Differences Between a Nurse Practitioner and a Doctor

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?”

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.

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:

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 28 states and Washington, D.C. have full prescriptive authority, the remaining 22 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.

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:

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:

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:

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 $126,260, 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 2022-2032 for physicians, but 45% growth over the same period for nurse practitioners.

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.

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.

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.

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.

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.

Page last reviewed October 20, 2022