An advanced nursing degree is a graduate-level degree, either a master’s or doctorate, that prepares registered nurses for expanded clinical, leadership, or research roles. The most common are the Master of Science in Nursing (MSN), the Doctor of Nursing Practice (DNP), and the PhD in Nursing. Nurses who complete these programs can qualify to become Advanced Practice Registered Nurses (APRNs), a designation that includes four distinct roles licensed in all U.S. states and territories.
The Four APRN Roles
Advanced nursing degrees lead to one of four recognized APRN designations, each with its own scope of clinical work and training requirements:
- Certified Nurse Practitioner (NP): Provides primary or specialty care to patients, including diagnosing conditions, ordering tests, and prescribing medications. NPs specialize in a specific patient population.
- Certified Registered Nurse Anesthetist (CRNA): Delivers anesthesia for surgeries and procedures. Training involves simulation, didactics, and full clinical subspecialty rotations.
- Certified Nurse-Midwife (CNM): Manages pregnancy, labor, delivery, and postpartum care, along with gynecologic and reproductive health services.
- Clinical Nurse Specialist (CNS): Focuses on improving patient outcomes and nursing practices within a specific patient population or clinical setting, often working in hospitals or health systems.
All four roles require at minimum a master’s degree in nursing from a nationally accredited program, though the trend is moving toward doctoral-level preparation.
MSN, DNP, and PhD: How They Differ
The Master of Science in Nursing is the traditional entry point into advanced practice. It provides the clinical training and specialization needed to sit for national certification exams and apply for APRN licensure. Most MSN programs take two to three years to complete.
The Doctor of Nursing Practice is a practice-focused doctoral degree. DNP students develop skills in translating research into clinical improvements, leading healthcare organizations, and shaping policy. The program includes a scholarly project rather than a traditional dissertation, and graduates typically require 1,000 supervised practice hours for program completion. DNP graduates work as nurse practitioners, chief nursing officers, healthcare executives, and directors.
The PhD in Nursing is a research doctoral degree. Students train to conduct original nursing research, develop theory, lead research teams, and teach. The culminating requirement is a dissertation. Graduates go on to become professors, research directors, postdoctoral fellows, and program leaders. If your goal is clinical practice rather than generating new research, the DNP is the more relevant path.
The Shift Toward Doctoral Preparation
Many APRN training programs are phasing out master’s-level preparation in favor of the DNP. The American Association of Colleges of Nursing and the National Organization of Nurse Practitioner Faculties have been working to make the DNP the standard entry-level degree for nurse practitioner roles. In April 2023, NONPF reaffirmed its goal of reaching this milestone by 2025, though no state licensing board has yet required a DNP for NP licensure.
The shift has already happened for nurse anesthetists. Since 2022, all new CRNA students must enroll in a doctoral program. The accrediting body for nurse anesthesia education no longer accredits new master’s-level programs. For the other three APRN roles, a master’s degree still meets licensure requirements in every state, but enrolling in a DNP program now may save you from needing to return for additional education later.
Common NP Specializations
Nurse practitioners choose a population-focused specialty during their graduate program. Your specialty determines which patients you can treat and which certification exam you take. The most common options include:
- Family Nurse Practitioner (FNP): Comprehensive primary care for patients of all ages. This is the broadest and most popular specialty.
- Psychiatric Mental Health Nurse Practitioner (PMHNP): Mental health care across the lifespan, including therapy and medication management.
- Adult-Gerontology Nurse Practitioner (AGNP): Care for adult and elderly patients, available in both primary care and acute care tracks.
- Pediatric Nurse Practitioner (PNP): Primary or acute care for infants through adolescents.
- Neonatal Nurse Practitioner (NNP): Care for premature or critically ill infants up to two years of age.
- Women’s Health Nurse Practitioner (WHNP): Gynecologic, reproductive, and sexual health services.
National certification is required to practice. Major certifying bodies include the American Academy of Nurse Practitioners Certification Board, which offers exams for FNP, AGNP, emergency NP, and PMHNP credentials, and the American Nurses Credentialing Center. These certifications are recognized by all U.S. state nursing boards, Medicare, Medicaid, the Veterans Administration, and private insurers.
What You Can Do With the Degree
The scope of practice for APRNs varies significantly by state. As of the most recent data, 22 states grant nurse practitioners full practice authority, meaning they can independently diagnose, treat, and prescribe medications (including controlled substances) without physician oversight. The remaining states impose some limits: 9 restrict only prescriptive authority, requiring physician collaboration for certain medications, while 20 restrict broader clinical activities like diagnosing and ordering tests unless performed under a collaborative agreement with a physician.
Where you practice matters for your day-to-day autonomy. In full-practice states, NPs often run their own clinics and serve as primary care providers. In restricted states, you still perform the same clinical work but need a formal agreement with a collaborating physician.
Salary and Job Growth
Advanced nursing degrees come with a significant financial return. The median annual wage for nurse practitioners was $121,610 as of May 2022. That figure varies by specialty, setting, and geography, but it represents a substantial jump from registered nurse salaries.
Demand is surging. The Bureau of Labor Statistics projects nurse practitioner employment to grow 46.3% between 2023 and 2033, adding roughly 135,500 new positions. That makes NPs one of the 15 fastest-growing occupations in the country across all industries. Physician assistants, often considered a comparable role, are projected to grow 28.5% over the same period.
Getting Into an Advanced Nursing Program
Admission to graduate nursing programs is competitive. You’ll generally need an active RN license, a minimum undergraduate GPA (typically 3.0 or higher, depending on the program), and completion of specific prerequisite courses. Many programs also require professional nursing experience, though the number of years varies. Some universities offer RN-to-MSN bridge programs for nurses with an associate degree, letting you earn both a bachelor’s and master’s in a streamlined path. DNP programs accept applicants who already hold an MSN (post-master’s entry) or, increasingly, BSN-prepared nurses through direct-entry BSN-to-DNP tracks.