I’ve been an NP for almost 5 years and was a nurse for 5 years before that. Nearly all of my experience has been in the outpatient setting, community health centers and urgent care clinics. I completed an FNP program at a very competitive school and was at the top of my class. Still, I am constantly baffled by the fact that as NPs we are expected to practice independently immediately after graduation from a 2 year program. We don’t get nearly as much training as medical students, and yet they would never be expected to work alone right away, they have at least 2-4 YEARS of residency and then can go on to years of fellowships etc. Our programs are full of “fluff,” theory, and busy work writing assignments. Medical students have cadaver labs and hundreds more hours of clinical /hands on training which to me is more valuable than endless research papers and “discussion posts.” I think schools are just thinking about the financial bottom line and churning out way too many NPs and not preparing them adequately. Where are our residencies and fellowships? Yes there are a few available for a small percentage of grads, but not nearly enough for it to be a viable opportunity for the majority. When it comes down to it, yes I feel capable of diagnosing and treating a lot of health conditions and I’ll always ask for help or make referrals when I am unsure of something...but honestly a lot of my learning was and is still done on the job, by constantly being on UpToDate and figuring things out “on the fly.” It shouldn’t be that way. It’s unfair to patients. This is probably also a factor in why burn out in primary care is so high—we aren’t adequately prepared! Of course this issue is multi factorial, but I think we need to restructure our NP education. More clinically rigorous programs, fewer students, residencies for all, fewer BS writing assignments. Instead of worrying about the DNP (a clinically useless degree —fine if you want to teach and do research) and getting independent practice authority we should focus on more hands on clinical training in the first place. We wonder why MDs don’t take us seriously and look down on us—a lot of times I don’t blame them. Am I alone in this? Does anyone else feel this way?