“Why not, NP?” was the most common response in medical school when I told people I was a former nurse. If I had a dollar for each time I was asked this question, I would be rich by now.
Before I get into the differences between NP and MD/DO and why I chose my path, I need to point out that this is a deeply personal decision.
There is overlap between these careers as well as sacrifices, challenges, and financial burdens. It truly depends on your own unique situation as to which career is best suited for you.
Differences between physicians and nurse practitioners
| Nurse Practitioner (NP) | Medical Degree (MD/DO) | |
| Education | Bachelor’s of Science in Nursing + Master’s or Doctorate in Nursing | Bachelor’s degree + Medical Degree (MD or DO) |
| Training Duration | 6-8 years total (BSN + MSN/DNP) | 8-12 years total (Bachelor’s + Medical School + Residency) |
| Patient Care Hours During Training | ~500-750 hours | ~12,000-16,000 hours |
| Online Only-Programs | Exists | None |
| Residency | Exists but is not required | Required to practice clinically |
| Scope of Practice | Diagnose and treat medical conditions Prescribe medications Perform procedures (varies by state) | Diagnose and treat medical conditions Prescribe medications Perform surgeries and procedures |
| Autonomy | Varies by state; full practice authority in some states | Full practice authority in all states |
| Specialization | Family, Pediatric, Adult-Gerontology, Psychiatric, CRNA | Numerous specialties and subspecialties (e.g., Diagnostic/Interventional Radiology, Surgery, Physical Medicine and Rehabilitation) |
| Supervision | May require physician collaboration or supervision in some states | Independent Practice |
| Regulatory Body | State Board of Nursing | State Medical Boards |
This table is not all inclusive but I hope it gives you an idea of the similarities and differences between these two careers. You will need to reflect on your own schedule, your “why medicine?”, your financial situation and your career ambitions to choose the path that is right for you.
As for me, there were numerous reasons why I chose medicine. I agonized over the decision for a long time. I shadowed several NPs, I flew to another state to tour an NP school, and I emailed many NP programs to get an idea of what the requirements were to apply. Ultimately, I chose medicine because I felt it gave me the most options. I have always leaned towards choosing options that gave me the most options.
Other reasons why I chose medicine may be controversial and I want to make it clear that NPs are essential members of the healthcare team and I am not here to convince you not to pursue this career. I am here to highlight why becoming an NP was not the right choice FOR ME, though it can very well be a good choice FOR YOU.
Why I did not become an NP
- Personally, I believe the most competent NPs I have worked with had many years of nursing experience and were experts in their specialties as an RN before pursuing higher education. When I chose to pursue higher education, I had only one year of nursing under my belt and wanted more in-depth training and experience before becoming a provider.
- While searching for NP schools, it did not sit well with me that NP schools varied so much: some were fully online, some had 100% acceptance rates, some were direct-entry NP schools that will accept you even without a nursing degree. If I applied to an NP school today, I could start next week! That lack of standardization was really concerning to me.
- I shadowed an NP who literally told me to go to medical school and that she would have done it if she could “turn back the clock.”
- Options! Without medical school, I would not have been able to become a diagnostic radiologist. Medical school opened me up to so many different options in specialities that is not available to me as an NP: interventional cardiology or radiology, surgery, electrophysiology, PM&R, etc. Sure you can become an NP and be a first assist on these cases which is pretty cool! But, it’s just not the same as being the person driving these cases.
Both an NP and MD/DO offers a rewarding and fulfilling career path. Ultimately, the decision to pursue a provider degree should align with your personal and professional goals, your commitment to patient care, and your readiness to take on the responsibilities that come with these advances roles. Nurses make great NPs and they also make great physicians! Which one is best for you?
