Why I Chose Nurse Practitioner School Over Medical School

I always imagined I would go to medical school. A biology major, I was on the premed track throughout the majority of my undergrad college experience. As graduation neared, however, I began to question my career path. Was I really passionate enough about medicine to dedicate the next 10 years or so to my studies? Medical school, residency, and a possible fellowship seemed like a daunting commitment. I wasn’t sure, so I decided to look at the other options out there. 

With a physician father, I was familiar with the various healthcare career paths. I was smart enough, and had the grades to get into medical school. So, ever the overachiever, I set my sights on the highest degree available in my area of interest. Choosing to do otherwise seemed like cutting myself short. Not to mention, the income I stood to make with an MD behind my name seemed much more attractive than that associated with other degrees. Not a risk taker, the opportunity for a clearly defined degree and role, as well as job security, made the profession a winner in my book. But, despite the positives, I sensed some soul searching was in order as I faced the next steps in my education journey

Given my attraction to the medical field, I was certain that I wanted to work in a healthcare profession. So, this is where I focused my career investigation. As an emergency department physician, my father worked with a number of physician assistants, so I was familiar with the role. Home from college for Thanksgiving break, I accompanied my dad to the hospital to pull an overnight shift one evening to get a better idea of what seeing patients as a PA was really about. I loved it. I job shadowed my father, as well as physician assistants and physicians in the department. My most distinct memories of the experience are the turkey buffet set out by the nurses for the holiday, and learning about rectal exams. Exposed bottoms aside, the PA profession seemed like a great option for me. 

Next, I job shadowed a nurse practitioner. An RN my father had worked with previously now owned her own clinic as an NP. I spent the day with her and was impressed by how she worked with her patients. Her emergency department background complimented her primary care role perfectly. She was not only able to manage chronic illness, but also acute complications. After this job shadowing experience, I could see myself as an NP as well. 

Ultimately, I decided that becoming a nurse practitioner or physician assistant was the right path for me, rather than a doctor. The length of education ahead of me was much shorter than that of a physician, not to mention the cost significantly lower. While I would have the option of financing my education with student loans, I also knew that one day I wanted a family, or at least work-life balance. The thought of working my behind off 90 hours a week in residency, only to become a slave to student loans upon graduation, made me cringe. I would be at least 30 years old by that point  (ah, to be young again!), and didn't want to be stuck in crazy work mode forever.

After researching a number of NP and PA programs (I didn't have a preference), I decided on the nurse practitioner profession. Without a background in healthcare, I would not have been a competitive applicant to physician assistant programs, as most require a significant number of direct patient care hours for admission. I chose to attend Vanderbilt University’s nurse practitioner program. I had enjoyed the university as an undergrad and preferred to stay in Nashville where I lived. 

Vanderbilt’s School of Nursing had many paths to choose from for aspiring NPs. Most required some form of nursing degree. One track, referred to as the ‘bridge program’, however, was tailored to students with a bachelor’s degree in a field other than nursing. The track conferred an RN degree upon completing the first year of the program, and a master’s degree in nursing upon completion of the second year of the program. 

When I discovered nurse practitioner bridge programs, I briefly investigated alternatives to remaining at Vanderbilt. The sunshine at the University of San Diego’s campus seemed attractive. And, the prestige of attending the NP program at Yale made me consider applying there as well. These programs, however, were significantly longer than the curriculum offered at Vanderbilt. Anxious to complete my education, I opted for the shortest route to becoming an NP

Some questioned my decision to choose nurse practitioner school over medical school. Classmates who were also on the premed track saw it as a bit of a compromise. My parents worried I was going to regret not achieving my full potential. I, however, believe I made the right decision for myself. The flexibility of the NP profession has allowed me career opportunities I might not have otherwise realized by embarking on another path. Working in the emergency department as an NP, my income potential is almost equivalent to physicians working in primary care. I enjoy my career, and also feel that my life is balanced. Well, most of the time, that is. 

Do I ever wish I had gone to medical school? Sometimes. When complex patients present to the ER, occasionally I wish I had a higher level of medical education. The great thing is, I may not have an MD, but I can always learn more, and practice at a higher level as an NP. 

What thoughts do you have in your medical school vs. NP/PA school decision?

 

Comments

Hi Rachel, 

Thank you for your words of encouragement! I'm glad you enjoy reading the blog and have found it helpful. Please let me know if there are any topics you would like me to cover as you start your FNP journey!

Erin Tolbert

Hello Erin! first of all, I LOVE reading your blog! Keep up the awesome work! I am starting FNP track at Vanderbilt University this coming fall and I screamed when I saw you went to Vanderbilt too! haha. Fan girl status here! I have been reading your articles and it is helping me so much. I am so glad you have chose this path and it is awesome to see nps like you out there making a difference. :)

Rachel

Thanks!

Sara

Hi Sara, 

Great question and insight. I notice the medical model vs. the nursing model most in the way NPs and PAs are educated, rather that in the workplace. 

In practice, at least in the emergency department, there is little or no difference in the way NPs and PAs practice. For example, both NPs and PAs work interchangeably at my hospital. This can vary depending on scope of practice laws in your state. If NPs have a less restricted scope of practice than PAs, for example, hospitals in your area may prefer to hire NPs over PAs. 

I would check to see if urgent care clinics and emergency departments use more nurse practitioners or physician assistants in your area. This may help you make your decision. 

Erin Tolbert

My story and route to becoming an NP is exactly the same, just a different school. :) I never regret my decision to go the NP route rather than med school. I have 2 young kids now, and having a schedule that allows a proper work-life balance is fantastic!

Kathleen

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