A simple google search for your desired nurse practitioner program will yield multiple pages of results. Starting with paid ads. Some seem legit, some seem sketch. So you go to FB forums only to see mixed results and lots of heated online arguments. So you ask people you know at the hospital, turns out they all go to the same one or two in your area that maybe doesn’t fit your needs. You do some deep introspection and honestly aren’t sure what you need anyways. Why is there no objective checklist out there in the world? Some tool that allows for school comparison and advice about what to choose? This is the blog for you my friend. In this discussion I’’ll give you the big list of variables to consider.

First rule of thumb. Nurse practitioner schools are a business, never forget that. Their primary objective is to make money and keep the business profitable and they do this by enrolling students. While we all want to live in a world where healthcare education is altruistic and exists for the betterment of mankind, this would be a somewhat naive assumption. Anything they tell you should be viewed through the lens of this reality. You as a consumer have to sort through their offering with a fine tooth comb to find the “catch.” If you go to the website and it feels sales-y, you should be suspicious. If the first thing you see pasted on every page is a “call now” banner, if the answers you are seeking are not transparent, if there are no teachers/directors names listed, if the pricing is not apparent, if they are heavy on the “look how easy and fast you can obtain a nurse practitioner education” message. These are all factors that indicate this school values numbers over quality, aka a “diploma mill.” I highly advise reading this Report of the National Task Force on Quality Nurse Practitioner Education to be in the know about the suggested legal requirements of the schools. Here are the variables I believe should be considered when making the choice of which school best meets your needs. I suggest listing these things out in order of importance and then begin your research.

1. Cost.

   Most NP programs range 20k-100k. The hidden variable here is how they present this information. Some will make it difficult to compute. They’ll present the numbers by semester rather than by year. Or perhaps as a rate per hour and the hours for each program vary. Price is an important variable, don’t get me wrong, no one wants to be in debt so certainly this factor should be high on your list of considerations. Having said that, in today’s competitive market a minor difference in cost could be offset by a higher reputation leading to better job opportunities. I personally followed the Dave Ramsey rule: never pay more for school than what you can anticipate earning as an annual salary. For us that’s around 100k.

2. Program Offerings.

   Let’s say you decide one semester into the program that you want to switch tracks, this will be considerably easier if you are remaining at the same school. I’ve heard some NP students say they were not allowed to transfer credits to another school as the programs are not structured the same.

3. Time to complete.

   This variable should be considered in conjunction with other factors to determine if you should go fast and furious or slow and steady while working on other endeavors.

   1. Do you need to work and how often?

   2. What other roles do you serve? Parent, caregiver, fitness coach on Saturdays, i.e. anything that requires a consistent time commitment from you.

   3. How old are you and what are your goals for practice? For me, I was older and the calculation of financial ROI (based on the school I chose - Emory for those interested) required at least a 15 year commitment to make it worth my while. This also spurred me on to choose an accelerated program as time was of the essence for my old butt.

4. Program structure

   In person, online, or hybrid? How much time do you want to spend commuting, are you better with in person - both are factors to consider. I find most all programs are some degree of hybrid. Online does not = bad IMO. But the quality of the online instruction is what matters most. Are the classes asynchronous? Is it an actual lecture or is it a module you click through. Y’all I’ve seen some students courses and they are literally 100% self-taught reading assignments. Come on. It’s ridiculous.

5. Quality of Instruction.

   You want to go stalker mode here. Look up the names of program directors and find out everything you can on them. You want to know if they are actively practicing and if it is within the field they are teaching. A few years ago an FNP who was teaching AGACNP students at a local university completed a clinical rotation with a colleague of mine. Her goal was to obtain the certification so she could continue as an AGACNP instructor. Y’all, observing her poor work ethic and drive to educate herself (asked to shadow only, not comfortable seeing actual patients, clearly zero desire to learn critical care) has heightened my sense of skepticism about the quality of instructors. I feel bad for the students she will instruct as she is certainly not an expert in her field. I respect that she is but one bad example, but my point is - be overly suspicious about the industry standard that your instructors represent. The more guest lecturers on the docket the better. Who best to teach you than the person with boots on the ground? The above task force suggestions: “The institutional policies support NP faculty teaching didactic courses with a clinical component and/or clinical courses by supporting faculty practice to maintain clinical expertise.” Did you catch the use of the verb support, rather than require.

6. Reputation

   1. Accreditation

   2. Ease of entrance (What testing? Entrance Interview? Essay? Grades? Letters of Reference? Seats available - the more there are the less selective they will have to be which could be telling in regards to reputation)

   3. Pass rate (avg is 90%)

   4. Attrition rate

   5. Percentage of students employed post graduation

   6. I suggest you find the answers to these questions by asking the school itself. Then join FB forums for the state and the school itself, assuming there is one. Search the site for topics related to the school. DM people who commented that they went to this school.

   7. True story. Many, many employers will throw away or have the ATS (automated tracking system) reject any resumes with certain schools on them. Yes, it happens all the time - way more than you think or that other students, NPs on forums suggest. This is mostly a factor for those without experience as an NP. After your first job your work experience carries more weight than your school selection.

7. Clinicals

   This is a hot topic. You will hear different facts from the public in regards to what is required of the schools. Read the aforementioned task force for the latest updates on school requirements. It has been said by some that the schools are required by law to assist you with clinical placement. While this may be true, the reality is that the degree of “assistance” is not regulated. Some will have minimal help, essentially just submitting the paperwork on your behalf and insuring there is a contract with the site. I have heard stories of schools that can’t get even that part right. Some will offer suggested sites but it’s up to you to secure a preceptor. Some schools will place you, but not many. Of those who do, the price may be quite steep. For some students this may be an ok trade - off. That was the case for me. I personally was willing to spend more money to receive an education from a school with a robust reputation for academic rigor (I knew this would increase my marketability as well as provide better instruction) and training from preceptors at highly sought-after sites which the school offered and placed for me. In a time when the supply of preceptors far outweighs the number of students you may have an extremely difficult time finding clinical sites. It is very common for students to have to delay graduation or pay for preceptors in order to complete their hours. Trust me when I say, this should be one of your highest variables to consider when choosing schools. My recommendation is to find a state school, preferably one associated with a school of medicine or hospital system. The connection with state schools is two fold - reputation and incentive for preceptors. There are a growing number of states that are adopting a policy incentivizing nurse practitioner preceptors with a tax credit of ~ 8-10K. Search to see if your state offers this. It is a big selling point and if your school does not offer much help, you will want numerous motivating factors to convince NPs to take you on as a student. Does this seem ridiculous and is it somewhat nauseating? Yes, but I deal in reality here friends. In the real world of graduate level NP instruction - finding a preceptor will be your biggest challenge at most schools. The single best place to go to find out what is truly happening at each school (in regards to how much actual support they offer) is to find the current students and ask them.

8. Procedure labs/Sim labs/OSCE

   You may think a high value for you is a school that requires minimal in person attendance dates. It’s a hassle, it may involve travel, expense, stress - so I get why you would want as few of these as possible. Here’s the (first) rub: do you want the easiest path to becoming a provider of potentially life saving to human beings? Is this what you would want for someone who is tasked with caring for you or your loved one? The fewer labs, the lower the rigor - period. I will die on this hill. The single best way to learn is by doing. Sim labs suck, but they refine your training. As a preceptor I am not likely to let a student who has not undergone a procedure lab perform a highly risky procedure on a patient. You need to have run through it at least once on a mannequin. This is not a popular opinion, but I stand behind it. The current suggestions to education reform hold the schools liable for providing a certain number of labs. Many are getting around this by conducting them virtually. Performing a procedure (even something as simple as performing a patient exam or history) virtually does not equate to performing it with other live people and/or in person with mannequins. The end of the story is - look for a school that genuinely wants you to learn, not just check the boxes. No labs = less desirable school.