All nurse practitioners (NP) specialize in a particular area of medicine. Nurse practitioners make their specialization decision before applying to NP school, which is a critical difference between a physician assistant and an NP; physician assistants graduate with a general medical degree while NPs typically focus on a particular population.
This article discusses the somewhat confusing world of NP specialties, and it clarifies terms including population foci and subspecialization. Understanding these terms will help prospective students choose the right NP school.
Nurse practitioners must choose among six “population foci.” Each foci represents a group of patients who require specialized treatment. The National Council of State Boards of Nursing developed these, which are detailed in their Consensus Model for APRN Regulation. Nurse practitioner population foci include:
Within the adult-gerontology and pediatric populations, NPs can choose to focus on primary care or acute care. Primary care typically refers to day-to-day healthcare, whereas acute care refers to short-term urgent care. Primary care NPs usually work in an outpatient office or clinic, whereas an acute care NP would work in a hospital setting.
Prospective NP students are encouraged to decide which patient population they would like to work with so that they can best determine which NP school to attend. For example, those interested in becoming a neonatal NP would want to attend a school that has a neonatal program. One cannot become a neonatal NP after graduating from a psychiatric-mental health NP program without completing additional education.
Depending on which population foci students choose, they may be qualified to pursue certain sub-specializations as well. For example, an acute care adult-gerontology (population foci) NP might choose to further specialize in cardiology or emergency medicine.
These sub-specializations do not require specific schooling beyond population foci; however, some require an additional certification exam. As a result, some schools offer specific programs to help prepare students for the certification exam and gain valuable experience in the field.
For example, Duke University offers a unique program for those who wish to become orthopedic NPs. This program adds three courses to the curriculum that focus on the diagnosis and management of musculoskeletal problems. Upon graduation, students will be eligible to take both their population certification exam as well as the orthopedics sub-specialization certification exam.
Remember: students must choose a population focus, but they can pursue any sub-specialty, provided that they have adequate experience and meet the requirements to pass the corresponding certification exam.
Finally, some sub-specialties do not require an additional certification exam. For example, a psychiatric-mental health NP can work in the subspecialty of psychosomatic medicine without any additional certification exams or schooling in the subject.
The table below includes examples of NP sub-specializations, suggested population foci, and resources about each subspecialty. The suggested population foci column lists the recommended population to pursue; however, these are merely suggestions and may not be required.
|Sub-Specialty||Suggested Population Focus||Resources|
|Orthopedics*||Day in the Life of an Orthopedic Nurse Practitioner|
|Emergency Medicine*||Day in the Life of an Emergency Medicine Nurse Practitioner|
|Palliative Care*||Day in the Life of a Hospice Nurse Practitioner|
|Oncology*||Day in the Life of a Pediatric Oncology Nurse Practitioner|
|Dermatology*||Day in the life of a Dermatology Nurse Practitioner|
|Nephrology||Day in the life of a Nephrology Nurse Practitioner|
|Cardiology||Day in the Life of a Cardiac Nurse Practitioner|
|Psychosomatic medicine||Day in the Life of a Consultation-Liaison Psychiatric Nurse Practitioner|
|Surgery||Day in the Life of a Surgical Nurse Practitioner|
|Holistic Care||Day in the Life of a Holistic Nurse Practitioner|
|*These sub-specialties offer specialized certification exams. You can learn more about these in our article, “Ask an Expert: Which Additional Certifications Should NPs Pursue?”|