How Do You Choose the Right Nurse Practitioner Specialty?

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July 15, 2022
Deciding to become a nurse practitioner may be one of the more significant decisions in your life. Your career options are diverse and there is no limit to the future need for your services. Still, you’ll have more milestone decisions to make on the path to your dream career. One of these decisions will be choosing which nurse practitioner specialty you’d like to pursue.
The most common master’s programs prepare graduates for credentialing in acute care (ANP), adult-gerontology primary or acute care (AGPCNP/AGACNP), psychiatric-mental health (PMHNP), family practice (FNP), women’s health (WHNP), and pediatric (PNP). There are many subspecialties you can earn through formal programs or based on hours of experience in a certain field and passing a certifying board exam. Here are some ideas to consider as you choose your nurse practitioner specialty.

Identify who (or what) inspires you

When it’s time to choose a nurse practitioner specialty, first take stock of the communities you already know you like to learn with and support. These will be the people and questions you will interact with daily for years to come. 

Do you love to spend your time in the company of kids or older adults? You may choose to become a pediatric or adult-gerontology nurse practitioner. Perhaps the notion of “cradle to grave” care calls you to become a family nurse practitioner. Or maybe you’re inspired to meet the ever-growing need for mental health care, so becoming a psychiatric nurse practitioner may be a great fit for you. You may already be working in the hospital as a registered nurse and recognize that becoming an acute care nurse practitioner will offer you more hospital-based opportunities in the future. 

Unless you’re already working within your intended specialty, there can sometimes be a large gap between your ideal work environment and the day-to-day reality. If you have a sense of the populations you hope to serve, spend some time shadowing a clinician or taking one of them out for coffee to learn what they love and what they find challenging in their professional life. 

Even if you don’t work in health care yet, you have undoubtedly crossed paths with a potential future patient who inspired you to serve certain communities. Evaluate yourself and your past experiences to see how they may contribute to your future specialty choice. 


Visualize the kind of lifestyle you enjoy

Next, consider where and how you want to work. Now more than ever, most roles for nurse practitioners are in large demand, and you will likely have many opportunities upon graduation.

If you’re already working in health care, you know the difference between hospital versus outpatient clinic-based work. Keep in mind that most hospitals favor or require acute care nurse practitioners. The hospital schedule, rotation, and environment are very different from staffing an outpatient clinic. Outpatient clinics typically follow an 8 am–5 pm, Monday through Friday schedule. Both may include a call rotation. Some specialties may provide more flexibility than others. 

If you’re new to health care or don’t have a specific vision just yet, you may want to start with a more general specialty such as a family or acute care nurse practitioner. Anyone becoming a nurse practitioner hopefully can expect a competitive salary, although subspecialties and geographies can further impact the amount. 


Remember that you don’t have to figure it all out now

Lastly, remind yourself that it’s okay for your specialty to evolve over the years. Clinicians commonly start with a broad experience such as working in primary care or as a hospitalist and, through this exposure, they pivot to a subspecialty or additional certification.

When I applied to graduate programs, I knew that I wanted to be as general as possible in my specialty. This way, my career could take on many shapes over the decades. I also knew that as a family nurse practitioner, I wanted to spend some time practicing in primary care before considering specializing.

As an experienced clinician, I was more attractive to employers even if I didn’t have that specialty certification under my belt. Through years of working in the trenches and learning the kinds of patient encounters that really inspired me, I eventually came to discover my calling. Once I reached that point, it was easy enough to sit for another board certification.


I hope some of the reflections above will help you create your own unique pathway. You hopefully are at the start of a very long and rewarding journey! Although it’s rare to land your “forever” job and specialty as a new grad, just like any relationship, your role will continue to evolve over the years and you will grow as both a person and a nurse practitioner.


Rosh Review is a board review company offering Qbanks and online educational resources to physicians, PAs, and nurse practitioners around the world. Find more free NP content on the Rosh Review blog or start a free trial.

By Alana Rose, FNP


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