NP vs. MD: Understanding the Differences

An NP and an MD in masks and protective clothing attend to a patient.

Whether they are a registered nurse taking a patient’s vital signs or a physician prescribing a much-needed medication, every health care worker plays an important role. In today’s health care system, nurse practitioners (NPs) and doctors of medicine (MDs) have important roles that often intersect.

When comparing the two roles, NP vs. MD, it’s clear they have many similarities. For example, both NPs and MDs work in health care facilities such as hospitals, clinics, and private practices. Additionally, NPs and MDs do many of the same patient care tasks, especially in states where NPs have full practice authority.

Although nurse practitioners and doctors work in the same environments, treat many of the same patients, and perform several overlapping duties in patient care, the roles definitely have distinct differences. Specifically, the differences lie in education, salary, and job roles and responsibilities.

For instance, a doctor would complete a four-year medical program to become either a doctor of osteopathic medicine (DO) or an MD, while an NP would need to complete a Master of Science in Nursing program. Additionally, aspiring NPs have the option to select a specialty for their master’s program. Some common choices include family care, pediatrics, and psychiatric mental health care.

NP vs. MD — Job Role and Responsibilities

Although NPs and MDs both deliver patient care, there are some key differences regarding how they can and cannot treat patients.

Medical doctors have full practice authority in every state, which means they have the ability to:

  • Diagnose and treat acute conditions
  • Order and interpret diagnostic tests
  • Manage a patient’s overall care as their primary health care provider
  • Counsel patients and provide treatment plans
  • Prescribe medications
  • Perform surgery (applies to specialized physicians)

NPs, on the other hand, will either have full practice authority, reduced practice authority, or restricted practice authority, depending on the state they work in. Practice authorities for NPs break down as follows:

  • Full practice authority: Full practice authority states allow an NP to perform all the same functions (except for surgery) as an MD, including prescribing medications.
  • Reduced practice authority: In reduced practice states, the state practice and licensure laws reduce an NP’s authority. The law requires that the NP make a career-long collaborative agreement with an MD to provide patient care services. If no collaborative agreement is in place, then one or more elements of the NP’s practice is reduced.
  • Restricted practice: In restricted practice states, state practice and licensure laws restrict at least one element of the NP’s practice abilities. State law requires the NP to have career-long supervision conducted by an MD, to have their responsibilities delegated by an MD, or to be managed by a team of physicians.

In addition to the differences in responsibilities, one other big difference when making the NP vs. MD comparison is the medical models each follows. Nurse practitioners follow the nursing model, a holistic form of patient care that emphasizes the psychosocial impact of a diagnosis on a patient. By comparison, MDs follow the medical model, which focuses purely on treating the patient’s disease or illness. Neither model is deemed superior or inferior. They are simply different approaches.

NP vs. MD — Education and Certification

Education and certification are other areas where NPs and MDs greatly differ. The steps to becoming an NP break down as follows:

  1. Earn an associate or bachelor’s degree in nursing.
  2. Pass the NCLEX-RN exam and get licensed with the state to become a registered nurse (RN).
  3. Gain experience as an RN.
  4. Earn a master’s degree in nursing (different specializations are available).
  5. Pass the NP certification exam (different specializations are available).
  6. Obtain certification as an advanced practice registered nurse (ARPN).

By comparison, an MD has a completely different educational journey. The main steps to become a medical doctor break down as follows:

  1. Earn a bachelor’s degree in biology, health science, or a related field.
  2. Get a qualifying score on the Medical College Admission Test (MCAT) and gain admission to a medical school.
  3. Complete the four-year medical school program to earn either a DO or MD degree (choosing a medical specialty in the final year of the program).
  4. Pass the U.S. Medical Licensing Exam (USMLE).
  5. Complete a medical residency (in three to seven years).
  6. Obtain state licensure.
  7. Become board certified (an optional step).

NP vs. MD — Salary and Job Outlook

Two other important considerations in the NP vs. MD comparison are salary and job outlook.

According to the U.S. Bureau of Labor Statistics (BLS), nurse practitioners had a median annual salary of $111,700 in 2020. By comparison, the BLS reports that physicians and surgeons had a median annual salary greater than $208,000 in 2020.

Regarding job outlook, the BLS projects the number of jobs for NPs will grow by 52% between 2020 and 2030. This is significantly faster than the average job growth of 8% projected for all occupations. By comparison, jobs for MDs are projected to grow by 3% over the same time period, which is slower than average.

The takeaway is that although the salary potential is much higher for MDs, currently the demand is far greater for NPs.

Begin Your Journey to an Advanced Career in Health Care

Becoming either an NP or an MD can provide an individual with the opportunity to offer patients essential health care services and make the world a better place. Both careers pay well and are projected to keep growing in the coming years. However, the role of NP will grow substantially faster, according to the BLS.

With the high demand for NPs, there has never been a better time to become a leader in nursing. For those aspiring to become an NP, the best first step is to enroll in a degree program that can develop the knowledge and skills required to make a difference as a nurse practitioner.

Discover how Hawai‘i Pacific University’s Master of Science in Nursing (MSN) program can help students reach their career goals as an NP with specializations such as family nurse practitioner, psychiatric mental health nurse practitioner, and adult-gerontology acute care nurse practitioner. Take the first step toward your career goals.

Recommended Reading:

Burnout vs. Compassion Fatigue in Nursing

The Importance of a Nurse’s Role in Patient Safety

Trauma Nursing in Vacation Cities


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CVS Pharmacy, What Is the Difference Between a Medical Doctor and a Nurse Practitioner?

Incredible Health, "Nurse Practitioner vs. Doctor: What’s the Difference?"

Indeed, "Nurse Practitioner vs. Doctor: What's the Difference?"

Link PAs, "Nursing Model vs. Medical Model (Similarities & Differences)"

U.S. Bureau of Labor Statistics, Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners

U.S. Bureau of Labor Statistics, Physicians and Surgeons