NP to MD

Hello Sheila

I have been an NP since 2001 and an RN for many years prior. I am now 47 and have just started med school. It is a totally different ball game than any thing I experienced in nursing. The material is so much more in depth and you are expected to know things at the cellular level. My best analogy is that in nursing you are given the 1st 2 stories of the house but you are not given the basement!! now I’m learning so much re biochem and how it relates to disease, which enzyme is missing, which acceptor, inhibitor is deficient. I totally agree with Mary that the NP programs are too top heavy with frivolous courses, ie nursing theory which in my opinion is pretty much useless to begin with. There is no way that the training an NP goes though is 1/10 of what a medical student goes though to become an MD.

No, but the general (core) bio 1 & 2 and gen chem. 1 are the same–least for the college programs around here or mine. The microbiology I learned in college for nursing was deeper than what other nurses from other areas have described. For me, at least part of that may have been b/c I had to miss a major microb. exam d/t a very sick two-year old. The professor’s policy was, if you missed a major exam for any reason at all, you had to sit for his full essay exam. Oy Vey. I wrote my brains out and my hands off. But I was then forced to study on a very in-depth level as well as a comprehensive once, b/c there was NO telling what this professor would throw out for the essay–anything in microbiology was allowed by him. Basically he said no one ever scored above a .8 on any of his essay exams over the years. I isolated myself from everyone for just about two weeks for this one essay exam. After I had taken it, I didn’t want to see what Prof. No Mercy/Busty Ones had given me. We had the lights down in the lab that day. He came by to show me my score. I thought it read .77. My heart dropped after I had killed myself writing intensely about pharmacological structural analogs, etc. I must have sounded choked up, b/c I cracked my voice when I repeated the grade of .77 out loud. He looked pensive and then annoyed and after some time he had to state aloud that it was a .97. I didn’t believe him until I looked at it for myself again.

For better or worse, I often tend to ‘over-learn’ in various courses in college–nursing courses or otherwise. My lesson learned, after writing my hand and fingers off (They sure felt like they were going to fall off.) for that microb. exam, was even if I had to go to a funeral, make sure they drive the hearse up to the college sciences department. I wasn’t about to write another essay exam like that again. No computer for those pages–just his typed questions, a pen, countless pages of paper, and my hand.

Now I only wish I had had the gumption to pursue medicine back then. My chem. lab partner was pre-med, and between the two of us, we scored the highest in any of the professor’s similar chem courses. That PhD gave classes at more than one post-secondary institution. (Yep. . . state school too. . . You know how some private university folks can be as they try to be superior over the state universities, etc. grin)

Something told me then to consider the long, hard road my lab partner was about to embark upon, but I just didn’t believe in myself. It has really only been through working the nursing process in critical care, in particular, as well as really a fair number of docs over that years, that have given me enough insight and confidence to consider moving beyond nursing–and that is after considering NP programs and nurse anesthetist programs. It’s not the money; b/c some CRNAs around here and a few other areas can make over $140-150,000 per year. That’s at least $20,000 - $30,000 more than some primary care physicians. Right or wrong that’s the way it is. If you are RN w/ critical care experience and have an undergrad degree, after 2 to almost 3 years in a nurse anesthesia program and a passing CRNA exam, you can become a CRNA and move toward making that amount. It doesn’t matter, however, for me. It’s not what I want.

But at least I feel that I can say I’ve had my children, gave them most of my attention, and they are now well on their way to their own paths pretty much. I didn’t really plan it so much that way; it’s just how it worked out for a number of reasons. I can now focus fully on pursuing this path until I can no longer do so. I’ve never been healthier than I am now, particularly b/c of a commitment to wellness and exercise. So God-willing, I hope to practice for a good, long time.

Back to your point . . . at a fair number of schools the core general bios and general chems are the same. Not every school “dumbs down” those sciences for nursing programs. At least that has been fairly much what I’ve seen here on the east coast north. There are lots of schools over here, and there are lots of nursing, allied health, pharmacy, and medical school programs. What a nursing student does not get (even if she has some challenging microb., A & P I & II plus the bios and chem., physiology, and pathophysio., etc, is the depth that you describe regarding biochemistry (which is way cool) or the deeper level of human structure and function that is studied in sciences such as histology or embryology, etc. Neither can we say that the nursing or allied health A& P courses compare to gross anat., etc.

It all makes sense to me that it should involve so much more depth and breadth. I’ve explored some things somewhat on my own time well beyond what I have been expected to know—mostly b/c I am a curious person; but, no, it’s not the same as being challenged on the tomes upon tomes of such sciences day in and day out. I think it’s supposed to be intense. I think that physicians should have an intimate understanding of these sciences and then some in order to take on the role that they must. I certainly expect that of any physician that my family members or I see.

Sheila, from one nurse to another, the very best of everything during and well after medical school!

Please spread the word out to all your NP colleagues.