Differences Between a Nurse Practitioner and a Doctor
Nurse practitioners and doctors might have similar responsibilities, but the requirements to enter each career can vary significantly. Learn about their differences in this guide.
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Nurse Practitioner vs Doctor
The roles of nurse practitioners (NPs) and doctors are often misunderstood. While doctors are usually viewed at a more advanced level, both positions have a high function and purpose. Each plays a valuable and crucial role in healthcare.
When deciding between a career as a nurse practitioner or doctor, it is good to know the educational and career differences between the two roles. Understanding the expectations, time commitment, and financial factors can help you determine if either is the right fit.
This guide breaks down the differences between becoming a nurse practitioner versus a doctor.
Career Differences Between Nurse Practitioners and Doctors
When choosing whether to become a nurse practitioner or doctor, there are many factors to consider. Both careers can offer a rewarding, satisfying professional life. Yet, the differences between them can help steer you to the choice you find most attractive.
Knowing the responsibilities, cost and length of education, salary expectations, and required licensure can help you determine which path to take. Whether becoming an NP or a doctor, the first step is to determine how the differences listed below fit into your personal and professional goals.
Roles and Responsibilities
While both NPs and doctors provide patient care, the type of care differs.
NP responsibilities typically include ordering, performing, and interpreting lab work; maintaining patient records; managing a patient's overall care; and educating patients and families. They can also diagnose and treat acute or chronic conditions, prescribe medication, and counsel both patients and families. It is important to note that the responsibilities of an NP vary by state.
Whereas NPs provide patient primary care, the responsibilities of a doctor revolve around more complicated diagnoses, specialty care, and treatment. NPs focus on the impact of diagnosis, while doctors focus mainly on the illness.
Autonomy and Prescription Authority
Unlike registered nurses (RNs), all NPs can evaluate and diagnose patients, order and interpret diagnostic tests, and prescribe medication; however, some are limited in how much independence they have.
While NPs in 23 states and Washington, D.C. have full prescriptive authority, the remaining 28 states allow either reduced or restricted authority. In reduced-authority states, NPs can diagnose and treat patients, but they need physician oversight to prescribe medications. For NPs who work in restricted states, they cannot prescribe, diagnose, or treat patients without physician oversight.
Doctors are able to prescribe, diagnose, and treat patients in all 50 states and Washington, D.C.
Common Practice Settings
According to the American Association of Nurse Practitioners, an NP's practice setting depends on the area in which the NP is certified. The most common certification is in family primary care and the most common practice setting for these NPs is private group practice.
The next most common practice settings for NPs are inpatient and outpatient hospital clinics and psychiatric/mental health facilities.
For doctors, four common practice settings are listed by the American Medical Association:
- Private individual practices
- Private group practices with equity ownership
- Group clinic, hospital, or healthcare systems
- Academic institutions
NPs can expect to earn an average annual nurse practitioner salary that is a little more than half of what doctors make. The lowest 10% of NPs earn less than $84,120, while the highest 10% earn over $190,900. Salaries can also depend on the work setting. Those who work in hospitals earn a little over $10,000 more than those working in educational ones.
While physicians who have a doctor of medicine (M.D.) or doctor of osteopathic medicine (D.O.) generally earn around $100,000 more than NPs on average, their salary depends on their specialization. For example, pediatricians earn an average of $184,750 per year and anesthesiologists earn $271,440.
Education Differences Between Nurse Practitioners and Doctors
When deciding between the two careers, some key factors to consider include the type of degree required, total clinical hours, and the length of time it takes to complete the program.
Doctors are required to complete a professional doctoral program in medicine and NPs must complete a master of science in nursing (MSN). The time it takes to complete these programs also differs. Doctors spend around twice the amount of time completing their program than NPs for an MSN degree. These differences often guide learners to one position or the other.
Education Time Line
The time it takes for doctors to earn their degree and license is longer than NP programs. It takes 6-8 postsecondary years of education and training to become an NP — four years to earn a bachelor of science in nursing (BSN) and 2-4 years for a graduate nursing education (master's or doctorate).
In comparison, the American Academy of Family Physicians reports it takes an average of 11 postsecondary years of education and training to become a doctor. The difference in length is due to the type of degree and a doctor's need to complete their residency.
While both positions require an undergraduate degree, NPs move into a master's program, while doctors enroll in a professional doctoral program. Aspiring NPs must hold an RN license by passing the National Council Licensure Exam for RNs (NCLEX-RN). Medical schools will require the Medical College Admission Test (MCAT). Before practicing, passing a licensure exam is also required for both.
Undergraduate degree: Four-year bachelor's program
Entrance exam: National Council Licensure Exam for RNs (NCLEX-RN)
Graduate degree: Master's program (2-3 years)
Practicums: Hours vary
Licensure examination: Specialty board certification exam
Total time: 6-7 years
Doctor (M.D. or D.O.)
Undergraduate degree: Four-year bachelor's program
Entrance exam: Medical College Admission Test (MCAT)
Graduate degree: Four-year professional doctoral program (M.D. or D.O.)
Residency: Three years
Specialty certification: Optional
Licensure examination: United States Medical Licensing Examination or Comprehensive Osteopathic Medical Licensure Examination
Total time: 11-15 years
Featured Online MSN Programs
NP Degree Programs
Undergraduate Degree: Bachelor of Science in Nursing (BSN)
- Eligibility: You typically need to provide high school transcripts, SAT or ACT scores, a resume, and a GPA of at least 2.5 or 3.0. You should also have experience in math and science, though it is not a requirement. Some programs require a nursing entrance exam.
- Program length: Most BSN programs take four years.
- Curriculum: Programs typically provide foundational knowledge in the following areas: anatomy, pharmacology, nursing informatics, pathophysiology, and psychology.
Graduate Degree: MSN
- Eligibility: You must hold a BSN and an RN license. Those without a BSN can complete an accelerated nursing program and earn a BSN in 12 months. Then, they can move into the MSN degree. Most graduate schools require a minimum GPA that ranges from 2.5-3.5. While not every program requires it, some request Graduate Record Examinations or Miller Analogies Test scores.
- Program length: MSN programs often last two years.
- Curriculum: Master's programs typically include the following: pharmacology, physiology, health assessment, and ethics. Programs may also have a focus on clinical nursing, nursing research, organizational systems, and the promotion of healthy habits.
Professional Doctoral Degree Programs
- While there are premed programs at the undergraduate level, there are several majors that can help prepare students for medical school.
- According to the American Medical Association, out of all of the students who enrolled in medical school in 2020, most completed an undergraduate program in the biological sciences, physical sciences, and social sciences. Completion of these programs typically takes four years. Curriculum varies based on the major.
Professional Doctoral Program: M.D. or D.O.
- Eligibility: While every medical school has different acceptance requirements, the majority of applicants had the following based on 2019 admission numbers:
- GPA: The median undergraduate GPA in 2019 was 3.75. Most schools require a minimum of 3.3.
- MCAT: The median MCAT score was 512 out of a maximum score of 528.
- Prerequisite courses: Most programs require students to have a range of undergraduate courses that not only include the physical sciences but also English and math.
- Undergraduate degree: While there is no specific undergraduate degree required to enter a medical doctoral program, most medical schools prefer that their students complete a bachelor's program from a four-year institution and not a community college.
- Program length: Programs typically take four years to complete.
- First- and second-year courses incorporate general medical topics. Courses include anatomy/physiology, epidemiology, foundations of disease, microbiology, psychiatry/neurology, obstetrics/gynecology, pediatrics, geriatrics, and surgery.
- Third-year courses are typically completed through clinical rotations. Some of the most common rotations include family medicine, obstetrics/gynecology, surgery, psychiatry/neurology, and pediatrics.
- In their fourth year, students choose clinical rotations that can help them explore specific fields in medicine such as anesthesiology, emergency medicine, and radiology, among others.
Education Costs and Debt
A major factor to consider when deciding between the two pathways is the cost of the programs and student loan debt. While NPs might make less than doctors, the amount of debt owed by doctors is often higher.
According to the American Association of Colleges of Nursing, the median amount of debt for NPs in 2016 ranged from $40,000-$55,000. There are programs for student loan forgiveness for nurses. The National Center for Education Statistics reports that doctors owe an average of $241,560.
Both career choices require the completion of a certain number of hours performing hands-on experiences in patient care settings. Clinical hours vary between the two.
NPs are required to complete between 500 and 1,500 clinical practicum hours, while physicians complete around 6,000 hours. Doctors are also required to complete around 10,000 residency hours, which is not required for NPs.
Licensure and Specialization
Upon completion of their undergraduate programs, prospective NPs must pass the NCLEX-RN, licensing them as an RN. RNs who are looking to become an NP must then complete a graduate program. NP programs typically require experience as an RN before applying.
Upon completion of the program, they then apply to their state board of nursing to practice. States may use NP certification exams and/or additional requirements for licensure.
Board certification is available in many different nursing specialty areas such as:
- Family nurse practitioner
- Adult-gerontology nurse practitioner
Once a prospective doctor has earned their M.D. or D.O. from an accredited medical school and completed their residency, they are eligible to apply for their medical license. Both M.D.s and D.O.s are required to get a license in every state they plan on practicing, which includes exams, training, education, and fees.
For board certification, doctors must demonstrate expertise in a medical specialty, which can include the following:
- Internal medicine
Continuing Education Requirements
Continuing nursing education (CNE) requirements vary by specialization and state. In general, NPs must renew their state advanced practice licenses every 1-2 years with varying CNE requirements. Specialty certifications are typically valid for 1-5 years, and they also vary in the amount of CNE required for renewal. American Nurses Credentialing Center certifications, for example, are valid for five years and typically require 75 hours of qualifying CNE to renew.
For doctors, continuing medical education (CME) or continuing education and improvement requirements also vary by state. Here are general ranges for the U.S.:
- Licensing cycle (medical license must be renewed): 1-3 years
- Required CME credit hours per year: 20-50 hours
- Hours must be dedicated to different specialized areas, depending on state and specialization
How to Choose Between Becoming a Nurse Practitioner vs. a Doctor
In choosing which path to take, it is best to weigh the advantages and disadvantages of both. While it may depend on personal and professional goals, there are factors that can influence your decision.
NPs spend around six years of their academic life preparing for their profession; doctors spend 11-15 years earning their degrees and license.
Due to the length of time it takes to earn a professional doctorate, M.D.s and D.O.s have more student loan debt than NPs.
M.D.s and D.O.s can make twice what an NP makes, with doctors having a salary of more than $200,000 and NPs at around $111,680.
In choosing which path makes the most sense, these areas highlight some crucial differences. While NPs have less debt and spend less time in school, doctors typically have higher salaries. Therefore, it is best to determine what matters more — time or money.
Frequently Asked Questions About Becoming a Nurse Practitioner or Doctor
Can you become a nurse practitioner or doctor online?
Yes, it is possible to become an NP online. To complete their clinical hours in person, students are typically partnered with a healthcare facility in their region.
There are no online programs for doctors. In order to earn their degree, aspiring doctors must attend a traditional, campus-based medical school.
Which is more stressful: nurse practitioner or doctor?
Since experiences will vary between individuals and workplaces, there is no absolute answer as to which position is more stressful. NP positions offer greater flexibility that helps nurses manage their work-life balance. M.D.s are also typically in charge of making overall decisions regarding a patient's care, which can increase stress and anxiety levels.
When should patients see a nurse practitioner vs. a doctor?
Typically, it is easier to make an appointment with an NP vs. a doctor due to an NP's flexibility. Since they are able to diagnose, treat, and prescribe medicine, patients can book an appointment for urgent issues with an NP instead of waiting for a future appointment with a doctor.
For treatment that may be more experimental or for patients who have an unclear diagnosis, it is best to visit a doctor. Seeing a doctor is also recommended for patients who require surgical procedures or who need invasive treatment.
What can a doctor do that a nurse practitioner cannot?
In 23 states and Washington, D.C., NPs are able to diagnose conditions, treat patients, and write prescriptions, just like M.D.s; however, in the other 28 states, NPs must receive doctor approval before prescribing medication. Laws in 11 states also require career-long supervision for NPs.
Page last reviewed December 6, 2021
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