Nurses taking NBME exam want to boost skills, not act as physicians

Regarding "AMA meeting: Physicians demand greater oversight of doctors of nursing" (Article, July 7): Several issues and inaccuracies should be clarified.

The offering of a certification exam to the doctor of nursing practice graduates using the National Board of Medical Examiners exam remains a hotly debated issue among NPs and NP faculty. Consistent support exists for sustaining the national NP certification exams that focus on the role and the patient population for which the NP has been educated. These exams are recognized by regulators, upon which NPs are granted clinical practice privileges by their state boards of nursing. Each state's nurse practice act identifies scope of practice. It is unlikely that 50 states would adopt an exam used to test physicians for determining NP scope of practice and regulation.

It is correct that passing the NBME exam does not make DNPs physicians. Similarly, unless an individual has received NP educational preparation, passing an NP certification exam does not make him or her a nurse practitioner.

The NBME exam is neither anticipated to be the national standard nor expected to replace the existing national NP certification examinations to certify DNP graduates. It is uncertain how many DNP graduates will choose to take the NBME, which does not test areas of NP education unique to nursing and is not required to practice. The estimate that 2,000 clinical DNP graduates will be eligible annually to sit for the NBME exam seems overly optimistic.

The use of the title doctor is a privilege earned when an individual has successfully completed doctoral education and is not unique to medicine. The DNP has evolved much like other clinical doctorates. It is not predicated upon an expanded scope of practice. NPs who earn a DNP seek to expand their knowledge and skills that will inform and enrich their clinical practice. We would expect all health care providers with doctorates to clarify their role preparation and not just degree titles. The DNP is not an effort to confuse patients or impersonate physicians.

Mary Anne Dumas, PhD, RN, FNP-BC, president, National Organization of Nurse Practitioner Faculties, Washington, D.C.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2008/08/18/edlt0818.htm.