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.
Either degree opens a fast-growing field. The Bureau of Labor Statistics projects employment of nurse anesthetists, nurse midwives, and nurse practitioners to grow 40% from 2024 to 2034, with a combined median wage of $129,210 in May 2024.
Frequently Asked Questions
Do nurse anesthetists need a doctorate now? Yes. Under the Council on Accreditation, students entering an accredited nurse anesthesia program on or after January 1, 2022 must graduate with a doctorate, and as of 2025 all new graduates need a doctoral degree for APRN licensure. CRNAs licensed before the change keep practicing under standard renewal.
Can I still become a nurse practitioner with an MSN? Yes. An MSN remains the accepted entry-level degree for NP licensure in all 50 states. The AACN has advocated for the DNP since 2004, and NONPF recommended it as the standard by 2025, but no state board mandates a DNP for NP licensure.
What about clinical nurse specialists and nurse midwives? CNSs can still enter with an MSN, though the National Association of Clinical Nurse Specialists has recommended the DNP by 2030. Nurse midwives require an MSN, and the American College of Nurse-Midwives does not endorse a DNP requirement for entry into practice.
Which doctoral degrees qualify for CRNA practice? The DNP is the common choice, but other doctorates 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).
Does an MSN I already hold still count? Yes. The degree changes do not affect a license you already hold. If you are enrolled in an MSN program for any role other than CRNA, you can finish it, earn your APRN license, and practice.
Is a DNP worth the extra time over an MSN? For NPs, CNSs, and nurse midwives, an MSN earns the same APRN licensure as a DNP, so weigh cost, time, and your goals. A DNP goes deeper into clinical leadership and may matter more if your specialty moves toward a doctoral mandate.