DOE Says Nursing Isn’t a Professional Degree?! #474 Part 1

This episode hits EVERY corner of healthcare. Medical students, residents, nursing students, and attendings. 

We’re diving deep into: 

1. The Department of Education’s classification of nursing as not a professional degree 

● What does this actually mean? 

● Does it affect student loans? 

● Will this change the future of nursing?

● Why EVERY healthcare worker should pay attention 

This episode hits home for: 

● Nursing students 

● Medical students 

● Residents & fellows 

● Attending physicians 

● 1099 & locums doctors

● Anyone interested in healthcare policy or physician lifestyle 

If you’re studying, training, practicing, or thinking about locums… this one’s for you. 

Comment Below: 

● Are you a nursing student affected by the DOE classification? 

● Would you listen to Wale’s new album in the OR? 

● Are you making your HSA contribution this year? 

● Are you considering locums in 2025–2026?

FREE DOWNLOAD -  7 Considerations Before Starting Locum Tenens - https://darkos.lpages.co/7-considerations-before-locums

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Transcript

Cold Open: Nursing Degree Reclassified

SPEAKER_00 1:27

The audience wants to know what's up with the Department of Education classifying nursing not as a professional degree. Basically, what happened is the Department of Education, or whatever's left of the Department of Education, they recategorize nursing programs, it puts them in a different category. What's the cap on federal student loans that nursing students are eligible to take? I don't know if you've even been to the Department of Education website. It's like Instagram, basically. It is like some petty 16-year-old. They believe if they put a cap on nursing degrees, that will force nursing schools to decrease their tuition.

Show Kickoff And Agenda

SPEAKER_01 2:01

I'm gonna say that I've never seen colleges actually decrease anything, much less tuition. So if I go to the same college, you're saying that I will have lower tuition than the engineering student, than the art history major, than the underwater basket weaving student. Is that what they're trying to say?

What The DOE Change Actually Does

SPEAKER_00 2:21

Yo, what's up, everybody? Welcome back to another episode of Docs Outside the Box. I'm Dr. Ni here with the incomparable Dr. Renee. Um, and today we've got a foreplay for you. We're gonna be talking about a lot today, Dr. Renee. Um, first, we're gonna be jumping into this quick conversation about the Department of Education, classifying nursing, not as a professional degree, and why that's important for upcoming nurses or upcoming future nurses. Then we're gonna switch gears. Um, you know me. Um I like music, particularly uh hip-hop music 2024-2025 has been an amazing year for really good rap music, if you know what I mean. Great rappers. So we're gonna talk about Wale dropping his new album. And then we're gonna talk about a personal update. Um, as you all know, we talk about us as doctors, us as locum physicians, um, but also we talk about um, you know, some of the financial decisions that we've make, that we make, and we have a tenant upstairs. So we're gonna give you guys a little bit of an update of what's going on with the renovations and some of the tax implications with having a tenant upstairs. Then we're gonna talk about HSA accounts. And we got another listener question. It's how do I know if I'm ready for how do I know if I'm ready for locums? That is a lot, and that's what I'm telling you. We need to get into it.

SPEAKER_01 3:40

That's a good question. That's a good question.

SPEAKER_00 3:43

Okay. All right, you ready to get into this?

SPEAKER_01 3:45

Let's rock. Let's rock. All right, let's go, let's go, let's go. I'm at my mother's house today.

SPEAKER_00 3:49

Yeah, I could tell by the background, yeah. But listen, um, the audience wants to know what's up with the department of education classifying nursing not as a professional degree. I don't know about you guys.

SPEAKER_01 4:03

I think that took a lot of people by surprise. Yeah.

SPEAKER_00 4:06

Yeah, it took a lot of people. Well, possibly. It didn't take me by surprise because I know what quote unquote they're trying to do. But basically, what happened is the Department of Education, or whatever's left of the Department of Education, they recategorize nursing programs in certain contexts. The most important part is that they're saying that it's not a professional degree. For whatever reason, they're saying it's not a professional degree. The ultimate endpoint is it decreases, it puts them in a different category as to how many loans, what's the cap on federal student loans that nursing students are eligible to take? Right?

SPEAKER_01 4:46

So, in essence, now question, question. So are they talking about just a bachelor of nursing or are they talking about NP, CRNA, you know, doctorate of nursing? Right.

The New $20,500 Cap And Confusion

SPEAKER_00 5:03

So what does this entire bachelor's, anything that is getting you a college degree, right? Anything that's related to something that they consider not well, anything that's getting you to graduate to a graduate degree, right? So getting you to a bachelor's in below is under this role. So LPN. Right. Even RN, right? Because you're getting a bachelor's. LPN, RN. Correct. Now, if you're trying to get an advanced degree, then you are considered a professional. So N P C R N A. The whole per the whole reason that they're saying this, according to their website. I don't know if you've even been to the Department of Education website. It is like a social media, it's like Instagram, basically. Like they, you know how like when you are on a government website, you don't expect much at all? Like, yeah, it is like some petty 16-year-old, like, first of all, second of all, third of all, like in that lingo. But the the the gist of it is they believe that if they stop, if they put a cap on nursing degrees in terms of how many student loans you can take out or how much, that that will force nursing schools to decrease their tuition. That's the ultimate thought. I don't know if it's gonna work. We don't have any proof that it's working, but that is a scary place to be. Hold on, hold on. That is a very scary place to be, um, mainly because we don't like they've already they kind of already started this process already. They say that based off of the statistics of nursing students and when they graduate, they say the majority of them already borrow under this cap anyway, which is going to be 20,500. They said on average, most nursing students borrow less than that amount.

SPEAKER_01 6:55

20,500.

SPEAKER_00 6:57

That is going to be the new proposed cap per year.

SPEAKER_01 7:00

For for for nursing students specifically?

SPEAKER_00 7:05

Yes, this is what they're proposing.

SPEAKER_01 7:09

Not college students.

SPEAKER_00 7:11

Nursing students.

SPEAKER_01 7:15

So I guess herein lies my question. Because I did hear that, I heard that as well, right? That if you go into, you know, these professions, that what's supposed to happen is that colleges are then going to decrease their tuition. Which I'm gonna say that I've never seen colleges actually decrease anything, much less tuition, not fees, not dorm fees, nothing, not graduation fees, nothing. My second question is so if I go to the same college as an engineering student, you're saying that I will have lower tuition than the engineering student, than the art history major, than the underwater basket weaving student. Is that what they're trying to say?

SPEAKER_00 8:12

I so that's the part that I'm trying to figure out right now. I don't know the definitive answer because when you're going to nursing school, you're not going to nursing school per se with college girls, you know, college students who's not school. Well, what I'm saying is like you're just you're, let's say, for example, you went to Pace, right? I went to Lehigh, right? Um I don't know if they had a nursing program, if you're considered in the same tier as if someone who's trying to get a liberal arts degree or an engineering degree. I don't know about that. But we do know that if you're trying to get a nursing degree, they're capping you at 20,500 per year. The thing that I am, and I agree with you, I've never seen that occur. I don't think we have any proof that um that schools will decrease their tuition. I understand where they're getting to. I don't think that they're being realistic, and I don't know if they're being if this is really a um, if this is a real, like this is what they're trying to do. If you're a nursing student, you're listening right now, I think a lot of them have been more focused on the um, they're more focused on uh worth, like this is my worth when it's not really about your worth, this is about policy, right? And this is about the downstream effects of you know these effects on policy and how it affects your ability to get loans. So I think they're focusing too much. I think the future uh students are focusing a little bit too much on, well, we're worth more than this. And like this is not about that. This is bureaucracy. And the administration knows how to play chess, and they think that by playing this chess move, it'll force schools to decrease their tuition. My concern is that in the meantime, while it's may take several years for them to decrease tuition if that even occurs, there's gonna be a lot of gatekeeping comp happening, right? Just like we talked about in previous episodes. You're gonna have a lot more students who are gonna have to go to private loans and be able to finish their education or at least start their education, right? And we already have a nursing shortage. So now you have a nursing shortage with no major cap. Now you throw in a cap, and you're I, in my opinion, you're probably gonna make the nursing shortage even worse. Right. So um go ahead, chime on and you seem like you want to say something.

Tuition Realities And Clinical Costs

SPEAKER_01 10:26

Yeah, so a quick Google search. Now I can't I can't say that this is 100% true, but a quick Google search says that nursing programs tend to have higher tuition than your general tuition for college. And that's often because, you know, in their last two years of school, right? I had I had a really good friend actually in college with me, and she was a nursing student. And at, you know, the last two years of of college, if you will, for nursing students tends to be their clinicals, right? Their clinical rotations. And so that makes sense that there would be a significant increase in costs for these students because now you're probably trying having to cover some sort of insurance for these students to go out and and kind of mingle with patients, if you will, right? Interact with patients. Um, so the cost is actually higher, right? So to answer my own question based on this, then yes, the tuition is going to be different, maybe not less, but currently it seems that the tuition is different, i.e., higher than your average, you know, art history major, theater major, underwater basket weaving major, right? So I guess I'm not clear on how nursing programs are supposed to decrease their tuition when they technically have higher cost to be able to get students through the program. As a pre-med, right? You and I were both pre-med science majors. We did not have the we didn't have the additional cost that comes with interacting with patients, right? So I'm not quite sure how that's supposed to happen now.

SPEAKER_00 12:27

Which point are you talking about? Which which point are you talking about? What are you talking about? In college?

SPEAKER_01 12:30

I'm yeah, in college.

SPEAKER_00 12:32

Yeah.

SPEAKER_01 12:34

In college. You don't have to interact with patients as a pre-med student. It's not it's not compulsory, right?

SPEAKER_00 14:01

Well, the education is different, though. Their education is different. You're not getting taught by you're not getting taught by by um professors who by physicians. Well, it's not even just physicians, right? You're not getting taught by PhDs and so forth who are adept at a medical school curriculum. You're just being taught by PhD. Yeah.

SPEAKER_01 14:23

Right. But that but that's exactly what I'm saying is that there is a higher cost. It makes sense that nursing programs have a higher cost because you're then college, then your regular college.

SPEAKER_00 14:38

Well, how about this? If we were to but that but I'm but I'm listening to I'm I'm answering your question. Like we do believe that there's an inflation issue, right?

SPEAKER_01 14:51

I I believe that.

SPEAKER_00 14:52

So what I'm saying is, outside of inflation. I get what you're saying. Okay, go ahead, go ahead, please, go ahead. I don't want to go in a circle.

SPEAKER_01 15:00

I'm saying outside of inflation, if we had to cost for cost, potentially figure out what the cost is for a nursing student to complete college versus a pre-med to finish college, who do we think will have the higher cost?

Will Caps Force Schools To Lower Prices

SPEAKER_00 15:24

See, I I actually tend to think about it differently. Like it's already known when you go to college, like you're going to college and let's say you want to be, you want to major in pre-med, I know not all my tuition dollars is going to that pre-med department. I know the significant portion of my monies is going into a pool to pay all of the professors. I know that a significant portion of my money is going to pay for on-campus housing and the cafeteria and the sports team and all these different things. Whereas when you go to, let's say you go to specifically a nursing school by itself, or if you go to a med school by itself, it's just med school. There's no team there. There's no, there's a cafeteria, but it's not anywhere near the cafeteria that you would see at a university. It's like you uh like I just for me, I would just think that paying for a med school or the operations of a med school by itself or the operations of a nursing school by itself would be far less than the entire budget for an entire college or university that offers multiple degrees. Don't you think?

SPEAKER_01 16:30

I I So you're saying that because you're saying there should be an offset, yeah.

SPEAKER_00 16:41

I'm just saying it's just more ex people are expected to be more expensive because they feel like you're gonna get paid more. And it's like, well, that's not that shouldn't be the case. It should just be, well, how much does it cost?

SPEAKER_01 16:50

No, we're mixing up a lot of things. Wait, what's the difference?

SPEAKER_00 16:53

No, I'm saying the tuition. You're saying tuition is higher, right? Tuition is higher. Tuition is higher, well, it is. Tuition is just as much or higher for a nursing degree than someone who's getting an undergrad, right? I think that that assumption is based on the fact that you expect to be making a lot of money as a nursing, as a nurse. Whereas I'm saying if we really go down pound for pound, what as an undergrad, I'm not just paying, like my if it's$50,000 to go to the school that I went to, I know that it doesn't cost$50,000 to get a pre-med degree. I know that the significant portion of my money is going to the budget of the entire university and so forth. Uh-huh. Right. So I should not expect to pay$50,000. Like, I'd be pissed if I had to pay$50,000 for nursing school. Because I'm like, well, where's my money going? Right? Like, it didn't cost this much 20,000, 20, 20 years ago. Why does it cost this much now? Right? And I think that's one of the main complaints of people in general about education. And I think that's where the administration is trying, they're they're using that argument. I don't know if it's a full-hearted effort though. But basically what they're trying to say is like, yo, you guys are just colleges and universities are just increasing tuition only because they know that students can get a loan. That's what they're saying. So they're saying if we take away your ability to get a loan, will that have will now will that force the student the schools to either decrease their tuition or keep it stable? I'm not saying I I think it's gonna work, but I think that's the rationale that they're using.

SPEAKER_01 18:18

Well, but that that so then that goes back to my question, right? If you are going to decrease the amount of student loans given to those students in particular, and you think that it's going to decrease the tuition of those students in particular, then let's say the first two years of college for your nursing students looks very similar to any other student going to college, right? They have to take their, you know, core classes, then they start into their major classes, right? That they have to sit in the classroom. So are we saying that in the first two years, let's say my tuition is$30,000 for you know, this school's tuition is$30,000, right? Are we saying that everybody else's tuition is gonna be$30,000, but the nursing students' tuition is gonna be$15,000 for the for the first two years? Like what are we like? I don't know. I don't even understand.

Private Loans, PSLF Limits, And Risk

SPEAKER_00 19:28

I think I think for the folks who I think for the folks who are listening right now, if you went through an accelerated program, right? So for example, if you went to college and then you went, like you went to those college programs that when you get into college, then you're gonna go into medical school that's already set up, or same thing with nursing. And a seven-year-old. They even have the same thing for PAs also. I'm really interested because I want to know, like, usually for those programs, like the first two years, whether it's PA, nursing, or even MD, you're basically in an undergrad curriculum. So the question is, are those first year, those two years of tuition, is it similar to a regular undergrad's tuition? And does it go up once they start taking those grad level courses, nursing, PA, or even um uh MDDO, is it does it go up once you start taking these? Right? That's what I want someone, if you're listening, if you're listening, I want you to let us know because that's that's another bit of information that would help kind of clarify this up. But before we go into a rabbit hole, because there's a lot of conundrums that we don't know, but we do know that people who are trying to get into school right now, particularly people who, you know, don't come from trust funds, you know what I'm talking about, people who come from certain demographics who already were going to use loans, right? Who were going to use loans to get through, this is just another hurt, another hurdle, right? So, you know, we're talking about getting private loans. And I think that where the general public may be like, well, come on now, like if you really want to get it, go and get it. The problem is is remember, private loans are not eligible for PSLF. Private loans, um, there's a lot of different uh benefits that you get when you take out a federal student loan. When you take out a private loan, it's way more stringent. You may not have the credit to get it. They want their money quick, the interest rates might be higher. All of these different things. And you already know the number one complaint that a lot of people have when they're in a hospital or when they go to the ED is why does it take so long for me to get seen? A lot of times it's not the physician, it's not the PA, it's not the nurse practitioner who's there. They're there. It's just that you don't have enough rooms to get these people in, right? There's not enough nurses to open up more rooms. You go upstairs, there's a there's patients in the ED who have already been admitted, right? And they can't get to the upstairs because there's not enough nurses upstairs to take care of these patients. So as a result, there's more people in the waiting rooms. So you already have a nursing shortage right now. Imagine what this will do on top of that.

SPEAKER_01 22:01

So I'm going to say this that I don't know any I don't know at any point in time when any decision has been made by the government such that anyone on the end of that decision would end up making less money. There is usually some sort of, in other words, this legislation, right? We've heard, this is the argument, that this legislation is coming into play so that. Colleges decrease their tuition, i.e., make less money. Yes. I've never heard of regulation where any entity at the end of that regulation ends up losing money. So there is only one thing that this legislation could do, it is to allow people to make more money. And that's why I'm glad you brought up the thing about taking out private loans. Because many students who go to school don't necessarily have to take out a large portion of private loans. Most of it is government funding. Federal, Stafford, unsubsidized, subsidized. Parent plus loan might factor into that.

unknown 23:44

Yeah.

SPEAKER_01 23:45

Which is you take out parent plus loans?

SPEAKER_00 23:47

Did your parents ever take out plus loans? For undergrad or for med school?

SPEAKER_01 23:51

For undergrad. I don't know. I don't remember.

SPEAKER_00 23:55

I can't remember.

SPEAKER_01 23:56

But definitely, definitely for the colours.

SPEAKER_00 23:58

My parents took out for plus loans. Oh yeah. Which sounds like scores.

SPEAKER_01 24:04

The only other thing left, right? The only other thing left is the private loans.

SPEAKER_00 24:11

Oh yeah.

SPEAKER_01 24:11

And so I'm like, well, did they get in the room? Definitely colleges. Colleges are definitely not lowering their tuition. They're just not. They're just going to be like, well, if you can't get it, I need you to be more optimistic, Bev.

SPEAKER_00 24:24

I need you to be more optimistic. Come on.

Shortage Math: Fewer Loans, Fewer Nurses

SPEAKER_01 24:26

Okay, that that's cute. But colleges are not going to lower their tuition. Because now you gotta remember, it costs something, it costs something to run a college. Now all of a sudden you're gonna decrease. That's like, honestly, that's like being demoted at your job. While you have a mortgage, you have a gas bill, you have electricity, you have X, Y, and Z. You think the mortgage company is gonna be like, ah, well, since you got demoted, we're just gonna reduce your your mortgage for you. Nah, bruh. Yeah. That's not the way that happens. They're not gonna decrease the cost of your house for you. Like that's what I'm gonna do. I can't remember the episode.

SPEAKER_00 25:03

I can't remember if, folks, I can't remember the episode that we did it, but recently we went over some of the resources that med students can use to find out alternative ways to finance education. Because I'm telling you, uh, you know, obviously with college not backing down, you know, you're going to exhaust a lot of those funds in college. Then you throw on top of that a nursing degree on top of that. So you just gotta be ready. You gotta be smart, you gotta make sure mom dukes, dad dukes, got good credit, auntie, whatever. You may have to do some hard work.

SPEAKER_01 25:33

That's like getting them scholarships.

SPEAKER_00 25:35

You might have to do an all-in-one loan, all of these different things, right? Might have to do to make sure that you're ready to pay for this education that you really want. And um, hey, elections have consequences. That's what I say.

SPEAKER_01 25:50

Let me say that in the short run, that is the answer. Right? In the short run, that is the answer. But I'm gonna say that those of you who are going to college now, if this is not a wake-up call for potentially what you are going to encounter when your children get to college, which may be this or maybe even worse, I'm telling y'all right now, if you're going to college, if you happen to get through caps and all, if you happen to get through the importance of financial literacy, understanding how money works, understanding how to use your money so that it works for you and your family and your children, beyond just I'ma get this house and I'ma get this car, and I'm gonna get, you can get all this stuff. But at the end of the day, if you want to have generationally your family be part of the legacy of people who go to college, get professional degrees, if that is your desire, I'm gonna tell you right now, you better start really, really, really thinking about how money works and not just acquiring things because perhaps, you know, like me, you didn't necessarily grow up with all the luxuries in life.

SPEAKER_00 27:17

So And that being said, hey guys, make sure you check out all the resources that are available. Um, because you're gonna need it. So, you know, whether it's uh private loans or learning how to decrease the amount of student loans that you're taking in college. This is real, this is real. It's gonna hit you now. I remember the days of yo, just take a loan, you'll be all right. Yeah, you're gonna have to think twice, three times, four times before you take out that loan because it may catch up to you five years, seven years down the line. So um, with that being said, let's change directions and let's go ahead and take a break, and we'll come back and talk about Wale's new album.