PhD Program Enrollment: Lessons from Nurses Pursuing a Second Doctorate

By Lauren Muñoz, MSN, FNP-BC

Theshortage of PhD-prepared professionals is prevalent in many disciplines, but it is particularly alarming in nursing, where PhD graduations have been outpaced by retirements of PhD holders for more than two decades and where PhD enrollments, which were initially stagnant, have now begun a gradual decline in the last eight years.1-3 During my own PhD in Nursing program, I set out to uncover the factors contributing to this shortage. What I discovered surprised and alarmed me.

My dissertation research focused on nurses who have obtained a Doctor of Nursing Practice (DNP) degree— which is nursing’s practice (or clinical) doctorate—and are pursuing a PhD. The DNP has been flourishing in nursing since its inception almost 20 years ago4 so I was curious as to why a small but growing number of DNP-prepared nurses were now turning to PhD education. I questioned, “What would lead a nurse who has already accomplished so much to seek a second terminal degree?”

Methods and Findings

Using a qualitative methodology called existential phenomenology5,6 I interviewed 10 DNP-to-PhD students from across the U.S. to better understand their career and educational decision-making. Each student described being on a unique mission, and the

PhD, they believed, was essential to accomplishing their mission.

For some, their mission was what I expected to hear. They wanted additional skills and knowledge to conduct research, or they desired to make long-lasting changes for entire populations of patients. But for others, their mission was less conventional. They wanted to manage their vulnerabilities. These DNP-PhD students saw the PhD as a shield to protect them from powerful others who might want to take advantage of them. Or they saw the PhD as a badge of honor, a gateway to acceptance within the academic community.

Implicitly resting in the background of each mission, influencing students’ career and educational decisions, was the nursing hierarchy. Many participants bluntly

“What would lead a nurse who has already accomplished so much to seek a second terminal degree?” - Lauren explained that nurses with a DNP are considered secondrate compared with their PhD colleagues, and they shared disturbing stories of microaggressions in academic and clinical settings. Whether they liked it or not, the PhD, they said, was the “pinnacle” of the nursing profession. Some admitted they were seeking a PhD because they wanted to be part of that elite group or at least wanted the clout and opportunities the PhD would afford.

Themes of DNP-PhD Pursuit

The reasons for PhD pursuit among the DNP-to-PhD student participants centered around five themes:

1. Having needs the DNP can’t meet: “I had to go back and do more”

2. Considering dreams and circumstances: “Now’s the time”

3. Developing confidence: “You can do this!”

4. “I’ve been very supported” / “I had no support”

5. “It had to be an internal drive for me.”

First, the DNP was seen as not enough. Some had been satisfied with their DNP careers initially but developed new interests and goals. Others had been dissatisfied with the DNP from the start. For this latter group, the PhD was giving them what they wanted all along from doctoral education. A few also felt that having both doctoral degrees would help them bridge the divide they saw between DNP- and PhD-prepared nurses in academia.

The second theme related to the timing of PhD pursuit. A few had dreamed of obtaining a PhD for many years but had been unable to do so because of family responsibilities, lack of confidence, finances, and other impediments. For most, changing circumstances had prompted their return to school. When scholarships and hybrid or online programs became available; coworkers, mentors, and family supported the decision; and frustration with their current role grew intolerable, these nurses felt the time had come to seek a PhD.

Developing confidence comprised the third theme and highlights one of the most surprising aspects of this study. Despite the participants being highly accomplished, they described severe intimidation of the PhD. Many admitted that the DNP was promoted by colleagues, faculty, and friends as being easier and quicker than a PhD, leading them to write off PhD education, even if their interests better aligned with a PhD-related career. It often took meaningful exposure to others with a PhD for them to realize that this degree was not out of reach.

The fourth theme centered on the presence or lack of support. While participants looked to family, colleagues, and others for support, their relationships with mentors most determined whether they felt supported or not. Many shared glowing stories of mentors who were “cheerleaders;” they recognized students’ capabilities and interests and encouraged them to pursue a PhD. Others, however, described mentors who were sources of intense discouragement. Interactions with unsupportive mentors during their DNP program actually convinced some students of the need for a PhD. Another participant endured a PhD faculty mentor who ignored and belittled her, nearly prompting her to quit the PhD.

Finally, theme five outlines an essential character trait of participants: internal drive. Each DNP-PhD student recounted a history of perseverance with other degrees and careers, as well as in their personal lives. Despite incredible obstacles that had threatened their PhD pursuit, they “powered through” and made a commitment to do whatever it took to finish. Most were also self-avowed lifelong learners. They loved school and had an insatiable desire to learn and grow.

Takeaways for PhD Enrollment

Intimidation of the PhD was prevalent even for nurses with graduate degrees and years of clinical experience, so it is surely a factor in others’ educational decision-making. To boost PhD interest and enrollment, students need meaningful exposure to PhD-type work and to those who have a PhD.

Promotion of the PhD is also paramount. PhD programs and students are costly for schools7 but without them scientific advancement within disciplines will suffer. GEM professionals must advocate for equitable attention and resources for programs that do not yield high margins. Internal drive is helpful, probably essential, for PhD pursuit. Therefore, GEM professionals should seek to increase enrollment of applicants who have a history of showing perseverance in the face of obstacles. Admission questions should elicit stories of internal drive, both within and outside of academic contexts.

Finally, PhD programs must be accessible. Individuals’ circumstances may change at any time, prompting them to consider PhD enrollment. GEM professionals must be ready to capitalize on these opportunities by meeting students where they are, offering simple enrollment processes, funding options, flexible program structures,