The highest degree you can earn in nursing is a doctorate, and there are two main types: the Doctor of Nursing Practice (DNP) and the Doctor of Philosophy in Nursing (PhD). Both are terminal degrees, meaning there’s nothing above them. The one you’d choose depends on whether you want to focus on clinical care or on research and teaching.
DNP vs. PhD: Two Different Paths
The DNP is built for nurses who want to stay in clinical practice at the highest level. It focuses on applying research to patient care, leading healthcare teams, and improving systems. Most DNP graduates work as advanced practice registered nurses, holding titles like nurse practitioner, nurse anesthetist, or nurse midwife. They diagnose, treat, and manage patients directly.
The PhD in Nursing is a research degree. It prepares nurses to generate new knowledge through original studies, teach at universities, shape health policy, or lead healthcare organizations. PhD-prepared nurses fill faculty roles at every level of education, from community colleges to research universities. They also serve as administrators within hospital systems, lead policy organizations, and support funding institutions at the state and national level. A comparative study of the two found that PhD-holding nurses tend to be about 10 years older than their DNP counterparts and are more likely to hold administrative or leadership positions, while DNP nurses predominantly work in direct clinical roles.
What You Can Do With a DNP
The DNP opens up several advanced practice specialties. Common paths include family nurse practitioner (primary care for all ages), adult-gerontology acute care nurse practitioner (critically ill adults), pediatric nurse practitioner in both primary and acute care, and psychiatric-mental health nurse practitioner. Each specialty prepares you to independently assess, diagnose, and manage patients within that population.
One specialty where a doctorate is now mandatory: nurse anesthesia. As of 2025, all new certified registered nurse anesthetists (CRNAs) must hold a doctoral degree to enter the profession. The American Association of Nurse Anesthetists approved this requirement back in 2007, giving programs nearly two decades to transition. If you’re interested in anesthesia, a master’s degree is no longer sufficient for new graduates.
How Long It Takes
If you already hold a Bachelor of Science in Nursing (BSN), a DNP typically takes about three years of full-time study. Programs generally require around 66 credit hours and over 1,000 clinical hours. All advanced-level nursing programs must include a minimum of 500 practice hours focused on demonstrating doctoral-level competencies, though most programs exceed that floor significantly.
A PhD in Nursing usually takes four to five years of full-time work, though part-time options stretch that timeline. The bulk of the program centers on research methods, statistics, and completing a dissertation based on original research. Clinical hours aren’t the focus here; the emphasis is on producing new evidence rather than applying existing evidence at the bedside.
Both degrees can also be pursued from a master’s starting point (MSN to DNP or MSN to PhD), which shortens the timeline since you’ve already completed graduate-level coursework.
Salary and Career Outlook
Doctoral-prepared nurses in clinical roles earn strong salaries. Bureau of Labor Statistics data from May 2024 puts the median annual wage for nurse anesthetists, nurse midwives, and nurse practitioners at $132,050, with nurse practitioners specifically earning $129,210. PayScale survey data reports a slightly lower average of $117,000 for DNP holders overall, which likely reflects the range of roles DNP graduates fill beyond direct patient care.
PhD-prepared nurses in academic roles often earn less than their clinical counterparts, which contributes to a persistent faculty shortage. Across the U.S., the average full-time nursing faculty vacancy rate from 2015 to 2024 was 7.64%. The top barriers to filling those positions include noncompetitive salaries compared to clinical practice, difficulty finding faculty with the right specialty expertise, and a limited pool of PhD-prepared nurses in many regions.
Which Doctorate Is Right for You
The simplest way to decide: if you want to take care of patients, choose the DNP. If you want to teach nursing students, run research studies, or influence health policy from behind the scenes, choose the PhD. Some nurses eventually earn both, though that’s relatively uncommon.
It’s worth noting that the DNP is still a relatively young degree, and its role in healthcare organizations is still being defined. Some leaders in healthcare systems deeply value the systems-level thinking and quality improvement skills that DNP education provides. Others remain uncertain about what distinguishes a DNP-prepared nurse practitioner from one with a master’s degree in the same clinical role. If you’re considering a DNP, look for programs with a strong clinical focus in your specialty of interest, since program quality and structure vary widely.