The nursing roles that require an advanced degree fall under the umbrella of Advanced Practice Registered Nurse (APRN). There are four APRN roles recognized in the United States: Certified Registered Nurse Anesthetist (CRNA), Certified Nurse Practitioner (CNP), Certified Nurse-Midwife (CNM), and Clinical Nurse Specialist (CNS). All four require at least a graduate-level degree, and several other nursing careers outside direct patient care, like nurse educators and nurse researchers, also require advanced education.
The Four APRN Roles
The APRN designation is a licensing title for nurses prepared with graduate-level education to provide direct patient care. To practice in any of these four roles, you need a formal graduate degree or post-graduate certificate from an accredited nursing program. This is not optional or employer-specific. It is a regulatory requirement for licensure.
Each role has a different clinical focus, but they share the same educational floor: a Master of Science in Nursing (MSN) at minimum, with a growing push toward the Doctor of Nursing Practice (DNP). The American Association of Colleges of Nursing has advocated for the DNP to become the entry-level degree for all APRNs, and that shift is already complete for one of the four roles.
Nurse Anesthetist (CRNA)
Certified Registered Nurse Anesthetists administer anesthesia for surgeries and other medical procedures. As of 2025, this is the only APRN role that universally requires a doctoral degree for new graduates. The American Association of Nurse Anesthetists announced this transition back in 2007, and it rolled out in stages: no new master’s-level programs were accredited after 2015, all schools had to enroll only doctoral cohorts by 2022, and the last master’s students either graduated by 2023 or transitioned into doctoral plans. Some smaller programs closed rather than redesign their curriculum.
If you’re applying to a CRNA program today, you’re applying to a doctoral program. CRNAs who earned their credential under the old master’s requirements are grandfathered in and can continue practicing and renewing their certification normally.
Nurse Practitioner (CNP)
Nurse practitioners diagnose conditions, order tests, and in many states prescribe medications with a level of autonomy comparable to physicians. You can enter the profession with either an MSN or a DNP, though the landscape is shifting. Many employers and state licensing boards now require a DNP, and NPs with a doctorate tend to have broader career opportunities.
Prescriptive authority for NPs varies significantly by state. Twenty-two states grant full practice authority, meaning NPs can prescribe with the same independence as physicians. Sixteen states require NPs to work alongside physicians through joint practice agreements, and the remaining twelve require physician supervision or delegation for controlled substances. NPs can prescribe controlled substances in all fifty states, though a handful of states restrict access to certain Schedule II medications.
Certified Nurse-Midwife (CNM)
Certified Nurse-Midwives provide reproductive and prenatal care, deliver babies, and manage gynecological health. Entry into the profession requires at minimum a graduate degree from an accredited midwifery program. Like nurse practitioners, CNMs currently enter practice with either an MSN or DNP, though doctoral preparation is increasingly encouraged.
Clinical Nurse Specialist (CNS)
Clinical Nurse Specialists focus on improving care within a specific patient population or clinical setting, such as oncology, pediatrics, or critical care. They blend direct patient care with system-level work like developing treatment protocols and training staff. To become a CNS, you need an MSN, DNP, or a post-graduate CNS certificate. The role is sometimes less visible than the other three APRN positions, but it carries the same graduate-degree requirement and the same APRN licensing title.
Advanced Roles Outside Direct Patient Care
Several nursing careers beyond the four APRN roles also require or strongly favor advanced degrees, even though they don’t involve the same kind of hands-on clinical practice.
Nurse Educator: Teaching in a nursing program typically requires at least a master’s degree in nursing education, and doctoral degrees are increasingly the standard for full faculty positions at universities. If you want to shape how future nurses are trained, a graduate degree is effectively non-negotiable.
Nurse Researcher: Nurses who want to design and conduct original research typically pursue a PhD in Nursing rather than a DNP. The distinction matters. A DNP focuses on translating existing research into clinical practice, improving care systems, and measuring patient outcomes. A PhD focuses on generating new knowledge through independent research, with coursework in advanced statistics, research methods, and theory development. PhD programs generally take four to five years, require a dissertation, and include a minimum of 140 hours of mentored teaching experience. DNP programs are often designed for working nurses and can be completed part-time.
Advanced Public Health Nurse: Nurses working in population-level health, rather than individual patient care, can pursue advanced public health nursing (APHN) credentials. Preparation typically involves a graduate degree, either an MSN, a Master of Public Health, or a DNP. About 17 DNP-level programs exist in the U.S. for this specialty. Since there is no national APHN certification, the graduate degree itself serves as the defining credential.
Nursing Informatics Specialist: This role sits at the intersection of nursing and health information technology. Board certification in nursing informatics requires at least a bachelor’s degree in nursing, but the more advanced career paths involve graduate-level coursework. One pathway to certification includes completing a graduate program in informatics nursing with at least 200 hours of supervised practicum.
MSN vs. DNP: Which Degree You Need
For most APRN roles today, an MSN is still the minimum. But the profession is clearly moving toward doctoral preparation as the standard. The AACN’s position is that the DNP should be the entry-level degree for all APRNs, and CRNAs have already made that transition mandatory. Nurse practitioners, nurse-midwives, and clinical nurse specialists can still enter practice with a master’s degree, but that window may narrow in coming years as more programs convert to doctoral tracks.
The practical difference between the two degrees comes down to depth. MSN programs prepare you for clinical practice in your specialty. DNP programs add training in evidence-based practice, healthcare leadership, systems improvement, and applied finance. A DNP typically requires a scholarly project and a minimum of 400 clinical hours within that project, while an MSN focuses more tightly on clinical competency. If your goal is to eventually lead a practice, influence policy, or hold a senior administrative position, the DNP gives you a stronger foundation. If your goal is to start practicing as quickly as possible, the MSN gets you there faster, and you can always bridge to a DNP later.