“DNP, DrNP, DNAP, DNS, DNSc, ND........” confusing isn’t it?

Let’s see…………………These types of degrees were developed in almost a reactive-fashion in response to other professional practice degrees. It is reasonable to have a practice doctorate in a discipline. However, there is no regulation or standardization of these degrees and that threatens our credibility and public confidence. In fact as soon as the thought of the DNP was introduced, Columbia and Drexel made a spin-off by introducing the DrNP. How does the mandate to develop a professional doctorate (i.e. DNP) affect our profession’s leadership, credibility, and the ability to educate our future nurses in a proper and respected academic setting? That is currently debated and an interesting perspective is written by Dracup et al., (2005; http://www.nursing.upenn.edu/dean/bl...erJuly2005.pdf) but that is not the focus of this essay. This essay will provide my opinions of the PhD and offer suggestions to gain entry if interested.

As a profession we have less than 400 nurses per year who obtain a PhD in Nursing and even fewer who obtain a PhD in another related field such as neuroscience, anatomy, pharmacology, etc. Globally, less than 1% of the population has earned the “Doctor of Philosophy” (PhD) degree. This requires the mastery of a specific subject and contributing to the existing base of scientific knowledge via the publication of work in a peer-reviewed scientific journal. This is not a degree that can be done “overnight” via an "online affair" or by having a "summertime fling" by adding 2-3 semesters, while that may be acceptable for a PRACTICE doctorate (DNP, DrNP, DNAP, DNS, DNSc, ND) it is not acceptable for obtaning the PhD which can take up to 7 years to complete as it incorporates a Master's Degree into the curriculum (most people enter a PhD with only a Bachelor's Degree and thus must be given the didactic background equivalent to a Master's Degree within that field). I know I am being a bit harsh in respect to the Clinical Doctorate but the "proof is in the pudding" just look at all the "online" and "part time" programs that are popping up, are those programs truly worried about credibility or money?

You do not attempt a PhD program if:

1. You want to know everything – A PhD is not all knowing, they have mastery in one subject area and expertise in a subtopic of that area. Also it doesn’t mean that you stop learning and only pursue one area all your life, in fact many PhD researchers cover many disciplines over their career. The PhD training provides you the tools to teach yourself in whatever field you’re interested. However to be taken seriously (by other PhDs) in other disciplines, one must perform all the tasks required to perform solid and published research in that area. Also, this degree is NOT ABOUT YOU!!! You are in this to help humanity by adding to the scientific/medical body of knowledge and training yourself to understandably explain tough questions to future students which will depend upon your ability to lead and instruct them for success in anesthesia. As a result, thousands of future patients will be affected (positively or negatively) by what you do as a PhD and instructor. When you quit learning, you quit on your future students and patients. You must be ready to accept the responsibility that accompanies the PhD.

2. You are looking for “props” or “respect” or looking to impress your friends and family – It doesn’t work that way, where do you think you will end up working? Everyone else around you will also have that same PhD degree. If you’re looking for “initials on a badge” to plug into your local nursing department for instant respect then you have come to the wrong place. Yes you will be called “Doctor” in the academic setting and if you obtain the status of Professor; according to the U.S. State Department Diplomatic Protocol, the title “Professor” ranks higher than the title “Doctor”. BUT, the desire for status usually does not yield the motivation necessary for the efforts required to earn the PhD.

3. You are looking to accomplish a “goal” – This degree is a "terminal degree" but not an end in itself; it trains you to research the current literature a specific problem within a discipline, form a hypothesis, establish a sound test to explore the hypothesis, and then decipher the results without rushing to judgment with as much non-biasness as possible. Once you get hooked, there is never an “ends” because an infinite number of questions arise that can be tested.

4. You are looking for financial success or job security – money is not why you do this, CRNAs will far exceed a PhD in earnings. Also, funding for grants is at an all-time low and competition is stiff. If you plan on keeping a job in a University setting, you have to be able to propose relevant health-related research ideas for funding and if not, “don’t let the door hit you on the way out”. If you go a certain period of time without obtaining funding, I don’t believe you will last long as a PhD in active research. Now you can of course instruct students, but many universities will require you to teach AND run a laboratory with active research (otherwise you are dead weight to the school).

Remember, the pursuit of this degree is NOT ABOUT YOU!!!


You may want to consider the PhD if:

1. You understand the time commitment (this is not an “online affair” or a summertime fling). You understand the true and deeper meaning of the above statements and are willing to accept an enormous amount of criticisms during your quest. Also with the time commitments (if you are married especially) are willing to struggle with your home-life for an extended period. Because in this respect, the pursuit of this degree is ALL ABOUT YOU!!!!

2. You are creative. Were you the one who always would open up the insides of your toys to see how they worked? Does everyone come to you to solve a difficult problem? Are you always asking yourself why things happen and are not satisfied with “because the textbook said so………” This degree is all about learning how to creatively think in order to solve a problem.

3. You are mature, motivated, a self-planner, and aggressive. This is not a structured program, it will be your responsibility to set your deadlines, schedules, manage your budget, and teach yourself new concepts by researching the scientific literature. The excellent thing about this program is your freedom; the evil thing about this program is your freedom. Your success or failure in this program is dependent upon your maturity, motivation, planning, and aggressiveness.

4. You are prepared to be a sound and contributing researcher, a strong leader, and an excellent instructor. Your actions will affect the lives of many people in a positive or negative manner and will reflect on the CRNA profession ultimately.

5. You are prepared for the rewards. My quest for knowledge and yearning to teach what I love (anesthesia) has brought me to my current situation. I know it’s been toughest on my family but the light in the tunnel is getting bigger. I have learned so much about myself and my abilities and have become a much better husband, father, person, clinician, instructor, and scientist because of this type of training. How I am rewarded cannot be expressed with words, when I make a small but possibly important discovery I get this feeling which rivals the rush I get when I successfully teach an SRNA (or anyone for that matter) a difficult concept, perform an awesome anesthetic, hear my kids say “I love you Daddy”, or every-single-time I look at my wife.

If you are interested, remember that there is a PhD in Nursing which is different than a PhD in another field (anatomy, physiology, pharmacology, etc.). A Doctor of Philosophy (PhD) is different than a Clinical Doctorate (DNS, DNSc, DNP, DNAP, DrNP, NP). The PhD prepares graduates to conduct original research and is the de facto “union card” for academic positions. The clinical doctorate only provides special preparation for CLINICAL PRACTICE areas and does so via “an online affair” or with a “summertime fling”.

The future of our profession is in peril, will the push for the clinical doctorate siphen potential PhD candidates and deplete the pool of respected academic professors teaching SRNAs?

If you want to take the plunge, you must:

1. Find an area of scientific research that thoroughly intrigues you and begin reading scientific journals (i.e. Nature, Cell, Science, etc). Also, have you heard of PubMed?

2. Establish what type of PhD field you are interested in, is it Nursing? Anatomy? Physiology? Pharmacology? Neuroscience?

3. Go to a lab at a local university and just observe (have you ever touched a pipette before?)

4. Use Google Search to your advantage, the internet has been around for a long time and has a lot of useful information. Type in phrases such as “What is a PhD”, “Applying for a PhD”, etc. Also use the web to research your university of interest.

5. Find out the programs you are interested in, email the directors for information (they are more than willing to send it) and set up a visit if applicable. Many programs have rolling admission. The entrance requirements are tough but the flexibility of the PhD program allows many universities to have a rolling admission. But like with every other type of program, there is an entrance process which is usually extremely well documented on each universities website.

6. You can always contact me, I will be more than willing to help you out.