PhD or DNP? How to choose

 Before looking into doctoral programs, prospective nursing students should decide which route is right for them. Currently, two major nursing degrees are awarded at the doctoral level—the Doctor of Philosophy in nursing and the Doctor of Nursing Practice. In my discussions with BSN- and MSN-prepared nurses, there seems to be a little confusion about the two doctoral degrees. My advice is, do your research and know which degree you want before deciding what school to apply to. Put another way, looking at various schools of nursing and using this information to decide which degree you wish to pursue is not the proper way to make the decision. This is because the two degrees are vastly different and, depending on what you want to do with it, pursuing the wrong degree will be a complete waste of your time.

The PhD is a research-oriented degree. The DNP, on the other hand, is a practice degree, which can be likened to degrees obtained by physicians, dentists, pharmacists and optometrists or ophthalmologists. There are a few major differences between the PhD and the DNP. While everyone may not agree with my explanation, consider the following categorical differences.

Prestige

Because of their vast differences, the degrees should not be directly compared but, in general, the PhD is regarded as the more prestigious of the two. Of course, the PhD has been around longer and is more widely recognized. It is also the terminal degree in nursing, meaning that no higher degree is attainable. If you looked at nursing degrees from a step-chart perspective, they would look something like this:

The chart may be slightly misleading because, in pursuing nursing degrees, a person doesn’t have to go from one step to the next. For instance, the point of entry for a person seeking a nursing license can be a diploma, an associate degree, a bachelor’s degree or an entry-level master’s degree. Also, a nurse doesn’t have to obtain a master’s degree before pursuing a doctoral degree. Still, the chart is a good indicator of how each nursing degree is viewed with regard to prestige.

Two types of knowledge

While both degrees are designed to produce nurses who will contribute to the knowledge base of the profession, one thing is clear—the PhD-educated nurse is expected to create new knowledge. A PhD dissertation cannot be successfully defended without the generation of new knowledge. As nurses who are more focused on practice than research, those in DNP programs may or may not have generated new knowledge upon completing their capstone projects.

An easy way to differentiate between the two degrees is to see the PhD nurse as a knowledge-creator and the DNP nurse as a knowledge-applier. Where a PhD program focuses on understanding the philosophical and theoretical foundations of nursing and using these foundations to generate new knowledge, a DNP program focuses on taking knowledge available to the profession and transferring it to practical application.

Focus on hands-on-nursing

Obtaining a PhD requires no clinical hours at the bedside or direct patient care. Obtaining a DNP, however, typically does require some type of practice hours to prove a student’s competence in his or her specialty area. If you are studying to become a nurse educator, for instance, you may have to work in an academic or clinical education setting. Or, if you are obtaining your DNP to become a nurse practitioner or clinical nurse specialist, you will spend many hours under the preceptorship of an already licensed advanced practice nurse.

PhD students take courses such as philosophy and theory to stimulate abstract thinking about the nursing profession whereas DNP students take courses such as pathophysiology and nursing assessment, knowledge and skills more geared to nursing practice. I have seen PhD nurses work per diem or volunteer in order to maintain their nursing skills, provide community service or supplement their income, but never have I come across a PhD-prepared nurse who works full time providing direct patient care. DNP-prepared nurses, on the other hand, often work in patient-care settings as nurse practitioners, clinical nurse specialists, nurse administrators, nurse educators and nurse researchers. Both PhD and DNP nurses teach in academic settings.

Choose wisely

Whichever degree you choose to pursue, make your choice wisely. If you are in a PhD program but want to be a full-time nurse practitioner, you may find yourself miserable. If you are in a DNP program, but want to be a world-renowned neuroscience researcher, you may also be miserable. Although it is OK—and highly encouraged—to compare and contrast the two doctoral degrees in nursing, it is imperative to understand that neither degree is “better” than the other. They are complementary. Both are needed to keep patients safe and to continue advancing the practice of nursing.

I like to joke that the PhD is the attractive, older sister and the DNP the sassy, younger sister, but their momma and daddy love them both the same. I need my DNP “siblings” just as much as they need me. We are one big happy family.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.