Written By: Caitlin Goodwin DNP, CNM, RN
In the United States, health care providers are in more demand than ever before. The baby boomers are aging into illnesses that demand more care, and with soaring obesity rates, our clinics are overflowing with chronic health conditions. However, with the increase in the need for health services, the amount of health care providers needs to grow accordingly.
Many communities are experiencing shortages that only becoming a clinician can fix. But the question remains- which route should you take? When considering a DNP vs M.D., it’s crucial to realize that the DNP and M.D. degrees are vastly different.
An M.D. is a medical doctor, also known as a physician, who has a focus on medicine. A DNP is an advanced practice nurse with a terminal degree in the nursing specialty. When deciding between the DNP or M.D., it is important to understand that their training is entirely different. Both professions are integral to the healthcare field. This article will discuss the educational, practice, salary, and job outlook differences between DNP and M.Ds.
What is a Doctor of Nursing Practice (DNP) Degree?
A Doctor of Nursing Practice (DNP) degree is the highest (terminal) degree in the nursing profession. A DNP-prepared nurse will have obtained both a Baccalaureate and a Master of Science in Nursing Degree after their education.
The American Association of Colleges of Nursing endorsed the Doctor of Nursing Practice as the minimum entry to advanced practice. All advanced practice nurses (APNs) like Certified Nurse-Midwives (CNM), Certified Registered Nurse Anesthetists (CRNA), and nurse practitioners (NP) will eventually need to have their DNP. The AACN also calls for APNs seeking top leadership roles to pursue the DNP.
Currently, NPs only need to receive their MSN to practice to the full extent of their license. While only 1 % of all nurses have their DNP, nurses with the degree are multiplying!
• From 2017 to 2019, the number of scholars enrolled in DNP programs increased from 29,093 to 32,678. That’s an increase of 3583 people (12.3%)!
• The number of graduates from DNP programs is growing even more quickly- by nearly 1000 graduates (15.5%).
In 2012, there were very few DNP programs, but there are now 348 programs nationwide in all 50 states and the District of Columbia. As if that wasn’t impressive enough, there are 98 more schools of nursing in the planning stages.
What is a Doctor of Medicine (M.D.) Degree?
A doctor of medicine degree is one of the two degrees required to become a physician in the medical profession. The other degree is the doctor of osteopathy, known as the D.O. An M.D. will first obtain a Bachelor’s degree, attend medical school, and then complete an internship and residency. There are more than 150 M.D. educational programs in the United States and the Liason Committee for Medical Education is the organization that accredits them in the U.S. and Canada. Some complete a fellowship following the conclusion of their residency, which gives them further training in their chosen specialty.
During their residency, the M.D. has the opportunity to specialize in their area of medicine. They can even further specialize in some of the broader areas:
• Internal
• Family
• Obstetrics and gynecology
○ Maternal-fetal medicine (MFM)
○ Reproductive endocrinology and infertility (REI)
○ Gynecologic oncology
○ Urogynecology
• Allergy and Immunology
• Hematology and Oncology
• Anesthesiology
• Dermatology
• Plastic Surgery
• Pulmonology
• Cardiovascular
• Neurology
• Radiology
• Pediatrics
• Pathology
• Psychiatry
• Surgeon
○ Cardiothoracic
○ Vascular
○ Cosmetic and reconstructive
○ Colorectal
○ Surgical oncology
○ Trauma
○ Transplant
○ Surgical endocrinology
• Emergency Medicine
○ Critical care
○ Intensive care
• Orthopedics
○ Hand Surgeons
○ Shoulder Surgeons
○ Knee Surgeons
○ Hip Surgeons
○ Spine Surgeons
○ Sports Medicine
○ Orthopedic Oncology
Health care is an excellent field to get into because the physician per capita is lower than in many places in the world. So many populations lack the care that they need. However, there were nearly 1.1 million physicians in 2015, although this includes inactive doctors.
What’s the number one specialty for doctors in the United States? Psychiatry.
1. DNP vs. M.D: Degree Specialization Options
Whether you choose the M.D. or DNP, the degree that you choose guides the specialization process. An M.D. receives a broad education that includes many specialties. They usually don’t declare their specialty until the third year or so of medical school. However, a nurse must specialize by selecting their population upon entering their educational program for their graduate (MSN) program.
A DNP student can choose from the following specialties:
• Certified nurse-midwife
• Certified registered nurse anesthetist
• Clinical Nurse specialists
• Nurse practitioner
○ NPs are further broken down by the population that they focus on, like neonatal, pediatric, women’s health, mental health, adult gerontological, and family. When they pursue a doctoral degree, nurses choose from a P.h.D. or a DNP.
In medical school, the student receives a broad education that covers the foundations of medicine. Students take courses, such as the essentials of dermatology and immunology, cardiovascular, respiratory, and hematology. They receive clinical experience in a wide range of fields like obstetrics, internal medicine, and population health. During their third year of school, they take the USMLE Step 1 and during year four, USMLE step 2.
After successful completion of medical school, they apply to a residency program. Most graduates of U.S. medical schools will be matched in a residency and choose their specialization. Residencies are between three and four years, depending on the specialty. For instance, internists and family practice physicians spend three years in residency. Obstetricians and anesthesiologists take four years following medical school.
2. M.D vs. DNP: Curriculum Focus
The differences between M.D and DNP education are significant. The nursing approach to healthcare is holistic, which means viewing the patient as a whole. Nurses see the physical, mental, emotional, and spiritual well-being of patients. The nursing approach focuses on client education to prevent disease.
The curriculum of the DNP is based on evidence-based practice, quality improvement, and systems leadership. The DNP offers an alternative to the researched-focused doctoral program (Ph.D.). DNP allows nurses to investigate and implement nursing science.
M.D.s have a comprehensive education in medicine, starting in medical school. The curriculum focuses on a broader spectrum of medicine and covers every medical specialization. Physicians follow the medical model, which is disease-based. They find ways to fix healthcare disorders. The good news is that physicians are beginning to focus on preventative medicine, as well.
3. DNP vs. M.D: Program Length
When comparing the DNP or M.D. programs, it is important to understand that both require a Bachelor’s degree first. Both programs are time-consuming, but the M.D. takes longer.
The DNP program starts with a graduate degree, also known as a Master of Science in Nursing (MSN). If you pursue a Nurse Practitioner specialization, you will choose your population focus because there are many different options. Some seek an MSN in Education, Leadership, or Administration.
This article will assume a traditional nursing educational path to determine the length of the program for the DNP. A conventional track includes a Bachelor of Science in Nursing (BSM), a Master of Science in Nursing, and then the DNP. A BSN is a minimum of four years, MSN is two to three years, and then the DNP is approximately two years (full-time). In total, this means a DNP has 8 to 9 years of education. However, there are MANY routes to obtain your BSN, MSN, and even your DNP.
An M.D. will first obtain a Baccalaureate degree in the sciences, which is a minimum of four years. Next, medical school is another four years. The residency training is three to four years, depending on specialty. Thus, from start to finish, the M.D. has 11 to 13 years of education.
4. M.D vs. DNP: Program Cost
The educational cost to become an M.D. is typically significantly higher than to become a D.N.P. They both require the price of a Baccalaureate degree, which cancels that out in our calculation. However, the cost of the DNP is the DNP+MSN, while the expense of the M.D. program is extensive.
The Association of American Medical Colleges (AAMC) states that the average first-year medical student paid $36,755 for a public medical school during the 2018-2019 academic year. Those who went to a private medical school paid $59,076. If the student is out of state, the totals were an average of $60K+.
When you factor in additional costs like fees and health insurance, the price increases. The average cost of a four-year medical school using these figures is $150,620 to $236,304 for the 2018-2019 year. Unfortunately, these numbers do not take the cost of living or tuition increases into account.
According to U.S. News, the average cost of an MSN is between $35K to $50K, and a DNP is $27,745. The average price of a BSN to DNP program is $32K to $109K. Together, the total estimated cost of a DNP is nearly $70K. This is still less than half of the cost of an M.D. degree.
5. DNP vs. M.D: Admission Requirements
If you are deciding between a DNP or M.D. program, the admission requirements are rigorous for each. The DNP has specific conditions for admission. However, it is crucial to realize that there are many steps to obtain your DNP. There are other routes such as RN to DNP, MSN to DNP, and BSN to DNP.
Applying to an MSN program entails:
• A BSN or Baccalaureate degree and Nursing degree (Associates or Masters)
• Unencumbered, active RN license
• Strong academic history (more than 3.0 GPA)
• 2-3 letters of recommendation
• A personal statement
• A completed application
• Some schools require an in-person or video interview
Entering a DNP program requires the following:
• MSN degree from an accredited nursing program
• Unencumbered, active RN license
• Strong academic history (more than 3.0 GPA)
• 2-3 letters of recommendation
• A personal statement
• A completed application
• Some schools require an in-person or video interview
The M.D. must be admitted to a baccalaureate program, medical school, and be matched with a residency. Entering medical school requires the following courses:
• Biology with lab
• Chemistry with lab
• Organic chemistry with lab
• Biochemistry
• Calculus
• Statistics
• Physics with a lab
• Humanities courses
Medical school expectations are incredibly demanding. The GPA requirements are high- the average GPA of the matriculating student varies by university, but many are a 3.7 GPA or higher. Other parts of the medical school application include:
• Personal statement
• Clinical work
• Research experience
• Teaching
• Extracurricular activities
• Employment history
6. DNP vs. M.D: Job Duties
The job duties are fairly similar in the case of an NP versus an M.D. In a nutshell, M.D.s can practice with full authority. State mandates are the limit for DNPs. Both professionals perform the following:
• Prescribing
○ An M.D. can prescribe medications in all 50 states and DC.
○ While a DNP can prescribe medication under their advanced practice registered nurse license, restrictions are depending on the state.
• Scope
○ An M.D. can practice to the full scope of their license in all 50 states and D.C.
○ DNPs autonomy and scope depend on the practice laws in their state. For example, California and Ohio requires a signed collaborative agreement with a physician in order to practice.
However, DNPs work in other fields. Thus, DNPs educate, manage, lead, write and implement policy, and perform research. DNPs work in high power jobs as Deans of nursing schools and Chief Nursing Officers.
M.D.s also perform the above tasks. They also work in high power jobs as Deans of medical schools, Chief Medical Officers, and Directors of Public Health.
7. In Which Settings Do They Work?
Choosing between a DNP or M.D. is challenging when it comes to the work setting. Both NPs and M.D.s work in medical offices, hospitals, academic facilities, and government jobs. Where the DNP or M.D. work in the hospital varies depending on their area of medicine. NP’s practice setting depends on which area they are certified.
According to the American Association of Nurse Practitioners (AANP), the most common certification is the Family Nurse Practitioner (FNP). For example, a surgeon will work in the operating room (OR), while an obstetrician will work on the labor and delivery unit. Nurse practitioners will work in the area of their degree from the Neonatology Intensive Care Unit (NICU) to the Emergency Department (ED). However, DNPs can also work in administration, education, and leadership. They provide an important role in the community.
The American Medical Association states that M.D.s work in four main practice settings:
1. Individual private practice
2. Group private practice
3. Hospital-based practice
4. Academic institutions
8. Work Environment and Work Hours
There is not much difference between M.D and DNP work environment and work hours. The shifts depend on the specialty. For example, many hospital-based physicians and nurse practitioners take turns being on call during nights, weekends, and holidays. Typically, DNP and M.D.s work during the day in offices and academic settings.
Most DNPs work in group practices, except in states where they have the license and are able to work independently and in solo practice. An NP works an 8-hour to 24-hour shift, depending on their job and specialty. Most NPs work at least a 40-hour week.
Some M.D.s work solo, and some work in group practices. According to a survey in 2018, physicians work an average of 52 hours.
9. DNP vs. M.D: Salary
If you are still struggling to decide between the two careers, income level can often make or break your choice. Taking a look at the DNP vs M.D. salary may help you choose. According to ZipRecruiter, the annual pay for an M.D. in the United States is $120,026.
A DNP-prepared nurse works in many different positions. According to ZipRecruiter, the salary range is $70,428 to $109,025. The top of the pay range tops out with the average salary for an NP in the U.S. at $109,025. With a DNP and experience, the salary can top out at $155,000.
If you prefer a career in business, a nursing administrator makes an average of $74,552. However, since a DNP focuses on advanced leadership for the APN, they are more likely to make significantly more money in these roles.
Many NPs obtain their terminal degree so that they can become a professor or other education. You may be surprised to see that a nursing professor makes only $70,428, while the average pay nationwide for a Dean of Nursing only slightly increases to $75,538.
10. DNP vs. M.D: Job Outlook
The difference between DNP and M.D. job outlooks are not as significant as many other issues. NPs do win here. There were 189,100 nurse practitioners in 2018, and there is projected to be a need for 242,400 NPs by 2028. That’s a growth of 53,300 (28%)! The NP profession is expected to grow significantly more than the average population.
The Bureau of Labor Statistics projects that the overall employment of physicians should grow 7 percent between 2018 and 2028. This is still faster than average for all occupations. There are currently 756,800 active, licensed physicians in the U.S., and they are expected to grow to 812,200. The physician job outlook is also positive because almost all graduates of U.S. med schools were matched with a residency program.
The Bottom Line - Which Degree is Right for You?
Both an M.D. and DNP-prepared nurse provide high quality and essential health care services. However, each differs in its scope, training, and focus. Which degree you select is a distinctly individual choice. When deciding between DNP vs M.D., arm yourself with knowledge and follow your heart.
Caitlin Goodwin DNP, CNM, RN
Caitlin Goodwin is a Certified Nurse-Midwife who has been a nurse for 12 years, primarily in women’s health. She is passionate about caring for children with developmental disabilities, as her son has Autism Spectrum Disorder. She is currently working as a freelance writer and consultant and is passionate about advocating for her patients, students, and profession.
