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    May 9, 2018

    Career Advancement: Registered Nurse to Medical Doctor

    Nurses and doctors are both essential parts of the healthcare field and work together closely to ensure that patients receive the best possible care. Both have vastly distinct roles and responsibilities. For this reason, a registered nurse (RN) cannot automatically become a medical doctor (MD) without additional schooling, training, and exams.

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    But Why? And what about the Stigma?

    There are some nurses who have always dreamed of becoming a medical doctor, but college happens, life happens and things change. Nursing sometimes is the next best option. It is only after being in the field and seeing the differences between nurses and doctors do those individuals desire this career path again. 

    Others want to be more helpful to their patients. Some want more responsibilities including more invasive procedures or overseeing the team. There is a milieu of reasons why someone would want to become a doctor; it is a decision that should not be made lightly. It impacts not only the nurse but also their family and friends. Medical training is long and carries a heavy financial burden. 

    There has always been a stigma surrounding doctors and nurses transitioning to this profession. A decade ago very few nurses would leave bedside nursing to enter medical school but now nurses, doctors, and medical schools are more accepting. While there is still the slight stigma, it is important for nurses in medical school to remember their training, bedside manner, and compassion towards the patients, but also remember that MDs look at patients with a separate set of objectives and these objectives are what saves lives. 

    Education Requirements

    First and foremost, the RN must already have an undergraduate bachelor’s degree. If the degree is a Bachelor of Science in nursing (BSN) then most of the coursework will be sufficient as prerequisites for medical school. If the nurse has a degree in another non-science field it is important to take notice to all prerequisite coursework. If the RN does not have a bachelor’s degree - this would be the first step in becoming an MD. 

    The next step is taking the Medical College Admission Test or MCAT. This exam must be taken within three years of applying to medical school. The MCAT is a standardized computer-based exam that assesses problem solving, critical thinking, written analysis and knowledge of scientific concepts and principles.

    Unfortunately, prior healthcare experience as a nurse does not give those individuals an advantage over others. In fact, it’s possible that the longer nurses have been practicing will actually have a disadvantage on the exam. Most students take the MCAT in their last semester of undergrad and prepare extensively in classes. Some major universities even offer students review courses. Nurses would be required to find their own study programs. 

    The MCAT exam is like the NCLEX that focuses less on real world application and more on textbook learning. This could be a disadvantage to some nurses.

    After sitting for the MCAT, scores are reported to the medical schools that were applied to. Some schools prefer nurses because of their prior experience in the healthcare field while others see it as a hindrance. Medical schools look at undergraduate grades, coursework, the university the individual graduated from and the MCAT scores. According to the Association of American Medical Colleges (AAMC) some medical schools do not look at applicants with MCAT scores under a certain score. 

    Medical school is two years in the classroom setting and two years in the clinical setting. Regardless of prior healthcare experience and training becoming a medical doctor still take four years. Being a nurse does not cut this time down. 

    After medical school, new physicians attend a residency program that is between two and four years. If an individual wishes to specialize in a specific field, a fellowship is required. Fellowships can be up to five years in length. The more specialized the field, the longer the post graduate training. Once all is said and done it could be almost ten years (i.e. cardiothoracic surgeons and neurosurgeons) before becoming a full-fledged attending physician.

    Cost of Medical School

    According to the AAMC, the average cost of attendance for one year at a public medical school (including tuition, fees, and health insurance) was $34,592 for in-state students and $58,668 for out-of-state students for the 2016-2017 school year. This figure was much higher for private universities. This means an out of state student would pay approximately $234,672 for their medical degree.

    In 2016, U.S. News & World Report’s released a list of the ten most affordable public medical schools. 6 of the 10 are in Texas. As seen in the table below, these low-cost medical schools are also ranked as some of the lowest, or not ranked at all in medical and osteopathic schools. While this may not seem important - graduating from a well-known and well respected medical school can make a stark difference in residency placement and future job opportunities. 

    Medical school (name) (state) In-state tuition & fees (2015-2016) U.S. News research rank U.S. News primary care rank
    Texas A&M Health Science Center $16,432 76 (tie) 78 (tie)
    University of Texas Health Science Center—San Antonio $17,661 60 (tie) 71 (tie)
    Texas Tech University Health Sciences Center $17,737 84 (tie) 84 (tie)
    University of North Texas Health Science Center $19,022 RNP 50 (tie)
    University of New Mexico $19,233 78 (tie) 45 (tie)
    University of Texas Southwestern Medical Center $19,343 25 (tie) 21 (tie)
    University of Texas Health Science Center—Houston $20,092 56 (tie) RNP
    Marshall University (Edwards) (WV) $20,100 RNP RNP
    West Virginia School of Osteopathic Medicine $21,650 RNP RNP
    East Carolina University (Brody) (NC) $22,281 88 (tie) 32 (tie)


    RNP denotes an institution that is ranked in the bottom one-fourth of all medical and osteopathic schools. U.S. News calculates a rank for the school but has decided not to publish it.

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    Other Options (CRNA & NP)

    For nurses there a plethora of advance medical degrees that do not require a four-year medical degree and the lengthy postgraduate residency and fellowship. The most common are Certified Registered Nurse Anesthetist (CRNA) and Nurse Practitioner (NP).

    CRNA programs are typically three years while NP programs can be completed in two years, if done full time. Furthermore, registered nurses are still able to work while attending these programs, whereas they cannot work while in medical school. Additionally, because NP and CRNA programs are seen as career advancements by hospitals, tuition reimbursement may be an option. Medical school would not qualify. 

    Becoming a MD does have its advantages and it is understandable why some nurses want to further their career in this way. The best advice for anyone considering this path is to have a frank, open conversation with others in the medical field and determine if the length of school, associated financial responsibilities, and change in lifestyle will ultimately be worth it.

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