Psychiatry NP or MD/DO?

by ruleighdy ruleighdy (New) New Student

Hello, everyone
I am in my early 40s, and I am currently completing a Bachelor’s in educational/clinical psychology but I have also been following the premed curriculum for the past few years. I am planning on taking the MCAT in Spring 2023 and applying for med schools that same year. I am 3-4 courses away from satisfying the med school prereqs and I plan to start studying for the MCAT in April 2022.
Since I have been extremely interested in psychiatry-mental healthcare( with addiction and child/adolescent psychiatry as sub-specialities in mind), I have been wondering if a career as a nurse practitioner could be a better fit for me. Beyond my age—even if I have read many posts of people in their early 40s and older having succeeded as a medical student/resident/physician—the idea of not earning a paycheck until the first year of residency while I have a family is a demoralizing thought.
I am a former semi-pro soccer player, used to be a police officer and I have been a teacher/tutor for the past 6 years, but I have always had an interest in medicine.
I am not requesting for others to make a decision on my behalf, but I am asking for feedback and perhaps come across pros and cons that I have not thought of yet.
Of course, all of that is happening while I am also in the process of purchasing a house so I have been having constant migraines☺️.
Thank you for taking the time to read, and any feedback would be greatly appreciated!

If you can get into an MD/DO program I’d say go for it. From what my friends from college told me, you get about a month for each clinical rotation starting in your third year. I’m not sure if this continues for the entire last two years of medical school but it would really give you the best opportunity to figure out whether you enjoy psych or if you like something else better. Although NP programs are slightly shorter, you do not get to go through rotations to figure out where your interests lie. The expectation is that you have worked professionally as an RN in the specialty so you know whether you like it or not. I am interested in psych theory but found that I did not like my very brief inpatient psych rotation (one day) in nursing school and I do not like dealing with certain types of psych patients in the hospital where I work. I have heard similar things from friends when they have done their rotations in MD/DO programs about not liking the atmosphere of inpatient psych. PA school also does a year of rotations through different specialties so if you’re interested in keeping your options more open I would look at MD/DO or PA. PA is a two year road and you can easily transfer specialties if you do psych for a few years and get tired of it.

I believe NP education is a minimum of three years because you have to get your RN first even if you do a direct entry program, and many brick and mortar programs are switching to the three year DNP so you would then be looking at a total of four more years of school. Vanderbilt may be the one exception, I believe they have a one year psych masters NP (this would be after you go through a one year accelerated BSN program of course).

I have heard from multiple people that the residency after medical school is really fun for some specialties (maybe except for surgery). I have also heard that the first few years of practice can be very hard for new NPs because there is a lack of formal residency training. If you’re worried about your age, time, and money, I would think more about PA because you already have the classes done with the premed curriculum. If you’re absolutely convinced that psych NP is it for you, I would look at Vanderbilt’s psych program. I would caution against online psych programs where you have to find your own preceptors because you will spend money on classes and then may not be able to finish the program.

Good luck!