I’m looking for objective advice from a financial/career perspective.
I was recently accepted into a BSN program starting this fall. My original plan was to pursue nursing, then potentially CRNA or PMHNP later. The appeal is a relatively secure path, earlier income, and the possibility of strong earnings without the long training timeline of medicine.
However, I’m also considering whether I should decline the nursing offer and focus on the premed/medical school path instead. My main long-term goal is FIRE/financial independence, not necessarily maximizing prestige. I’m trying to think about this from a lifetime ROI, risk-adjusted earnings, and optionality standpoint.
Some relevant context:
- I’m in my early 20s.
- I’m currently finishing undergrad.
- I have a BSN acceptance in hand from a good school in PNW region. Tuition is about 25k (parents willing to support). Starting RN salaries around the region are about 45-50 an hour (hard to get specifics).
- Medicine would require additional prerequisites, clinical experience, MCAT, applications, and then the long med school/residency timeline. (probably minimum extra 2 years of hard work. Need to take full year of Gen Chem, O Chem, Physics and perhaps more)
- Nursing would let me start earning much earlier, with possible paths into CRNA, PMHNP, travel/per diem work, overtime, or advanced practice.
- I do care about income ceiling, but I also care about time, debt, probability of success, and burnout risk.
- My main question is not “which career is cooler,” but which path is more rational if the goal is FIRE.
The tradeoff I’m struggling with:
Nursing/CRNA/NP path: earlier income, lower debt, more predictable, but possibly lower lifetime ceiling, also see to get disrespected a lot, always seen as midlevel etc.
Medicine path: potentially much higher income depending on specialty, but much longer training, higher debt, delayed compounding, and much more uncertainty if I can even get admitted and then do well in med school then get into a good speciality.
If everything goes right (big IF I know), the earliest possible time would be CRNA at 29 or Attending MD at 33/34.
For people here who understand physician finances, opportunity cost, and FIRE math: would you accept the nursing school offer and build from there, or decline it and commit to the med school route?
I’d especially appreciate thoughts on:
- Whether the physician path still wins financially after accounting for delayed earnings and debt.
- Whether CRNA or high-earning nursing paths can realistically compete with many physician paths for FIRE.
- How much specialty choice changes the calculation.
- Whether it’s irrational to walk away from a guaranteed BSN seat for the uncertain med school path.
Thanks in advance. Happy to answer any questions.
Edit: Thanks for the helpful comments!