Online Degree Mills Will Destroy Our Profession Slowly but Surely

Disclaimer: I am not saying online programs are inferior to brick and mortar programs. The point of this article is to enlighten everyone about the reality of this situation.

Online diploma mills are an extreme disservice to our profession. Every nurse practitioner is aware of this issue. If you are not, you must have graduated from one or have been on Mars. These schools accept anyone and pump out massive amounts of new graduate nurse practitioners. This trend is destroying the job market and staining our credibility.

These online diploma mills really started gaining traction in the late 2000’s. I remember when I was applying for my MSN in 2010 and there were far fewer online programs compared to today. At that time, most of them were through legitimate state ran universities, not for-profit entities. I remember talking with physician colleagues as a registered nurse and many of them thought the idea was hilarious. During this same time, I also talked with human resource departments and many of them said they don’t find these graduates to be very well prepared and don’t even consider them for interviews. THIS WAS IN 2010!

Just by hearing a few negative remarks, I decided on going to a brick and mortar school. Did I find this education to be more superior to that of an online program? Probably not, but I know that I was able to interact with the professors and other students face to face. I also know that because of these real-life connections, I was able to obtain better clinical rotations and it helped me land a job when I graduated. Regardless, would I still be the same nurse practitioner I am today if I had gone to an online program? Probably… You get what you put into it with nurse practitioner schools. In reality, this is true with most things in life. In my opinion, the debate is mute because of this. There are plenty of successful nurse practitioners who have gone to online programs.

Nevertheless, perception is reality. Physician groups and other entities that do not like the nurse practitioner movement are using the fact that nurse practitioners can obtain a degree online against us. Will this actually affect legislative proceedings? Who knows, but it is still a negative perception. If the general public knew about online degree programs, would it change their perception on nurse practitioner care? Again, who knows. These are important questions moving forward.

The main issue is the lack of oversight in these programs. Students can cheat on tests and lie about their clinical hours. These two things are what make a good nurse practitioner good: putting the hours and the hard work into their education. Students now can pay for a license to prescribe medications and diagnose conditions for heaven’s sake! Are all students cheating? No, but a lot are. I guarantee it.

Another big issue is clinical preceptorship. There is no system in place for these online schools to screen the preceptor. Students could be receiving horrible clinical education from an unqualified nurse practitioner.

Not only that, but the admission standards for these programs are laughable. You essentially just need to be an RN and willing to pay. Many programs don’t even require the GRE!

Do you realize what this is doing? Get your head out of the sand! Our market is becoming saturated with ill prepared individuals in many areas of the country. If you live in a fruitful area, find yourself fortunate but you need to prepare yourself, because every market will become saturated eventually. These schools are pumping out 20,000+ graduates a year according to the AANP. I want you to think about that for a second… 20,000… That is an epic crap load of nurse practitioners entering the market every year.

Who is to blame? Academia. Especially for-profit entities. All they care about is tuition dollars to inflate their salaries and to justify their jobs. It should be criminal in my opinion. There are no standards among nurse practitioner programs. The AANP and ANCC should step in… HAH! Yea right, the more graduates mean more people taking their tests which means more profit for them. This is how the world works.

So, who is going to stop this? Who can change what is going on? I will tell you right now that national nursing organizations aren’t going to do it. They would have by now. Only state boards could at this point. If anything, a physician lobbying group will. This will be detrimental too many of the competent nurse practitioners out there who practice independently.

The more important question is, WHAT CAN YOU PERSONALLY DO ABOUT IT? You need to focus on your own well being in this situation. Your family, friends, and way of life are more important than wasting your time trying to change things. There is too much money to be lost… It is like a goldfish trying to stop a cruise ship. Good luck.

Instead, change your own personal circumstances. Think really hard and ask yourself:

“What would I do if my market became so saturated that I became disposable and my salary decreased?”

This is a fact for many nurse practitioners in many areas of the country. If you are in a saturated market and have a good job, you need to consider what you would do if you lost that job? If you apply for another job, you are competing against HUNDREDS of other nurse practitioners. The same goes with those in good markets, if you lose your job and the market becomes saturated, your life is going to be harder. I have known nurse practitioners whose contract was not renewed because administration caught wind of the market saturation and decided to go with other CHEAPER applicants.

You better have a plan.

The only course of action I have found is to become self-sufficient. You do this by starting your own business. It doesn’t even need to be in medicine, just start a business! You need to become financially redundant. You need to have multiple income streams that back each other up. Relying on just your job to sustain your life is asinine in today’s unpredictable economy. You are in control of your own success.

As a nurse practitioner, you should utilize your license and open a practice. It would be dumb not to! But also consider other things like real estate investing. Try to create 2-3 side gigs. If you do this and your local market becomes saturated, you won’t be sweating bullets. I promise.

Consider the principles of the Elite NP Model. It is designed to help the astute nurse practitioner build a secure life. You need to think of the short to mid-term future friends. These diploma mills will continue to pump graduate after graduate out. There are only so many jobs! Have a plan in place that will secure your future for the long term. Live below your means, try to start a side business, get out of debt, save your money, and prepare for what WILL happen. You and your family will be better for it.

36 Responses

  1. Whoa! You have stated several untruths in this article. I’m FT faculty in an online MSN FNP program and it’s graduates are highly respected and highly sought after. We pride ourselves in the rigor of the courses and pay close attention to the pertinence of the material- including diagnostic excellence. Preceptors and employers pick our students over the brick and mortar institution students, including the prestigious state universities.
    Reality: My son is in medical school and a friend is in PA school. Even though they both have BS degrees, neither had touched a single patient walking into PA or Med school. They have to learn the basics from scratch-all the way down to learning how to take a BP! My Online NP students have years of experience in healthcare and this puts them head and shoulders above the Med students and PA students at the beginning.
    We don’t approach NP school as a trade- we have our students engaged in professionalism, policy, volunteerism, and social determinants of health. All presented online from a computer screen- but written by me and my colleagues.
    As far as physician perception- we NPs fight it all the time from many angles. Nurses have traditionally been viewed as substandard and subservient to doctors. We are not trying to be doctors, we are our own profession and do a damn good job at it. We need to stand together, not tear each other down based on uninformed opinions.
    I challenge you to take one of our online Primary Care courses – then write this article.
    btw, I’ve had my own NP business for 4 years and a lot of what you say about healthcare business is spot on. But, please do your homework (you can do that online) for accuracy before stating your opinion as truth to the masses- that’s fb mentality.

    1. Did I say all online programs? I did not, I said for profit diploma mills. I am glad your program is rigorous. That is what the NP profession needs.

    2. While it sounds like your online coursework is excellent, it is going through the diagnostic thinking and work-up at the bedside where all this fundamental knowledge translates and unfortunately, that is where many NP programs fall short. I would never let a 3rd year medical student (having completed two years of rigorous coursework), practice independently. And while some, and maybe yours, may require *some* bedside RN experience prior to the program, many now do not and it’s impossible for patients to know who has that experience and who does not. It is also VASTLY different experience…a bedside nurse follows the orders laid out by a physician without necessarily understanding the background, pathophysiology, or pharmacology for why; a physician uses all that background and translates it into a differential diagnosis, concise work-up, and appropriate treatment plan. You are absolutely right that they are fundamentally different (and both very important) professions, nursing and medicine, however, you can’t translate from one into the other with a few online courses, no matter how “rigorous”. And on that note, as a physician, I would LOVE to take you up on the challenge to complete your Primary Care Course. Please let me know how.

    3. There are straight RN to NP programs without needing to have any healthcare experience. In the future, those NP will be the majority and I will be happy to see the demise of poorly trained NPs from online diploma programs. Your comment is totally biased.

  2. So true! I see this all the time
    I graduated in 1999. I did double the clinical hours for my degree because I knew i wanted to be as prepared as possible to care for patients.
    But I also knew its experience that prepares you.
    I asked many questions, kept bothering my preceptors and they loves it. The NP role was new and many docs had no idea what you can do.
    Now new RNs can apply to grad school! No basic physical assessment skills or clinical intuition.
    Its sad and frustrating…
    So yes, online schools will destroy out profession, I agree
    -Jessica Portu APRN

      1. I agree, there should be at least a 5 year minimum of nursing experience required to apply to any NP program. How can you claim to be an advanced practice nurse if you were never a novice.

  3. Hard facts. NPs are being offered less than RN salaries in some areas. And they are desperate, because they’ve been looking for employment for over a year. It is a very sad situation for us, but you’re right, there’s not a lot we can do about diploma mills. I do agree that you get out what you put in to your program. I personally went to an online program, but it was with a major university. I also had to take the GRE. So they’re not all bad…

    1. No they are not. There are plenty of quality online programs. The for-profit ones that graduate hundreds of students a semester are the problem.

  4. This read like you shot a lot of it from the hip and seemed to be out of character from much of what I have read on your site. I certainly didn’t appreciate the:

    “Are all students cheating? No, but a lot are. I guarantee it.”

    Even if this were true, and I whole-heartedly believe it’s not, academic integrity is something for our institution to police and take care of, not something that needs to be promoted to our haters.

    It is no secret that perhaps the defining limitation of NP’s is how we are educated. But this article reads like an angry Student Doctor Network (SDN) troll wrote it. And those jerk-offs *hate* NP’s, and even go so far as to have an 8-page discussion of “What do to about Nurse Practitioners” during which a few imply violence…

    I know you’re trying to sell a product, and good on you, seriously! But I suggest you take this one back to the press and chew on it a little bit. Your tone is far more empowering than this!

    1. I know students who have cheated. I have seen and heard about it. Hell, med students cheat too. This is simply my opinion and it is to enlighten the NPs who care to know what is going on within our profession. These diploma mills will continue to water down our profession.

      1. Well, I’m in an online NP program. We can’t cheat. We have to purchase a program that is installed in our computer, and records the test taker and everything on your computer during your exam. So, yea.

    2. Student doctors should be angry. The invest far more time effort and money than anAPN for the same privledge of practicing medicine.

      1. and they end up making at least double what a nurse practitioner is paid, so they should not be too mad.

        1. Not all about money. Its about giving enough of a DAMN to invest that time money and sacrifice to bring your best to your future patients. Very few physicians go into medicine to get rich but so many NP comments seem to focus on money money money

  5. I really appreciate your honest and blunt opinion. Too many people take this and take it personally. Maybe you area a bit brash, but in a world of cupcakes and rainbows, we need more leaders like you. I went to a janky online program, it was embarrassing. I basically self taught found my own clinical sites and that is what I paid for with 32K program. Again I am self sufficient as I maximized my studying, continue to learn and utilized my nursing career for learning. The market will correct itself. Thank you for sharing Justin.

    1. Thank you for your comment. Yes… Some people got butt hurt about this article… They missed the point. I am not pointing fingers, I am simply enlightening everyone about what is going on. Like you, I feel like I had to self-teach myself a lot in NP school as well… It is a real sad state of affairs all around.

  6. Sober up ! Thank GOD _ for online programs. Keep in mind no two people have the same situation. Online programs provide the scheduled needed by most working RN’s. Many online programs now make NP programs affordable for single mothers and for couples with limited incomes. Simply, put online programs are opening doors for person who desire and deserve the opportunity to practice as nurse practitioners. Lastly, online or brick and mortar; the real learning begins when you meet that patient face to face.

    It’s not how you got there, but what is really important is you make a difference in the lives of others.

    1. I agree with you 100%. I don’t care if you obtain your education from an online program, that doesn’t matter. I think online education is the future of education and should be utilized as much as possible.

      The ISSUE are diploma mills that just pump out people that lack any real admission standards. Most of those tend to be online DIPLOMA MILLS. Are there brick and mortar diploma mills? Sure, but there are more online ones… You missed the point of the article… Which is why there is a disclaimer at the very beginning of the article that says that.

  7. There are so many choices with online, hybrid and in-person options. How can we tell if it’s a diploma mill? What is the criteria that we should look for or stay away from?

    1. Hello Bobbi,

      Look at the admission criteria. The more difficult it is to be accepted, the less likelihood of it being a diploma mill. If the program has very loose requirements and will just accept anyone, then stay away from it. Employers are realizing which programs are diploma mills and which ones are not. Thanks for the comment!

  8. I went to an online Hybrid program through a major state university system. We had to travel to campus each semester for skills check off, OSCES, and procedures labs. Our exams were all proctored through online video proctor service which we paid for. We had to pass comprehensive standardized exams each semester and predictor exam before graduation or you did not graduate. There were good preceptors and bad ones which I had to secure on my own but when I had a bad one (one was MD) I was able to work out something with the faculty to secure another one by having the option to come to clinic with a faculty member. That being said you get what you put into it. If you are having bad experience it is important to self advocate. If not not, no one else to blame. It’s not the online courses that are the problem. My courses required weekly Webex meetings and were synchronous. So I was able to form strong relationships with classmates just as if in person. I see your point with diploma mills but not all online programs are bad. I’m definitely not offended by this article but just saying buyer beware to anyone considering going to NP school.

    1. That sums it up. You get what you put into it. I have nothing against online education. Honestly, I prefer online education as sitting in a class room is pointless most of the time. I have a problem with subpar admission and graduation requirements. Our market is saturated, and diploma mills are partially to blame.

  9. As a preceptor, I have encountered 2 types of online programs. The first program had realtime online lectures. They were able to ask questions and get another perspective from other students. The other program I encountered the student learned from reading their texts and taking tests. They were able to email an instructor to ask questions. I believe they could also call and leave a message. It is the second online program that scares me.
    I noticed a difference in interviewing patients, asking appropriate questions, doing an exam and coming up with a plan of care. The second program is ANCC approved. How does that happen? What are the rules for colleges getting ANCC approval?

  10. I have been an NP for over 25 years. Before becoming an NP I worked as a RN in a teaching hospital rounding with the attending daily and reviewing cases for 7 years. I CAN NOT imaging how these NPs come out and practice without any nursing or clinical experience behind them. I recently took on a new NP from one of these online schools and was appalled at the lack of knowledge and lack of respect for the responsibility the profession warrants. We owe it to the population we serve to be the best we can be, to be up to date on the guidelines and research. Practice must be based on evidence based research and skills honed by clinical experience. I am concerned about where the NP profession is going.

  11. I am horrified that RN’s are going straight from nursing school into NP school without bedside nursing experience! I was an RN in a highly autonomous ER for years before even considering it. I attended a rigorous program. I worked one on one with an amazing physician mentor the first 6 years of my NP career, and I still learn something new everyday. These practitioners do not know what they do not know. Not only is it terrifying it’s becoming more and more difficult as a dedicated and knowledgeable NP to garner any respect from colleagues because of this situation. It’s embarrassing.

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