A classic question that you are often asked at a medical school interview is ‘why do you want to study medicine and not nursing?’ This is because the motivations to study these vocations can overlap and without appropriate research you might not know which suits you best. Unfortunately, a career is nursing is often overlooked as it may be seen as more female-dominated, inferior and not as mentally challenging as medicine. However, this is a very naïve view, and the reality is that anyone of any gender can become a nurse and they are just as intelligent and important as doctors. This blog will hopefully emphasise their importance and is one part of our blog series where we explore vocations similar to medicine to help decide whether medicine is the right fit for you.
A doctor’s training is more extensive compared to nursing as they are educated in understanding anatomy, physiology and the way different treatments work. This allows them to diagnose, organise investigations and devise management plans for a variety of conditions. They can therefore direct patient care and their decisions have a huge bearing on how a patient progresses, especially once you become a senior doctor (consultant / General practitioner). Therefore, traditionally a doctors’ role in medicine is to assess and diagnose patients to then create appropriate treatment/management plans which a nurse then carries out.
On the other hand, the key roles for a nurse include spending time with patients to provide hands-on care such as administering medication, performing bedside tests and regularly monitoring the wellbeing of patients on the wards. Like medicine, the field of nursing can have a variety of specialisms ranging from being a ward nurse, paediatric nurse, district nurse, mental health nurse and so on, each with their own tasks and responsibilities. Perhaps the ultimate difference between being a doctor compared to other vocations like nursing is that doctors have the most responsibility and make decisions with more authority, especially once they become senior (consultant or GP). There are also a few specific things like prescribing certain medications or performing surgical procedures that can only be performed by doctors.
Over time, these jobs have become less mutually exclusive with nurses being given more independence, particularly as an advanced nurse practitioner who can have prescribing capabilities and create their own management plans (see more about them here: https://medmentor.co.uk/blog/what-is-the-difference-between-a-doctor-and-an-advance-nurse-practitioner-anp), a role which could be likened to a junior doctor in several ways. This can make it increasingly difficult to separate the fields of medicine and nursing.
A nursing course is quite different to medicine. Like medicine, nursing can be a degree undertaken at university however, there are also other routes such as an apprenticeship. It is usually a three-year full-time course which is split roughly 50:50 between theory and clinical placements. The first year involves studying the core modules and the second and third year is usually when you can choose a specific field of nursing (e.g. adult, child, mental health and learning disabilities). On placement, students will shadow nurses and gradually become more independent in caring for patients on their own and undertaking long shifts as a qualified nurse would (12 hours usually). Upon completion of a nursing degree you are registered with the NMC and can start working immediately in the NHS at band 5. For those undertaking a nursing degrees in the UK, there are bursaries available too which include £5000 (or more depending on means testing) for each student every year (note these are bursaries not loans so are not paid back).
On the other hand, medicine is a longer 5/6year course which is broken up in different ways depending on the university. Some medical schools split the course so the first 2/3 years are pre-clinical where students learn the anatomy and physiology of the body, followed by 3 clinical years where they spend the majority of time on placements learning about clinical medicine and shadowing doctors. However, other medical schools offer integrated courses so students may be expected to be on the ward from as early as their first year.
Comparing salaries between a doctor and a nurse is a bit arbitrary as the job role, training length and the working hours are different for both jobs. However, it is still important to have a basic understanding of it to know what you are getting yourself into. Nurses are paid via the agenda for change pay rates which pay staff via bands based on their qualification and experience. Qualified nurses enter at Band 5 which earns you £27,055, which is coincidentally quite similar to what you would earn as a Foundation Year 1 Doctor after completing medical school. This salary increases as you become more senior up to band 7, 8, and 9 which go beyond £40,000. However the average salary of a nurse in the UK is around £34,0000. This is different to doctors who have a higher ceiling, with their salary outlined in our blog here: https://medmentor.co.uk/blog/what-happens-after-medical-school-in-the-uk. Of course, whenever we do discuss salaries on medmentor (and I do it often) there is always the caveat that this is the current salary in the NHS and so it could change in the future and ranges significantly around the world.
In short, no a nurse cannot perform surgery. Becoming a surgeon is a gruelling process taking several training years after qualifying as a doctor to be confident in the anatomy, become competent in the skill and also be aware of any complications and how to manage them. Unfortunately, nurses aren’t given the same opportunity to learn it as doctors do. However, there are advanced nurse practitioners who are trained in minor surgeries such as removing small skin lesions.
Nurses are not able to prescribe medications unless they have completed an accredited prescribing course and registered their qualification with their regulatory body (e.g. NMC). These nurses are called Nurse Independent Prescribers. Many advanced nurse practitioners have completed this course and are able to prescribe medications. However, most nursing staff do not prescribe medication, though they are generally responsible for administering it to patients.
Deciding whether to study medicine or nursing is a classic dilemma students often have, and therefore a question that is often asked at interview as they both fulfil the criteria of wanting to care for and treat patients, albeit in slightly different ways. In order to make this decision, you need to have a good understanding of the role of a doctor, a nurse, and other similar professions whilst recognising the importance of each one and how they all work together as part of the multi-disciplinary team. This will give you a good basis to then compare each profession by the differences in training process/length, responsibilities, skills required, pay, career progression, and the job itself. Once you have effectively mapped out the differences, fill in what makes you suited to the profession you choose. For example, if you are applying to study medicine, think about what relevant skills you have developed, and what your experiences of medicine (e.g. work experience) showed you about the profession.
This is what you need to illustrate during your medical school interview when they ask "Why Medicine?". When answering this question, you must acknowledge how invaluable nurses are to the NHS. It can be easy to sound demeaning to other healthcare professionals so be careful about the words you use.
To understand more about how to answer the classic ‘why medicine’ question, read Sakina’s article here: https://medmentor.co.uk/blog/interview-series-2-why-medicine as well as Sana’s blog here https://medmentor.co.uk/blog/interview-series-4-understanding-a-career-in-medicine-do-you-really-know-what-youre-in-for.
In conclusion, medicine and nursing can seem quite similar and both can be incredibly fulfilling. However, like medicine, nursing has its cons and in recent times, there have been serious question marks drawn over appropriate pay conditions. It is worth reading about the national strike ballot organised by the RCN in deciding whether nurses should strike over inadequate ‘real’ pay increases in the last few years. When deciding which profession to do, it is important to pick the career that you are most passionate about but also consider the practical aspects such as finances and work life balance as these are also very important.
Author: Dhillon Hirani
Editor: Dr Latifa Haque