Question: What Are the Differences Between a Master of Science in Nursing (MSN) and a Doctor of Nursing Practice (DNP)?

Answer: MSN and DNP refer to two different types of practice-based, graduate-level nursing degrees. An MSN is a Master of Science in Nursing, and a DNP is a Doctor of Nursing Practice. The MSN is an intermediate graduate degree designed to provide Registered Nurses (RNs) with leadership and professional management skills as well as proficiencies in a nursing specialization. The DNP is a terminal professional degree designed to prepare RNs and advanced practice nurses for upper level positions in clinical leadership, administration, education, and research. Like MSN programs, many DNP programs offer training in a nursing specialization, especially programs that offer a Bachelor of Science in Nursing (BSN) to Doctor of Nursing Practice (DNP) track (BSN-to-DNP). There are various pathways for RNs who want to earn an MSN or a DNP degree; the educational background of an applicant typically determines the appropriate MSN or DNP pathway.

MSN and DNP programs are graduate programs in nursing practice, which means they are designed to provide advanced skills and training to nurses who hold a state-issued license to practice as a Registered Nurse (RN). RNs who would like to advance in their careers and augment their professional responsibilities can do so by earning either an MSN or a DNP.

Graduate Training in Nursing

Nursing graduate programs provide training in evidence-based practice, leadership and management, health policy and finance, and healthcare technologies. They also give RNs an opportunity to choose an area of nursing practice in which to specialize. Nursing specialties fall into two general categories: there are Advanced Practice Registered Nurse (APRN) specializations, which include Clinical Nurse Specialist (CNS), Certified Nurse Midwife (CNM), Certified Registered Nurse Anesthetist (CRNA), and Nurse Practitioner (NP); and there are non-APRN nursing specializations, such as nursing administration, nursing education, and Clinical Nurse Leader (CNL). There is an additional level of specialization for NPs, which include but are not limited to the following:

• Adult-Gerontology Acute Care Nurse Practitioner (AGACNP)
• Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP)
• Family Nurse Practitioner (FNP)
• Neonatal Nurse Practitioner (NNP)
• Pediatric Acute Care Nurse Practitioner (PACNP)
• Pediatric Primary Care Nurse Practitioner (PPCNP)
• Psychiatric-Mental Health Nurse Practitioner (PMHNP)
• Women’s Health Nurse Practitioner (WHNP)

APRNs, CNLs, and nurse educators must hold a graduate degree and graduate-level training in their specialization in order to practice. Most nursing administration and executive leadership positions require a graduate degree as well. MSN and DNP programs are the two most common ways to attain the type of degree needed to qualify for work in these advanced practice nursing fields.

Note: Currently, a master’s degree, or an MSN, is sufficient to attain eligibility for professional certification in an advanced practice specialization. However, the American Association of Colleges of Nursing (AACN) recommended in a 2004 position paper that the DNP replace the MSN as the minimum degree required for APRNs. While there is no plan to implement that recommendation for all APRNs as of 2019, the American Association of Nurse Anesthetists (AANA) has put into place a plan that will require new CRNAs to hold a DNP degree as of 2025, and the National Association of Clinical Nurse Specialists (NACNS) has similarly endorsed instating the DNP as the minimum requirement for new CNSs by 2030.

Master of Science in Nursing (MSN) Programs

MSN programs, as described by the AACN in The Essentials of Master’s Education in Nursing, have three primary components:

1. Graduate Nursing Core: foundational curriculum content deemed essential for all students who pursue a master’s degree in nursing regardless of the functional focus.
2. Direct Care Core: essential content to provide direct patient services at an advanced level.
3. Functional Area Content: those clinical and didactic learning experiences identified and defined by the professional nursing organizations and certification bodies for specific nursing roles or functions.

Students in MSN programs study healthcare systems, healthcare policy, nursing technologies, and organizational dynamics as part of the graduate nursing core. The direct-care MSN core features training in pathophysiology, pharmacology, patient assessment, and other general areas of clinical nursing practice. The functional area content of an MSN program covers a specialized field within nursing, such as administration, education, or one of the various APRN specializations. Other non-APRN MSN program specializations include nursing informatics, health systems management, and patient safety and healthcare quality (PSHQ).

The AACN’s Essentials of Master’s Education in Nursing further delineates nine areas for master’s-level training and instruction:

1. Background for Practice from Sciences and Humanities
2. Organizational and Systems Leadership
3. Quality Improvement and Safety
4. Translating and Integrating Scholarship into Practice
5. Informatics and Healthcare Technologies
6. Health Policy and Advocacy
7. Interprofessional Collaboration for Improving Patient and Population Health Outcomes
8. Clinical Prevention and Population Health for Improving Health
9. Master’s-Level Nursing Practice

Specific courses and internship/practicum requirements vary by program and by specialization. They may also depend on a student’s level of educational attainment and professional training prior to enrollment, as there are various academic pathways for RNs to earn an MSN degree. For example, RNs who hold a BSN degree are generally eligible for programs that can be completed in two to three years of full-time enrollment; RNs who do not have a bachelor’s degree typically engage in three to four years of full-time study in designated RN-to-MSN and RN-to-BSN-to-MSN programs; and RNs who hold a non-nursing bachelor’s degree may be able to earn their MSN degree in two-and-a-half to three years by completing a bridge curriculum in addition to core MSN requirements.

Doctor of Nursing Practice (DNP) Programs

The DNP degree is one of two types of terminal degrees in nursing. It is designed to provide advanced level training for practicing nurses, rather than for those who wish to pursue a career in academic teaching and/or research, which is the purpose of a Doctor of Philosophy or PhD in Nursing. In The Essentials of Doctoral Education for Advanced Nursing Practice, the AACN describes two primary components of a DNP curriculum. The first consists of foundational competencies for all DNP students regardless of specialization, some of which are similar to foundational competencies for MSN programs. These include:

1. Scientific Underpinnings for Practice
2. Organizational and Systems Leadership for Quality Improvement and Systems Thinking
3. Clinical Scholarship and Analytical Methods for Evidence-Based Practice
4. Information Systems/Technology and Patient Care Technology for the Improvement and Transformation of Health Care
5. Health Care Policy for Advocacy in Health Care
6. Interprofessional Collaboration for Improving Patient and Population Health Outcomes
7. Clinical Prevention and Population Health for Improving the Nation’s Health
8. Advanced Nursing Practice

The second component of a DNP curriculum is comprised of courses and clinical hours that define the program’s emphasis. There are four types of traditional, MSN-to-DNP programs:

• Nursing Leadership DNP: These programs offer additional doctoral-level coursework in nursing administration and leadership and are typically open to RNs with any type of MSN specialty.
• Clinical DNP: These programs offer several advanced clinical practice courses and typically require students to be licensed APRNs.
• General DNP: These programs provide broad doctoral training in advanced practice nursing and may or may not require applicants to be licensed APRNs. In general, these programs offer both nursing leadership and clinical nursing electives so students can choose their area of emphasis.
• DNP in an NP Specialization: These programs are designed for licensed APRNs within a particular specialization and offer advanced courses in that same specialty area. Eligibility for these programs is generally restricted to APRNs or NPs with a specific specialty. For example, there are DNP programs with an FNP emphasis that are designed for licensed FNPs. (Note: MSN-to-DNP programs in an NP specialization are different from MSN-to-DNP programs with a new NP certificate, which combine the DNP curriculum with a post-master’s certificate curriculum for MSN trained nurses who want to add an NP specialty while completing their DNP. See below for more information.)

Note: The DNP curriculum is fairly standardized across these four different types of programs. DNP curricula only differ by two or three courses and by the settings in which students complete clinical hours (e.g., administrative vs. clinical vs. clinical specialty).

In addition to the four general types of DNP programs listed above, there are four distinct DNP pathways that determine the coursework and clinical training students must complete in order to earn their doctoral degree and thus the amount of time it typically takes to graduate from a DNP program. These pathways are as follows:

• MSN-to-DNP: This is the most common DNP pathway and these programs can be thought of as traditional DNP programs, as they provide RNs who hold an MSN degree with DNP coursework and training. A traditional DNP does not include training in a new nursing specialty and thus can typically be completed in one to two years. These programs require a minimum of 500 clinical hours and may require more if a student did not complete at least 500 clinical hours during their MSN program.
• RN-to-DNP: These programs are designed for RNs who hold an ADN degree and some require a non-nursing bachelor’s degree in addition to an ADN. They provide students with a bridge curriculum to complete BSN training, a full MSN curriculum including coursework in an APRN or non-APRN specialty, and general DNP coursework. As a result, RN-to-DNP programs are typically long (four to six years) and require 1,000 or more clinical hours.
• BSN-to-DNP: RNs who have a BSN degree are eligible for DNP programs that combine master’s and doctoral training in nursing. Students in these programs are typically able to earn a DNP in less time than it would otherwise take to complete an MSN program followed by a DNP program. Some but not all BSN-to-DNP programs allow students to earn an MSN degree and become licensed in a specialty during the program. These programs typically take three or four years to complete and include a minimum of 1,000 clinical hours.
• MSN-to-DNP with a new NP Certificate: These programs combine DNP training with the equivalent of a post-master’s certificate curriculum in an NP specialty. They are designed to allow MSN graduates to earn a DNP and add a new specialty at the same time. Depending on a student’s prior graduate training, the NP certificate coursework and clinical hours may add a year or more to the time it would otherwise take graduates from MSN programs to complete their DNP training.

RNs who are interested in pursuing a DNP degree should research programs carefully in order to find programs with a pathway that aligns with their level of prior academic training and a curricular focus that meets their professional practice needs.

MSN and DNP Clinical Requirements

MSN and DNP programs require students to complete a certain number of clinical hours. While the exact number of clinical hours varies by program and by specialization, most MSN programs include at least 400 to 600 hours of clinical practicums and these hours typically count toward the total number of hours required for a DNP degree. The conferral of a DNP degree requires RNs to complete a minimum of 1,000 formally supervised clinical hours over the course of their graduate training (i.e., post-baccalaureate) and at least 500 of those hours must be completed as part of the DNP curriculum. Therefore, students who completed less than 500 hours during their MSN program will have to complete more than 500 hours during their DNP program to meet the 1,000 hour threshold. RNs who enroll in RN-to-DNP or BSN-to-DNP programs are required to complete the full 1,000 hours of clinical training while earning their DNP degree.

MSN vs. DNP Programs

The table below offers a side-by-side comparison of features and components of MSN and DNP programs, highlighting many of the differences between these two types of graduate degree programs and some of the similarities.

Pros and Cons of Pursuing an MSN vs. a DNP

For RNs who have not yet enrolled in a graduate program, there are several factors that may be worth considering when weighing the relative benefits of pursuing an MSN or a DNP degree. Currently, an MSN degree is sufficient for certification and licensure in most APRN specializations, although new CRNAs will be required to hold a DNP beginning in 2025 and the same will be true for new CNSs as of 2030. In fact, DNP programs have already replaced most Nurse Anesthetist MSN programs. However, for RNs who are aiming to advance into an NP role, an MSN is generally the fastest route to gaining the education and training required for NP certification. RNs who hold a BSN degree can earn an MSN degree and reenter the workforce in an advanced practice specialization in as few as two to three years. Some nurses may prefer to spend one or more years gaining professional practice experience as an NP before deciding whether or not to pursue a DNP degree. This may be especially important for RNs who do not have several years of clinical experience and who would like to gain some experience before pursuing an additional graduate degree.

There are, however, advantages to enrolling directly in a DNP program after earning a bachelor’s degree. BSN-to-DNP programs are generally designed to reduce the total amount of time it takes for RNs to complete their master’s and doctoral training. BSN graduates who enroll in a BSN-to-DNP program may be able to complete their program in as few as three to four years, while it might otherwise take four or five years to earn an MSN and then complete a DNP program. This is due to the fact that students can begin the DNP curriculum while they are still completing MSN courses. In addition, RNs who opt for a BSN-to-DNP program rather than a BSN-to-MSN program do not have to go through the process of applying to DNP programs if and when they decide they want a terminal degree in nursing.

Ultimately, the decision to pursue an MSN or a DNP degree is a personal one that may depend on several factors, including an individual’s academic background, years of experience, and professional goals. For RNs who would like begin working as an NP in a shorter timeframe, an MSN program may be the best route. For RNs who are sure they want to earn a DNP, a BSN-to-DNP program may be a better option, as it represents the most efficient pathway to a nursing doctorate. For RNs who are undecided, it may be valuable to solicit advice from MSN and DNP program graduates, faculty, and/or administrators for additional pros and cons of pursuing an MSN vs a DNP.

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