Differences Between a Nurse Practitioner and a Doctor
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If you are wondering "Should I be a nurse or doctor?" then this guide can help explain the differences in required education, roles, and salaries between advanced practice nurses and physicians. Nurse practitioners (NPs) and doctors have several similarities, but they have many differences in training and roles.
Check out this guide for answers to the most common questions about nurse practitioners and doctors, including "Are nurse practitioners doctors?" and "Can a nurse practitioner prescribe medicine?"
Career Differences Between Nurse Practitioners and Doctors
Nurse practitioners have less extensive medical education than doctors and more limited scopes of practice. The training to become a nurse practitioner is narrower. They are authorized to practice only within their licensed specialty area, such as pediatrics, women's health, or family practice. The training for doctors is much longer, intense, and generally much more expensive.
Nurse practitioners and doctors are both authorized to diagnose conditions, prescribe treatments, and act as primary care providers. Nurse practitioners are authorized to prescribe medications, including controlled substances and may practice autonomously. However, in some states, they must practice under a doctor's supervision or in collaboration with a doctor.
Roles and Responsibilities
Nurse practitioner practice authority varies by state, while physician authority is uniform across all states. While nurse practitioners can specialize in different areas, most nurse practitioners work in primary care. With the ongoing shortage of primary care providers, this keeps demand for nurse practitioners high.
Typical roles and responsibilities for nurse practitioners include:
- Assessing patients and diagnosing conditions
- Prescribing treatments, including medications
- Educating patients on their conditions and health
- Supervising other healthcare staff, such as registered nurses (RNs)
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
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 show proof of completion of an accredited residency program. They must also demonstrate expertise in a medical specialty, which can include the following:
- Internal medicine
Both physicians and nurse practitioners enjoy salaries well above the national average. However, if salary is the most important factor in your nurse practitioner vs. doctor career choice, physicians earn considerably more.
The median annual salary for nurse practitioners is $120,680, compared to more than $208,000 for physicians. The gap is wider in certain specialties. For example, according to the U.S. Bureau of Labor Statistics (BLS), the top-paying physician specialty, cardiology, pays an average $353,970 annually, followed by anesthesiology, at an average $331,190. Aside from degree and specialty, salaries vary based on experience, board certifications, and geographic location.
However, if job growth is a factor in your nurse practitioner vs. doctor career decision, NP jobs are growing faster. The BLS projects 3% growth from 2021-2031 for physicians, but 40% growth over the same period for nurse practitioners.
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.
Education and training to become a doctor can take between 11-15 years. Doctors are required to complete an undergraduate program, attend medical school to earn an MD or a DO, and complete 3-7 additional years of residency training.
NPs must complete an undergraduate nursing program and earn an MSN, which includes a minimum of 500 hours of clinical training. The time it takes to complete these programs also differs significantly. Doctors spend about 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
Time in nursing school versus medical school also differs. Postundergraduate education for doctors includes at least four years in medical school and a minimum of three years completing their residency. Nurse practitioners typically spend 2-3 years in a nurse practitioner program earning an MSN.
Nursing school is faster than medical school and nurse practitioners are not required to participate in residency, though they must complete clinical hours. If you prefer to work as soon as possible rather than spend time in school, this might make the NP vs. MD decision easier.
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 by state, but at least 500
Practicums: Hours vary
Licensure examination: Specialty board certification exam
Total time: 6-7 years
Doctor (MD or DO)
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 minimum
Specialty certification: Optional
Licensure examination: United States Medical Licensing Examination or Comprehensive Osteopathic Medical Licensure Examination
Total time: 10-15 years
Featured Online MSN Programs
Nurse Practitioner Degree Programs
Undergraduate Degree: Bachelor of Science in Nursing (BSN)
- Eligibility: BSN programs require a high school diploma or GED certificate, typically at least a 3.0 GPA, classes in math and science, at least two references, and a personal statement or essay about why you want to become a nurse.
- Program length: Most undergraduate nursing programs take four years.
- Curriculum: Programs typically provide students with foundational knowledge in the following areas: anatomy, pharmacology, nursing informatics, pathophysiology, and psychology.
Graduate Degree: MSN
- Eligibility: You must have a current and unencumbered registered nursing license, typically at least a 3.0 GPA in your nursing degree, at least two professional references, and 1-2 years of nursing experience. Some programs offer accelerated options for students with an undergraduate degree in a subject other than nursing or an associate degree in nursing.
- Program length: Program often lasts two years.
- Curriculum: Master's curriculum 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.
Medical 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.
Medical School: M.D. or D.O.
- Eligibility: While requirements vary by school, most programs require an undergraduate degree in a scientific field, a high GPA, at least two references, and high scores on the Medical College Admissions Test. Most schools require or strongly prefer around 150 volunteer, shadowing, or student work hours in a medical setting.
- GPA: 3.5 is typical, though top-tier schools generally require 3.8 or higher
- MCAT: 510 or higher
- Prerequisite courses: Schools require biology and advanced biology, organic and inorganic chemistry, physics, calculus, and statistics. Some schools require biochemistry too. Courses in genetics, psychology, ethics, anatomy, public health, and related topics are often a plus, if not required.
- Undergraduate degree: Biology and chemistry are the most common. Many schools have recommended premed tracks.
- 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
Both medical school and nursing school are major investments. Because medical school takes longer and because residency salaries are considerably lower than physician salaries, medical students tend to graduate with far more debt. The average medical school debt for public schools is $194,280 and for private schools is $218,746. The average debt for MSN programs is $47,321. However, there are loan forgiveness programs for nurses and physicians.
Both nurse practitioners and physicians can expect above-average salaries and high demand for their skills, so many consider the cost and debt a good investment.
Both medical school and nursing school require clinical hours. Most nurse practitioner schools require between 500- 600 clinical hours, depending on the specialty and state requirements. (The national minimum for NP school accreditation is 500 hours. Other MSN programs, such as clinical nurse specialist, require up to 1,000 hours.) This is another reason the answer to the question "Is a nurse practitioner a doctor?" is no.
Medical school requires 6,000 clinical hours, followed by residency, which requires roughly 9,000-12,000 clinical hours, depending on the specialty. A nursing doctorate, by comparison, requires around 1,500 total clinical hours.
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.
From high school graduation through licensing, a nurse practitioner program takes about 6-7 years, compared to 11-15 years for medical school.
Average medical school debt is around four times the level of MSN-NP debt.
Average physician salaries are typically twice the average NP salary. Some medical specialties have an average salary that is three times the average NP salary.
Overall, in determining which path makes the most sense, these areas highlight some crucial differences. While NPs are in school longer and have less debt, MDs 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?
Some nurse practitioner programs are entirely or mostly online, though you must complete clinicals in person. There are no existing accredited online MD programs. If studying online is the only option you are seeking, the NP vs. MD decision is straightforward.
Which is more stressful: nurse practitioner or doctor?
Stress levels depend on what you personally find most stressful, your specialty, and your role. Doctors have more responsibility and are more likely to be sued. Nurses and nurse practitioners are more likely to experience bullying and harassment from patients and colleagues.
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. Patients can see an NP first to address an issue, and then see the doctor second if needed. Seeing an NP can get the patient in faster, help triage, and begin to treat the issue. Then the patient can get in faster to see a doctor if necessary.
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 26 states and Washington, D.C., NPs are able to diagnose conditions, treat patients, and write prescriptions, just like MDs; however, in the other states, NPs must receive doctor approval before prescribing medication. Laws in some states also require career-long supervision for NPs.
Page last reviewed October 20, 2022
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