MSN or Doctorate? What You Need to Know

For years the Master of Science in Nursing (MSN) has been the standard degree for nurses moving into advanced practice registered nurse (APRN) roles, which offer more autonomy, more room to advance, and often better pay. That is shifting toward the doctorate, and how much it affects you depends entirely on which APRN role you want.

The clearest change is already in effect. Nurse anesthetists now need a doctorate to enter practice. Recommendations point the same direction for nurse practitioners and clinical nurse specialists, though neither has become a hard requirement.

Why the Shift Toward Doctorates

The doctorate most common in nursing is the Doctor of Nursing Practice (DNP). It takes a few years longer than an MSN and goes deeper, building on your existing knowledge to prepare you for high-level clinical and leadership roles.

The push reflects how complex APRN work has become and how much more nurses are leading in healthcare. Patient safety is a major driver, going back to the Institute of Medicine's 1999 report on the physical and financial cost of hospital errors. Other factors include the rapid expansion of nursing knowledge, the rising complexity of basic patient care, staffing shortages, demand for leaders who can design and evaluate care, and a shortage of doctorally prepared faculty.

What Each APRN Role Requires

Certified Registered Nurse Anesthetists (CRNAs)

CRNAs are the only APRN role with a firm doctoral mandate, and it is now in force. Since January 1, 2022, every student entering an accredited nurse anesthesia program must enroll in a doctoral program, and as of 2025 all new graduates must hold a doctorate to earn APRN licensure. The DNP is the common choice, but other doctoral degrees qualify, including the PhD, EdD, Doctor of Nursing Science (DNS or DNSc), Doctor of Nurse Anesthesia Practice (DNAP), and Doctor of Management Practice in Nurse Anesthesia (DMPNA). CRNAs who were licensed before the change keep practicing under the standard renewal process.

Nurse Practitioners

An MSN still earns you NP licensure, and it remains the accepted entry-level degree in all 50 states. The American Association of Colleges of Nursing (AACN) has advocated for the DNP since 2004, and the National Organization of Nurse Practitioner Faculties (NONPF) recommended the DNP as the entry-level standard by 2025 and reaffirmed that position in 2023. That 2025 target passed without becoming a requirement. No state board mandates the DNP for NP licensure, so the MSN remains a valid path.

Clinical Nurse Specialists

CNSs can still enter the field with an MSN. The National Association of Clinical Nurse Specialists has recommended the DNP as the entry-level degree by 2030, with a long transition window. No firm requirement is in place yet.

Nurse Midwives

The MSN is the requirement for nurse midwives, with no active move toward a doctorate. The American College of Nurse-Midwives does not endorse requiring the DNP for entry into midwifery practice, noting there is no evidence additional education is needed to practice safely and that a degree requirement would add substantial cost and time for students and schools.

If You Already Have or Are Earning an MSN

If you hold an MSN, the degree changes do not affect the license you already have. CRNAs licensed before 2025 continue practicing. If you are enrolled in an MSN program, you can finish it, earn your APRN license, and practice. Both an MSN and a doctorate prepare you to work as an APRN.

The one closed door is CRNA: nurse anesthesia students now must be in doctoral programs. Every other aspiring APRN still has a choice between the MSN and the doctorate.

Requirements can keep moving, so stay current in your specialty. Join nursing organizations, keep up with your alumni association, and follow nursing news.

So Should You Earn an MSN or a Doctorate?

For NPs, CNSs, and nurse midwives, an MSN earns the same APRN licensure as a DNP, so weigh cost, time, and your goals. A few questions help:

• What do APRN jobs in your area require, and is there a pay difference for roles asking for a doctorate?
• Which APRN role do you want? CRNAs need a doctorate now; NPs and CNSs face recommendations but no mandate; nurse midwives do not.
• Are you aiming for leadership, direct care, or both?
• How much time can you spend in school? An MSN is generally faster.
• Are there bridge or fast-track options near you, such as BSN-to-DNP programs?
• What can you afford, and what financial aid is available?

If a DNP fits your budget, life, and goals, there is a strong case for doing it sooner rather than later. The longer you wait, the rustier you get as a student, and you may face a more competitive market if the doctorate becomes a mandate in your specialty.