to shadow a psychiatrist ASAP. Psychiatry is also a field you can enter from D.O. school, correct? This is a more secure path than MD (the entrance standards are lower)?

I have shadowed a psychiatric nurse and interviewed another psych nurse as well as a psych NP, and spoken with various therapists about their careers. I'm pretty sure I want to go into mental health/counseling but not sure I want to stay in it forever.

I suppose I should also set up an appointment with my advisor.

If anyone has any similar stories of deciding between BSN vs pre-med, pleeeease share them. Thank you =)

It seems to me that your passion is psychiatry. Couldn't you get a BSN but still work through the pre-med track? I believe it's a possibility considering you do your BSN and instead of elective courses, you take the pre-med reqs. Although I'm pretty sure a lot of the courses intersect between pre-med track and BSN.

 

[HuskerMed1816]

Those grades don't necessarily need to be a fluke. But I would caution about getting too excited about a bio class and a prereq to the actual prereqs (chem 1 and 2). You still have a long way to go.

You really need to make a decision about which path you want to pursue because once you start down one, it may be hard to switch back to another. Afraid that you won't succeed is a bad reason to rule out med school, but you haven't really shown that you understand what being a physician entails either (getting A's shouldn't be a reason to pursue med school either). I would suggest either shadowing a physician or getting more clinical experience before you decide to go down one path or another.

I have to argue here. I teach for one of the major MCAT prep programs and have students in there 40s sometimes switching from law, nursing, pharmacy, etc into medicine. On the other hand, I have coworkers who left medicine after residency to get an MBA and now work in healthcare admin. Do what you are passionate about because that is where you will succeed. You have the rest of your life to take chances and change plans. Don't ever feel like you "have to" do one or the other. Some ex-nurses make great doctors.. And some make terrible ones too

 

[Eon]

I have to argue here. I teach for one of the major MCAT prep programs and have students in there 40s sometimes switching from law, nursing, pharmacy, etc into medicine. On the other hand, I have coworkers who left medicine after residency to get an MBA and now work in healthcare admin. Do what you are passionate about because that is where you will succeed. You have the rest of your life to take chances and change plans. Don't ever feel like you "have to" do one or the other. Some ex-nurses make great doctors.. And some make terrible ones too

Yeah, but switching over makes you recollect on the time when you could have gone to the path as an undergrad in college, but you didn't. My mom told me that it feels like ****. But she didn't end up switching and she just stuck with her business degree. Anecdotal, I understand, but I would assume that it does end up feeling bad considering you could have made the decision earlier but you didn't consider your options and end result clearly and thoroughly through.

 

[HuskerMed1816]

Yeah, but switching over makes you recollect on the time when you could have gone to the path as an undergrad in college, but you didn't. My mom told me that it feels like ****. But she didn't end up switching and she just stuck with her business degree. Anecdotal, I understand, but I would assume that it does end up feeling bad considering you could have made the decision earlier but you didn't consider your options and end result clearly and thoroughly through.

IMO that's like being upset because you aren't the fireman you wanted to be when you were 10 years old. I get what you're saying though, yes you lose time and you are stuck later in life (kids and family make career changes harder) going back because you "changed your mind". But to play devils advocate, you could be in med school with little sleep and spending time wondering "what if I took an easier path". Final thought: the hardest thing in life can sometimes be deciding exactly what to actually do with your life

 

[Eon]

IMO that's like being upset because you aren't the fireman you wanted to be when you were 10 years old. I get what you're saying though, yes you lose time and you are stuck later in life (kids and family make career changes harder) going back because you "changed your mind". But to play devils advocate, you could be in med school with little sleep and spending time wondering "what if I took an easier path". Final thought: the hardest thing in life can sometimes be deciding exactly what to actually do with your life

Then you probably shouldn't have applied for an interview. At that point of applying/interviewing/accepting a med school admission, you should be 100% sure medicine's the calling because you are essentially taking the spot of someone who was 100% sure and you decided to drop you.

 

[RomanTaylor]

Then you probably shouldn't have applied for an interview. At that point of applying/interviewing/accepting a med school admission, you should be 100% sure medicine's the calling because you are essentially taking the spot of someone who was 100% sure and you decided to drop you.

There are physicians, successful physicians out there today that wasn't 100% sure if this was their "calling" until they finished medical school.

The "calling" thing is hogwash. Finish your undergrad, take your pre-reqs, do you due diligence in investigating the profession and take your MCATs. If it's what you want, then go for it.

And that "taking the spot of someone that is 100% sure" thing is hogwash too. Let me fix it for you...

"...you are essentially taking the spot of someone who was 100% sure (like me, omg me, that was my spot, stay away from my spot, you don't deserve it because I ate a poop hotdog and you didn't) and you decided to drop you."

 

[Barcu]

I have to argue here. I teach for one of the major MCAT prep programs and have students in there 40s sometimes switching from law, nursing, pharmacy, etc into medicine. On the other hand, I have coworkers who left medicine after residency to get an MBA and now work in healthcare admin. Do what you are passionate about because that is where you will succeed. You have the rest of your life to take chances and change plans. Don't ever feel like you "have to" do one or the other. Some ex-nurses make great doctors.. And some make terrible ones too

I agree that it is always possible to change careers. What I was really trying to tell the OP to do was to find their passion. Their decision between MD or BSN seemed to be dependent on the grades they were receiving (or at least it seemed like that from the posts). They aren't stuck on a path, but it's better to try and sort that out now than later.

 

[NickNaylor]

Hi, Jaz--

I see you're in Seattle. I lived there for 5 years during/after college, and got a great job at the UW hospital. The position is called "unit services coordinator," and there are several positions available for each inpatient floor (and they're ALWAYS looking for more people). It's sort of a secretarial job, but you are working on an inpatient floor, and you learn TONS about the way the hospital works. I'm an MSII now, and I am much more familiar with the hospital environment than my classmates.

Job Duties as a USC: coordinate patient transfers and admissions to the floor, order labs, transcribe physicians' orders (you learn a lot about medicine this way if you have initiative and ask questions and look up the meds you write down), order blood and blood draws, order special equipment, help residents with paperwork, get to know the nurses and what they do(after working there, I LOVE nurses. They're the nicest people in the world). I learned a lot just from chatting with residents--they're very receptive when they find out you're a pre-med. It's a busy, sometimes stressful job, but I worked full time for a year and loved every minute of it. (You can work just nights, or weekends, or one day a week, too, if you're still in school.)

I learned a ton about medicine, I realized I really enjoy the hospital environment, and admissions committees really liked this part of my resume, as it was great clinical exposure. Also, the pay is pretty good for an undergraduate. I was 35 hours a week, so I had full health insurance coverage plus ~$1700/month, if I remember correctly. If you work part-time, you don't get benefits, but the pay is equal or better.

Yeah, agreed. OP should shadow some nurses and physicians and see which seems more interesting. He/she could even shadow some NPs to see more of the nursing spectrum.

(sent from my phone)

 

[priorities2]

The other tough thing is, with outpatient psychiatry, physicians and PMHNPs have really similar job descriptions. Psychiatrists will do med management, therapy, and take the lead on more difficult medically co-morbid cases. Pmhnps do med management, therapy, intake/assessment, maybe triage. But really in either case it's mostly med management and therapy. From that brief description, the work of a PMHNP sounds more interesting to me - but can't a psychiatrist also shape her practice to focus on the things she wants? If that's the case, there's no practical difference between PMHNP vs psychiatrist for me. The difference fundamentally is:

1. Become a PMHNP - get done with school at 23-25 - make 70-130k working ~40 hrs a week for the rest of my career. More secure that it will work out.
2. Become a psychiatrist - get done with school at 30-32 - make 80-110k working ~20 hrs a week for the rest of my career. Less secure that it will work out.