Physician assistant vs nurse practitioner

[Anonymous]

This thread has been informative. Thanks everyone.

Do clinical hours with patients in a direct admit nursing school count towards what NP or even PA schools see as required patient hours?

We will check, but is it pretty standard that nursing classes at a 4 year direct admit program (school also has prehealth; I am not sure if nurses take these same classes) do NOT count towards PA school requirements, or even dental school (i know, threw in a tangent)

Does anyone know any schools where they do?

[Anonymous]

Anonymous wrote:This thread has been informative. Thanks everyone.

Do clinical hours with patients in a direct admit nursing school count towards what NP or even PA schools see as required patient hours?

We will check, but is it pretty standard that nursing classes at a 4 year direct admit program (school also has prehealth; I am not sure if nurses take these same classes) do NOT count towards PA school requirements, or even dental school (i know, threw in a tangent)

Does anyone know any schools where they do?

I don't think they do anywhere. There are very specific rules for what a nursing program must include, and very specific rules about prereqs for PA or dental or medical school, and there isn't a lot of overlap.

[Anonymous]

Doctor married to another with many physician friends: PA and NP are solid jobs we encourage for our own kids or relatives when it is clear the premed coursework will not lead to an MD admission, either from grades or the mcat score. All of us have encouraged our capable medical-interested kids to pursue MD. It is far more autonomy than mid-levels get, and one can pursue many fields to the level of expert. The PA or NP is never the expert, whether it be hospital rounds or clinics. The most common model is they are assigned the needed days(no taking off mon or fri) and the popular vacation weeks the docs are off. They are fillers. They can handle basic conditions but not the complex and for some fields they are never independent (surgery). They do not have ownership in practices nor vote. They are not privy to salary negotiations. If they get bonuses, which many do not, it is 1/10 of docs. Insurance does not reimburse Midlevels well, and that has gotten much worse the past 8yrs or so. Most of us as docs would never see one for our own care, unless it was a basic visit. The training is simply not there for them to be be able to handle complexity. PA spends 85-90k x 2 yrs to eventually get to a salary that is around 100-120k and that is the max for the better fields. Med school if you watch living expense loans is 85-90x 4 yrs BUT many schools at the ivy/Duke/ucsf/washU level have fellowships to cover 1-2 of those years which they award to a large segment of the med school class. The lowest paid fields (primary care) make 250-300k once you are past the 3 year buyin/ramp up. Specialties make 400-600k. Residency pays 80k now which is enough to save and start paying some loans back. 25 yrs ago it was 26k per yr for 80-100 hrs a week for 4 yrs. Half the docs I know are part time and love the balance because they still make 180k+. PA /NP are often not allowed to be parttime.
TLDR Docs only recommend PA/NP to those that have no realistic shot at MD. MD is by far preferable.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:This is helpful, but really doesn't answer what the real difference are between the two. From what I read, they are very similar and both can do patient care. Do some of the above posters have insight.

Also, what if my DD goes to a direct admit nursing school, but then decides to switch to a PA after graduation (and will have her BSN). Anyone seen that happen?

PA school is 2 years after graduation. As long as you have the pre-requisite classes you can apply. Be careful with nursing science classes vs standard science classes taught at a university for STEM majors. The nursing classes are often not as rigorous and may not be accepted by the PA program. Your DD may have to do a post-Bacc year to get the requirements. Your best bet is to contact a few PA schools admissions offices and ask if they accept nursing science classes.

This is incorrect. Virtually all, if not all, PA programs require some medical work experience. What each program considers to be good enough experience varies.

The schools I've looked at require a minimum of 1,000 hours.

PP here. I looked into PA school as well, and this is pretty much what I saw too — 1000 hours with patients, minimum. As far as what kind of experience counts, that varies a bit (for example some will take the less complicated work — like phlebotomists and CNAs — and some won’t). If I were in college I’d consider getting certified as an EMT and spend summers getting experience on the ambulance, in a hospital, and volunteer hours with a fire dept/in the community.

EMTs spend the vast majority of their time sitting in parking lots. Of the calls they do get, vast majority are not emergencies at all (think morbidly obese person needs to go to the bathroom and cannot get out the recliner chair and they live alone). It isn’t the clinical experience you think it is.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:This is helpful, but really doesn't answer what the real difference are between the two. From what I read, they are very similar and both can do patient care. Do some of the above posters have insight.

Also, what if my DD goes to a direct admit nursing school, but then decides to switch to a PA after graduation (and will have her BSN). Anyone seen that happen?

PA school is 2 years after graduation. As long as you have the pre-requisite classes you can apply. Be careful with nursing science classes vs standard science classes taught at a university for STEM majors. The nursing classes are often not as rigorous and may not be accepted by the PA program. Your DD may have to do a post-Bacc year to get the requirements. Your best bet is to contact a few PA schools admissions offices and ask if they accept nursing science classes.

This is incorrect. Virtually all, if not all, PA programs require some medical work experience. What each program considers to be good enough experience varies.

The schools I've looked at require a minimum of 1,000 hours.

And they are many that don’t require any work experience at all

You think there are "many" PA programs that don't require experience with patients? No. There are a few -- and even though they don't technically require it, good luck getting in without it.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Neither. CRNA. They make great money and are very competent and respected. The training is more rigorous, but better job and pay.

$200k Salary

My SIL is a CRNA with a pretty good job in the DMV. She makes just over 100k. Nowhere near 200k.

[Anonymous]

Anonymous wrote:This thread has been informative. Thanks everyone.

Do clinical hours with patients in a direct admit nursing school count towards what NP or even PA schools see as required patient hours?

We will check, but is it pretty standard that nursing classes at a 4 year direct admit program (school also has prehealth; I am not sure if nurses take these same classes) do NOT count towards PA school requirements, or even dental school (i know, threw in a tangent)

Does anyone know any schools where they do?

The answer would be no at the handful of programs I looked at -- if the hours counted toward academic credit, they didn't count them as work experience.

[Anonymous]

Anonymous wrote:Doctor married to another with many physician friends: PA and NP are solid jobs we encourage for our own kids or relatives when it is clear the premed coursework will not lead to an MD admission, either from grades or the mcat score. All of us have encouraged our capable medical-interested kids to pursue MD. It is far more autonomy than mid-levels get, and one can pursue many fields to the level of expert. The PA or NP is never the expert, whether it be hospital rounds or clinics. The most common model is they are assigned the needed days(no taking off mon or fri) and the popular vacation weeks the docs are off. They are fillers. They can handle basic conditions but not the complex and for some fields they are never independent (surgery). They do not have ownership in practices nor vote. They are not privy to salary negotiations. If they get bonuses, which many do not, it is 1/10 of docs. Insurance does not reimburse Midlevels well, and that has gotten much worse the past 8yrs or so. Most of us as docs would never see one for our own care, unless it was a basic visit. The training is simply not there for them to be be able to handle complexity. PA spends 85-90k x 2 yrs to eventually get to a salary that is around 100-120k and that is the max for the better fields. Med school if you watch living expense loans is 85-90x 4 yrs BUT many schools at the ivy/Duke/ucsf/washU level have fellowships to cover 1-2 of those years which they award to a large segment of the med school class. The lowest paid fields (primary care) make 250-300k once you are past the 3 year buyin/ramp up. Specialties make 400-600k. Residency pays 80k now which is enough to save and start paying some loans back. 25 yrs ago it was 26k per yr for 80-100 hrs a week for 4 yrs. Half the docs I know are part time and love the balance because they still make 180k+. PA /NP are often not allowed to be parttime.
TLDR Docs only recommend PA/NP to those that have no realistic shot at MD. MD is by far preferable.

+1

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:This is helpful, but really doesn't answer what the real difference are between the two. From what I read, they are very similar and both can do patient care. Do some of the above posters have insight.

Also, what if my DD goes to a direct admit nursing school, but then decides to switch to a PA after graduation (and will have her BSN). Anyone seen that happen?

PA school is 2 years after graduation. As long as you have the pre-requisite classes you can apply. Be careful with nursing science classes vs standard science classes taught at a university for STEM majors. The nursing classes are often not as rigorous and may not be accepted by the PA program. Your DD may have to do a post-Bacc year to get the requirements. Your best bet is to contact a few PA schools admissions offices and ask if they accept nursing science classes.

This is incorrect. Virtually all, if not all, PA programs require some medical work experience. What each program considers to be good enough experience varies.

The schools I've looked at require a minimum of 1,000 hours.

PP here. I looked into PA school as well, and this is pretty much what I saw too — 1000 hours with patients, minimum. As far as what kind of experience counts, that varies a bit (for example some will take the less complicated work — like phlebotomists and CNAs — and some won’t). If I were in college I’d consider getting certified as an EMT and spend summers getting experience on the ambulance, in a hospital, and volunteer hours with a fire dept/in the community.

EMTs spend the vast majority of their time sitting in parking lots. Of the calls they do get, vast majority are not emergencies at all (think morbidly obese person needs to go to the bathroom and cannot get out the recliner chair and they live alone). It isn’t the clinical experience you think it is.

What makes you think you know what I "think it is"? The only thing at issue here is hours required for admit to PA school.

[Anonymous]

Anonymous wrote:Doctor married to another with many physician friends: PA and NP are solid jobs we encourage for our own kids or relatives when it is clear the premed coursework will not lead to an MD admission, either from grades or the mcat score. All of us have encouraged our capable medical-interested kids to pursue MD. It is far more autonomy than mid-levels get, and one can pursue many fields to the level of expert. The PA or NP is never the expert, whether it be hospital rounds or clinics. The most common model is they are assigned the needed days(no taking off mon or fri) and the popular vacation weeks the docs are off. They are fillers. They can handle basic conditions but not the complex and for some fields they are never independent (surgery). They do not have ownership in practices nor vote. They are not privy to salary negotiations. If they get bonuses, which many do not, it is 1/10 of docs. Insurance does not reimburse Midlevels well, and that has gotten much worse the past 8yrs or so. Most of us as docs would never see one for our own care, unless it was a basic visit. The training is simply not there for them to be be able to handle complexity. PA spends 85-90k x 2 yrs to eventually get to a salary that is around 100-120k and that is the max for the better fields. Med school if you watch living expense loans is 85-90x 4 yrs BUT many schools at the ivy/Duke/ucsf/washU level have fellowships to cover 1-2 of those years which they award to a large segment of the med school class. The lowest paid fields (primary care) make 250-300k once you are past the 3 year buyin/ramp up. Specialties make 400-600k. Residency pays 80k now which is enough to save and start paying some loans back. 25 yrs ago it was 26k per yr for 80-100 hrs a week for 4 yrs. Half the docs I know are part time and love the balance because they still make 180k+. PA /NP are often not allowed to be parttime.
TLDR Docs only recommend PA/NP to those that have no realistic shot at MD. MD is by far preferable.

Thank you for your detailed reply. But I mean this nicely, everyone knows this. The people whose kids are consider PA or NP are very likely kids we have concluded will not get into med school. But thanks for reminding us of the very sucky pay and the fact that are second class citizens to MDs. With all due respect.

[Anonymous]

I have both NPs and PAs in my family and it is universally understood by all of them that the NPs have more and better training. The ones that went the PA route wanted the quicker path. But the NPs all had years of working as an RN under their belt first and went to high quality programs. One of them went on to get their DNP (doctorate degree) as they say it may become the requirement to practice,at least independently in the future. They have their own private practice and wanted to get ahead of it. Not sure how accurate that is, but if so, the NP route could require even more school and training in the future which I guess you could see and positive or negative.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Doctor married to another with many physician friends: PA and NP are solid jobs we encourage for our own kids or relatives when it is clear the premed coursework will not lead to an MD admission, either from grades or the mcat score. All of us have encouraged our capable medical-interested kids to pursue MD. It is far more autonomy than mid-levels get, and one can pursue many fields to the level of expert. The PA or NP is never the expert, whether it be hospital rounds or clinics. The most common model is they are assigned the needed days(no taking off mon or fri) and the popular vacation weeks the docs are off. They are fillers. They can handle basic conditions but not the complex and for some fields they are never independent (surgery). They do not have ownership in practices nor vote. They are not privy to salary negotiations. If they get bonuses, which many do not, it is 1/10 of docs. Insurance does not reimburse Midlevels well, and that has gotten much worse the past 8yrs or so. Most of us as docs would never see one for our own care, unless it was a basic visit. The training is simply not there for them to be be able to handle complexity. PA spends 85-90k x 2 yrs to eventually get to a salary that is around 100-120k and that is the max for the better fields. Med school if you watch living expense loans is 85-90x 4 yrs BUT many schools at the ivy/Duke/ucsf/washU level have fellowships to cover 1-2 of those years which they award to a large segment of the med school class. The lowest paid fields (primary care) make 250-300k once you are past the 3 year buyin/ramp up. Specialties make 400-600k. Residency pays 80k now which is enough to save and start paying some loans back. 25 yrs ago it was 26k per yr for 80-100 hrs a week for 4 yrs. Half the docs I know are part time and love the balance because they still make 180k+. PA /NP are often not allowed to be parttime.
TLDR Docs only recommend PA/NP to those that have no realistic shot at MD. MD is by far preferable.

Thank you for your detailed reply. But I mean this nicely, everyone knows this. The people whose kids are consider PA or NP are very likely kids we have concluded will not get into med school. But thanks for reminding us of the very sucky pay and the fact that are second class citizens to MDs. With all due respect.

Not PP ... but ... they are. Sh!t rolls downhill in medicine.

[Anonymous]

Anonymous wrote:I have both NPs and PAs in my family and it is universally understood by all of them that the NPs have more and better training. The ones that went the PA route wanted the quicker path. But the NPs all had years of working as an RN under their belt first and went to high quality programs. One of them went on to get their DNP (doctorate degree) as they say it may become the requirement to practice,at least independently in the future. They have their own private practice and wanted to get ahead of it. Not sure how accurate that is, but if so, the NP route could require even more school and training in the future which I guess you could see and positive or negative.

I certainly hope so.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Doctor married to another with many physician friends: PA and NP are solid jobs we encourage for our own kids or relatives when it is clear the premed coursework will not lead to an MD admission, either from grades or the mcat score. All of us have encouraged our capable medical-interested kids to pursue MD. It is far more autonomy than mid-levels get, and one can pursue many fields to the level of expert. The PA or NP is never the expert, whether it be hospital rounds or clinics. The most common model is they are assigned the needed days(no taking off mon or fri) and the popular vacation weeks the docs are off. They are fillers. They can handle basic conditions but not the complex and for some fields they are never independent (surgery). They do not have ownership in practices nor vote. They are not privy to salary negotiations. If they get bonuses, which many do not, it is 1/10 of docs. Insurance does not reimburse Midlevels well, and that has gotten much worse the past 8yrs or so. Most of us as docs would never see one for our own care, unless it was a basic visit. The training is simply not there for them to be be able to handle complexity. PA spends 85-90k x 2 yrs to eventually get to a salary that is around 100-120k and that is the max for the better fields. Med school if you watch living expense loans is 85-90x 4 yrs BUT many schools at the ivy/Duke/ucsf/washU level have fellowships to cover 1-2 of those years which they award to a large segment of the med school class. The lowest paid fields (primary care) make 250-300k once you are past the 3 year buyin/ramp up. Specialties make 400-600k. Residency pays 80k now which is enough to save and start paying some loans back. 25 yrs ago it was 26k per yr for 80-100 hrs a week for 4 yrs. Half the docs I know are part time and love the balance because they still make 180k+. PA /NP are often not allowed to be parttime.
TLDR Docs only recommend PA/NP to those that have no realistic shot at MD. MD is by far preferable.

Thank you for your detailed reply. But I mean this nicely, everyone knows this. The people whose kids are consider PA or NP are very likely kids we have concluded will not get into med school. But thanks for reminding us of the very sucky pay and the fact that are second class citizens to MDs. With all due respect.

Not PP ... but ... they are. Sh!t rolls downhill in medicine.

Honest question. Do you think people don’t know this?

[Anonymous]

Anonymous wrote:

Anonymous wrote:Doctor married to another with many physician friends: PA and NP are solid jobs we encourage for our own kids or relatives when it is clear the premed coursework will not lead to an MD admission, either from grades or the mcat score. All of us have encouraged our capable medical-interested kids to pursue MD. It is far more autonomy than mid-levels get, and one can pursue many fields to the level of expert. The PA or NP is never the expert, whether it be hospital rounds or clinics. The most common model is they are assigned the needed days(no taking off mon or fri) and the popular vacation weeks the docs are off. They are fillers. They can handle basic conditions but not the complex and for some fields they are never independent (surgery). They do not have ownership in practices nor vote. They are not privy to salary negotiations. If they get bonuses, which many do not, it is 1/10 of docs. Insurance does not reimburse Midlevels well, and that has gotten much worse the past 8yrs or so. Most of us as docs would never see one for our own care, unless it was a basic visit. The training is simply not there for them to be be able to handle complexity. PA spends 85-90k x 2 yrs to eventually get to a salary that is around 100-120k and that is the max for the better fields. Med school if you watch living expense loans is 85-90x 4 yrs BUT many schools at the ivy/Duke/ucsf/washU level have fellowships to cover 1-2 of those years which they award to a large segment of the med school class. The lowest paid fields (primary care) make 250-300k once you are past the 3 year buyin/ramp up. Specialties make 400-600k. Residency pays 80k now which is enough to save and start paying some loans back. 25 yrs ago it was 26k per yr for 80-100 hrs a week for 4 yrs. Half the docs I know are part time and love the balance because they still make 180k+. PA /NP are often not allowed to be parttime.
TLDR Docs only recommend PA/NP to those that have no realistic shot at MD. MD is by far preferable.

Thank you for your detailed reply. But I mean this nicely, everyone knows this. The people whose kids are consider PA or NP are very likely kids we have concluded will not get into med school. But thanks for reminding us of the very sucky pay and the fact that are second class citizens to MDs. With all due respect.

Let me add on to PP. My kid is the type who could likely get the grades for med school. They have the work ethic and the intelligence. THey have also spent time shadowing MDs and PAs in the field that interests them the most and came away thinking the PA path was preferrable. One of the docs was absolutely miserable and tried to convince my kid not to go to med school. Don't assume someone chooses PA b/c they aren't smart enough for med school.