INTRODUCTION
The movement of nurses and nursing students into medical school is known in clinical folklore and visible though widening access policy, graduate-entry medicine routes and individual stories of nurses who decide to become doctors. However, this movement from nursing to medicine is poorly measured where such individuals are usually absorbed into broad categories such as mature entrants, graduate entrants, health professional applicants, prior tertiary qualification holders or students with health-related degrees (Aston-Mourney et al., 2022; Puddey et al., 2019). Instead, there is a need for greater understanding of the movement of nurses to medicine to identify both implications and opportunities for both nursing and medical professions as well as the health workforce.
The topic matters because it sits at the intersection of nursing workforce retention, medical school selection, clinical education, professional identity and career mobility. In workforce terms, a registered nurse entering medicine may be read as a loss to nursing, especially in systems already facing staffing pressure. That interpretation requires caution, because it assumes the nurse would otherwise have remained in nursing; some may have left clinical nursing, changed profession or moved into another non-clinical role regardless. From a wider health-system perspective, the move may represent mobility within the health workforce rather than a simple one-for-one loss. In educational terms, prior nursing knowledge may be an asset. Nurses may enter medical education with patient contact, communication skill, familiarity with clinical risk, awareness of deterioration and an understanding of the realities of working in the health system.
Career mobility can also move in the opposite direction. Lazarus (2008) documented Filipino doctors retraining as nurses, largely in response to migration and labour-market incentives, while Skinner (2006) described changing expectations and career preferences within the Australian medical workforce. These examples are not equivalent to nurses entering medicine, but they caution against treating professional movement as one-way. Reverse mobility may be particularly difficult to see when medical students leave during training or doctors leave during early postgraduate years, because education and registration datasets are rarely linked to later entry into another health profession.
The purpose of this rapid review is not to argue that nurses should or should not become doctors. It is to map what is known, separate direct evidence from indirect evidence, and avoid dressing assumptions up as data. The central questions are: what evidence exists, what motivations are reported, what is known about numbers and outcomes, what experiences are described, and where does the evidence stop?
METHODS
A rapid review approach with a scoping purpose was used. Rapid reviews are appropriate when a focused question requires timely mapping of evidence and when available studies are small, dispersed or inconsistently indexed (Garritty et al., 2025). The approach was informed by contemporary rapid review guidance, including transparent description of search choices, inclusion decisions, evidence limits and method trade-offs (Devane et al., 2024; Garritty et al., 2025; Stevens et al., 2025). The review was not designed as a meta-analysis because the evidence base was neither sufficiently quantitative nor homogeneous.
Review questions
This rapid review was guided by six questions. First, what academic and official evidence exists concerning nursing students and experienced nurses who leave, pause or move beyond nursing to enter medical school? Second, what motivations are reported for transition into medicine? Third, what numerical data are available concerning applications, admissions, prior nursing qualifications, progression, pass rates, failure, withdrawal, graduation and later medical registration? Fourth, what experiences are reported during medical school and early medical training? Fifth, what is known about why nurses choose medicine rather than advanced nursing or nurse practitioner pathways? Sixth, what are the main gaps in the evidence base, particularly for the United Kingdom, Australia and Aotearoa New Zealand?
The term “leaving nursing” is used cautiously. The literature rarely uses this wording, and it is often impossible to determine whether a medical student with a nursing degree was a practising registered nurse, a newly qualified nurse, a student who changed pathway before registration, a midwife, or a health graduate whose nursing identity was never central to their working life. Where the evidence does not allow that distinction, this review says so explicitly.
Searches
The review began with a deliberately narrow focus on the United Kingdom, Australia and Aotearoa New Zealand because these areas share related nursing and medical education histories and have current interest in graduate-entry or healthcare professional entry pathways. The initial search showed that direct evidence from these three countries is much thinner than expected. The review was therefore widened internationally, not to pad out the argument, but to test whether the same pathway had been studied elsewhere. Canada and the Philippines added useful material.
Searches were conducted across PubMed, ERIC, Google Scholar, Semantic Scholar, and ResearchGate; official reports from Medical Schools Outcomes Database (MSOD) for Australia and Aotearoa New Zealand; Nursing Council of New Zealand workforce and annual practising certificate information; and university pathway pages and thesis repositories. No lower publication date limit was applied and material available up to 15 September 2026 was eligible for inclusion. Search terms included combinations of nurse to doctor, nurse physician, registered nurse, medical student, nurses retrain as doctors, nursing to medicine, nursing as premedical, nursing pre-med, health professionals becoming doctors, prior nursing degree medical school, prior health professional experience medical students, graduate-entry medicine nursing, medical students former nurses, nurse practitioner versus medicine, professional identity, hierarchy and hidden curriculum.
Evidence was included if it focused directly on nurses entering medicine; included nursing within a health-professional-to-medicine pathway; reported previous nursing, midwifery or health-related degrees among medical students; examined medical school performance by prior degree or professional background; or provided official national data relevant to medical student background. Peer-reviewed articles, thesis research and official national datasets were prioritised. Recruitment pages, blogs, social media and personal stories were excluded unless they provided pathway context that was clearly distinguished from outcome evidence.
Synthesis of evidence
The synthesis of evidence was guided by additional rapid review methodological guidance concerning narrative synthesis and assessment of the certainty and directness of evidence (Gartlehner et al., 2024). Contextual sources were used to situate broader professional mobility, including reverse movement between medicine and nursing (Lazarus, 2008), and the hidden curriculum within medical education (Brown et al., 2020). Information concerning advanced nursing scope was obtained from national nursing professional or regulatory sources, while information on graduate-entry and healthcare-professional entry pathways was obtained from official medical school and national admissions websites.
A hierarchy of evidence was applied (Gartlehner et al., 2024; Guyatt et al., 2011). Direct empirical studies of nurses retraining as doctors were treated as core evidence. Studies of health professionals entering medicine were treated as supporting evidence. Studies of prior health-related degrees and medical school performance were treated as indirect educational outcome evidence. Official datasets were treated as high-value descriptive evidence only where the variables were sufficiently clear. Where data combined nursing and midwifery or did not distinguish registered nurses from other health graduates, that limitation was retained rather than smoothed over.
For Australia, the Medical Deans Australia and New Zealand (2026) National Data Report was treated as the public national output of the Australian MSOD; separate student-level MSOD data were not accessed. For Aotearoa New Zealand, the New Zealand Medical Schools Outcomes Database Steering Group (2024) national report on students commencing medical school from 2019 to 2023 was used as the corresponding public national dataset; separate student-level NZMSOD data were not accessed. Nursing Council of New Zealand annual practising certificate and workforce information were also reviewed to determine whether nurses who continue clinical work while studying medicine could be identified. These data include variables such as main area of practice, employer type and usual weekly hours, but do not identify concurrent enrolment in medical school, so they cannot quantify nurses who remain on the nursing register and continue nursing shifts during medical training (Nursing Council of New Zealand, n.d.-a).
Ethics approval was not required for this review because no participants were recruited and no private or identifiable datasets were used. The review drew on published literature, thesis research and public official reports. For included primary studies involving human participants, ethics and consent reporting in the source material was considered as part of source appraisal and transparency.
RESULTS
Overview of the evidence base
The review included 12 substantive evidence sources: two direct nurse-specific qualitative studies (McLean, 2017; Robinson, 2023); one closely aligned qualitative study of registered health professionals entering medicine (Gallagher & Hoare, 2016); five indirect cohort or performance studies (Aston-Mourney et al., 2022; Banal et al., 2024; Cunanan, 2020; Puddey et al., 2014, 2019); two official national datasets (Medical Deans Australia and New Zealand, 2026; New Zealand Medical Schools Outcomes Database Steering Group, 2024); one professional identity paper (Langendyk et al., 2015); and one pathway source (King’s College London, 2025, 2026). The evidence base was small and uneven. Two sources formed the direct nurse-specific experiential core: McLean’s Australian study of three registered nurses enrolled in an undergraduate medical programme, and Robinson’s Canadian doctoral thesis involving 13 medical students and residents who had completed nursing training before entering medical school. Philippine studies provided quantitative evidence where nursing was recognised as a premedical course and, in the main, concerned new nursing graduates rather than experienced nurses leaving established nursing careers (Banal et al., 2024; Cunanan, 2020).
The next evidence layer concerned health professionals entering medicine or medical students with prior health-related degrees. Gallagher and Hoare’s (2016) Aotearoa New Zealand study added evidence from 12 medical students who were or had been registered health professionals, although nurses were not reported separately. These authors found that registered health professionals entering medicine commonly described a desire for fresh challenge and perceived limits in their former roles, although the move from autonomous practitioner to novice medical student was initially uncomfortable (Gallagher & Hoare, 2016). Australian graduate-entry research suggested that students with health-related prior degrees may perform strongly across medical school, including clinical, professionalism and OSCE-related domains (Aston-Mourney et al., 2022; Puddey et al., 2014, 2019).
The weakest evidence area is one that many readers may want: numbers and outcomes. From the national datasets available from the United Kingdom, Australia or Aotearoa New Zealand, none provided a complete nurse-specific pathway from nursing education or registration into medical school application, admission, progression, failure, attrition, graduation and later medical registration. Australia comes closest through MSOD data, but public reporting combines nursing and midwifery and does not establish registration or prior employment status (Medical Deans Australia and New Zealand, 2026). Data from Aotearoa New Zealand reports previous tertiary qualification status but does not publicly isolate nursing (New Zealand Medical Schools Outcomes Database Steering Group, 2024). The United Kingdom shows increasing pathway visibility, but published outcome data are not yet available for newer programmes such as King’s College London’s Healthcare Entry Medicine Bachelor of Medicine, Bachelor of Surgery (MBBS) (King’s College London, 2025, 2026).
Evidence by country
A summary of the evidence, alphabetically by country, is shown in Table 1.
Aotearoa New Zealand
Aotearoa New Zealand had one directly relevant qualitative study. Gallagher and Hoare (2016), based at the University of Otago, interviewed 12 medical students who were or had been registered health professionals. Participants described seeking a fresh challenge and viewing aspects of their former professional roles as limited, while returning to student status after practising autonomously was initially uncomfortable. Because the professions were grouped, the study cannot provide nurse-specific prevalence or motivation estimates, but it is important local evidence that the transition from established health professional to medical student has been observed in Aotearoa New Zealand.
Aotearoa New Zealand had useful background reporting through the New Zealand Medical Schools Outcomes Database (New Zealand Medical Schools Outcomes Database Steering Group, 2024). The national report on students commencing medical school from 2019 to 2023 included 2,478 responses from 2,883 commencing students, a response rate of 85.9%. It found that just over 39% of respondents had a previous tertiary qualification, most commonly a bachelor’s degree. This confirms that prior tertiary education is a substantial part of the New Zealand medical student profile.
The limitation is that the public report does not break prior qualifications down in a way that answers the nurse-to-doctor question. It cannot tell us how many commencing students were nursing students, nursing graduates, registered nurses, enrolled nurses, midwives or experienced nurses leaving clinical practice. Nursing Council of New Zealand annual practising certificate data also could not identify concurrent medical study. A nurse who keeps an annual practising certificate and continues nursing shifts during medical school remains visible in workforce data as a practising nurse, not as a nurse-to-doctor transition (Nursing Council of New Zealand, n.d.-a). This means movement out of nursing may be delayed, partial or invisible in current datasets. The planned University of Waikato graduate-entry medical programme is relevant context because it is designed around graduate entry, primary care and regional or rural health need (University of Waikato, 2026). Its structure may be particularly accessible to nurses who already hold bachelor’s degrees, but applicant profession and outcomes are not yet available, so its relevance remains prospective rather than empirical.
Australia
Australia provided both the strongest direct study in the core geography and the best public descriptive dataset. McLean’s study remains the most directly relevant peer-reviewed article centred on nurses becoming doctors (McLean, 2017). It used interpretative phenomenological analysis with three highly qualified registered nurses enrolled in an undergraduate medical programme. The sample is small, so it cannot support prevalence or outcome claims, but it is valuable for understanding the meaning of the transition.
McLean’s (2017) findings challenge simplistic readings of nurses entering medicine as status-seeking or mere upward mobility. Participants imagined themselves as doctors who would add diagnostic skill, clinical reasoning and medical decision-making to the patient-centred ethic developed through nursing. They also linked the transition to community service and the wish to improve healthcare culture. At the same time, they had to negotiate when to reveal their nursing background, how to make sense of hierarchy, and how to retain nursing values while entering a profession with different authority and expectations.
Australian MSOD data provide useful descriptive context (Medical Deans Australia and New Zealand, 2026). The 2026 National Data Report is the public national reporting output of the Australian MSOD. In the report, 3,994 final-year Australian medical students were reported in 2025 and 3,840 graduated, giving an overall final-year graduation proportion of 96.1%. This is an all-student figure, not a nurse-specific outcome. The same report recorded nursing/midwifery as a small but consistent prior discipline among final-year respondents from 2021 to 2025, ranging from 27 to 47 respondents a year. These figures are useful but limited because they combine nursing and midwifery, rely on final-year respondents, and do not identify registration, prior employment, failure, withdrawal, remediation or later medical registration.
Canada
The strongest evidence was Robinson’s Canadian doctoral thesis, Jumping ship and going to the other side: Experiences of nurses who retrain as doctors (Robinson, 2023). This constructivist grounded theory study interviewed 13 medical students and residents who had completed nursing training before entering medical school. Although it is thesis-level rather than peer-reviewed journal evidence, it is directly aligned with the question and has a larger qualitative sample than the Australian direct study.
Robinson found that many participants left nursing because of the negative effects of healthcare hierarchy. In preclinical medical school they felt both advantaged and burdened by advanced clinical knowledge. During placements they experienced social distress and role confusion, particularly when learning in familiar settings or working alongside former nursing colleagues. Importantly, the thesis concluded that nursing identity diminishes but is never fully lost. This is consistent with McLean’s (2017) findings and strengthens the argument that nurse-to-doctor transition is professional identity reconstruction rather than simple occupational transfer.
The Philippines
The Philippines contributed quantitative evidence involving nursing as a premedical course. This reflects a different educational context and must be interpreted carefully. These studies often concerned nursing graduates as premedical students rather than experienced registered nurses leaving established nursing careers. Cunanan’s retrospective cohort study examined 1,528 accepted students at the University of Santo Tomas Faculty of Medicine and Surgery from 2012 to 2015 (Cunanan, 2020). Nursing and physical or occupational therapy graduates achieved higher final scores than some other premedical groups, but nursing did not clearly remain an independent pass/fail predictor after adjustment. Banal and colleagues’ study of 1,203 first-year medical students at Pamantasan ng Lungsod ng Maynila College of Medicine similarly found that prior academic achievement and National Medical Admission Test (NMAT) were important predictors of first-year performance, with nursing represented as one premedical course (Banal et al., 2024). The careful claim is, therefore, that nursing background may support stronger early marks in some settings, not that nursing independently predicts completion or passing across medical school.
United Kingdom
The United Kingdom currently offered more pathway context than academic outcome evidence. King’s College London has announced a Healthcare Entry Medicine MBBS, designed for qualified healthcare professionals with at least two years of full-time equivalent patient-facing clinical experience (King’s College London, 2025, 2026). This is important because it makes explicit something older graduate-entry routes often left implicit: experienced healthcare professionals, including nurses, may be a distinct and desirable group for medical entry.
Pathway existence, however, is not outcome evidence. Because the programme is new, it does not yet provide published evidence on applications, acceptances, attrition, pass rates, failures, graduate outcomes, or whether nurses perform differently from paramedics, pharmacists, physiotherapists, midwives or other health professionals. No strong UK peer-reviewed study was located that specifically tracked nurses or nursing students leaving nursing to become doctors. For this review, the UK should therefore be described as an evidence gap with emerging pathway development rather than a mature research field.
Motivations for nurses entering medicine
Across the direct qualitative evidence, the most consistent motivation is expanded clinical scope. Nurses entering medicine appear to want access to diagnostic reasoning, prescribing, medical decision-making and authority to shape treatment plans. This should not be simplified as rejection of nursing. In McLean’s (2017) study, participants valued nursing’s patient-centred ethic and imagined becoming doctors who retained that orientation. The motivation was additive: to combine nursing’s relational knowledge with medicine’s diagnostic and decision-making authority. A second motivation was frustration with hierarchy. Robinson’s (2023) participants described the negative effects of hierarchical healthcare systems as one reason for leaving nursing. This does not mean every nurse entering medicine is fleeing nursing, but it suggests that perceived limits on nursing voice, authority and influence may contribute to the decision. A third motivation is service. Participants in the direct studies did not simply describe status movement; they also described wanting to practise medicine through values shaped by nursing and, in some cases, to repair or improve healthcare culture (McLean, 2017; Robinson, 2023).
Why medicine rather than nurse practitioner?
The current literature does not directly answer why a nurse chooses medicine rather than an advanced nursing or nurse practitioner pathway. This is a substantive gap, particularly in Aotearoa New Zealand where nurse practitioners are autonomous, can diagnose and manage common and complex conditions, order and interpret investigations, prescribe medicines, and admit or discharge patients within their competence (Nursing Council of New Zealand, n.d.-b). Some motivations reported for entering medicine, such as greater diagnostic reasoning, prescribing and decision-making authority, therefore overlap with capabilities available in advanced nursing practice.
The direct nurse-to-doctor studies nevertheless describe medicine as offering a different breadth of diagnostic, treatment and professional authority, alongside a new professional identity (McLean, 2017; Robinson, 2023). It would be unsafe to infer that participants rejected nurse practitioner practice, were unable to access it, or were motivated primarily by status, because the studies did not make that comparison. Future research should ask the choice explicitly, including desired scope and specialty breadth, access to training, geographic availability, perceived career ceilings, professional hierarchy, remuneration, portability, identity and whether the individual wished to remain within nursing as a profession.
Experiences during transition
The strongest experiential finding is professional liminality. The transition from nursing to medicine is a minimum of four to five years (depending on programme entry requirements). Nurses, therefore, occupy an in-between space in which they may know the ward, understand patient care, recognise risk and read team dynamics, yet still be positioned as medical students at the bottom of the medical hierarchy. This creates an unusual mix of competence and novice status.
Prior nursing knowledge can be an advantage. It may support communication, patient assessment, professionalism, interprofessional awareness and OSCE performance (Aston-Mourney et al., 2022). It may also help students understand deterioration, medication safety, escalation and documentation. The same knowledge can become a burden (Robinson, 2023). Former nurses may see gaps or contradictions in teaching and practice or feel awkward when expected to perform as novices in environments where they previously practised as competent nurses (Robinson, 2023). They may also selectively disclose their nursing background. Disclosure can bring credibility, but it can also invite assumptions, suspicion, role confusion or resentment (McLean, 2017).
Academic performance, pass rates and failure
The evidence on academic performance is stronger than the evidence on nurse-specific pass and failure rates but remains mostly indirect. Australian studies of graduate-entry medicine suggest that students with health-related prior degrees can perform well. Aston-Mourney and colleagues (2022) studied 1,159 graduate-entry medical students at Deakin University. They found that students with health-related degrees consistently outperformed students from other disciplines across themes of the medical programme, even though science and biomedical science students often entered with stronger Grade Point Average (GPA) and Graduate Medical School Admissions Test (GAMSAT) profiles (Aston-Mourney et al., 2022). Reported sub-analyses indicated strong nursing performance in ethics, law, professionalism, clinical practice and OSCE-related domains, although early medical science performance could be lower and improve over time (Aston-Mourney et al., 2022).
Puddey and colleagues (2014, 2019) also found that health backgrounds were associated with stronger academic performance in Australian graduate-entry medicine, supporting the argument that prior health professional education can be a useful foundation for medical training. However, they do not prove that registered nurses specifically pass medical school at higher rates than other students. Health-related categories often include multiple disciplines, and nursing is not always separated from midwifery or other health professions.
The current evidence-based conclusion is therefore restrained. Prior nursing or health professional education may support aspects of medical school performance, particularly clinical and professionalism-related domains, but nurse-specific pass, fail, remediation, attrition and graduation statistics remain unavailable in the public academic literature. Any stronger claim would exceed the evidence.
IMPLICATIONS
Numbers and workforce implications
The workforce question is important but under-researched. From a nursing workforce perspective, every registered nurse who moves into medicine may be seen as a loss to nursing. From a health system perspective, the same individual remains in healthcare and may eventually contribute as a doctor with nursing-informed clinical insight. The policy question is therefore not simply whether nursing loses a nurse, but what the system gains, what nursing loses, and whether the transition exposes preventable problems in nursing career structure, autonomy and recognition.
The available data do not permit a robust count of nurses leaving nursing to become doctors. Australian MSOD data show that nursing/midwifery is a small prior-degree category among final-year medical student respondents. New Zealand MSOD data showed that prior tertiary qualification is common, but not whether nursing is a significant source. UK pathway developments show institutional interest in health professional entrants, but not yet outcomes. No located source provides a national annual number of registered nurses applying to medical school, receiving offers, withdrawing from nursing registration, failing, graduating or entering medical practice.
Professional identity and hierarchy
Professional identity is the strongest conceptual thread in the evidence. Nursing and medicine are distinct professions with different histories, educational structures, status positions, modes of authority and forms of accountability. Movement from nursing into medicine therefore requires acquiring new and different knowledge as well as negotiating a move between two established professional identities. McLean (2017) and Robinson (2023) both showed that nursing identity was not erased by medical training and may be hidden, softened, reworked or subordinated. However, it remains part of the person’s clinical self. Langendyk and colleagues’ (2015) work on professional identity boundaries between nursing and medical students was useful here. Even though they did not directly study nurses becoming doctors, their research showed how nursing and medical education could reinforce professional boundaries and hierarchical assumptions (Langendyk et al., 2015).
No included nurse-specific study explicitly investigated the hidden curriculum. In medical education, the hidden curriculum refers to the informal and often unintended organisational, cultural and interpersonal influences that operate outside the formal curriculum and shape students’ professional identity and behaviour (Brown et al., 2020). Findings concerning hierarchy, selective disclosure of nursing background, role confusion and professional identity nevertheless overlap with wider medical education research. That literature shows that role modelling, organisational culture, stereotypes and informal professional norms can influence medical student identity formation (Brown et al., 2020).
Implications for medical education
Medical schools should not treat former nurses as generic graduate entrants. Their prior experience may help them clinically, but it may also create specific educational and pastoral needs. They may need support to adjust to biomedical science demands, particularly where nursing education emphasised applied clinical knowledge rather than detailed preclinical science. They may also need safe spaces to discuss identity conflict, disclosure of prior nursing status, hierarchy, and the discomfort of being repositioned as novices.
Admissions processes should avoid unsupported assumptions. It is tempting to assume that nurses will automatically be excellent medical students because they have clinical experience. It is equally tempting to assume they are entering medicine because nursing is inferior. Neither assumption is supported by the evidence. Admissions processes should avoid assuming that prior nursing experience either guarantees readiness for medical training or indicates a particular motivation for entering medicine. Selection should instead consider the applicant’s academic preparedness, prior professional experience and stated reasons for pursuing medicine.
Implications for nursing education and workforce retention
For nursing, the pathway into medicine should not be treated purely as betrayal or loss. It may reveal where nursing career structures are failing to retain ambitious clinicians who want greater diagnostic authority, broader clinical scope or stronger influence over treatment decisions. Some of these aspirations can be met within advanced nursing roles, nurse practitioner pathways, clinical education, research, leadership and specialist practice. Others may genuinely align more closely with medicine.
The more uncomfortable question is whether some nurses leave because the healthcare system positions nursing as subordinate while relying on nursing expertise to function. Robinson’s (2023) findings suggest that hierarchy can be a driver of departure. A nursing workforce strategy is necessary to retain clinically ambitious practitioners, reflecting their need for autonomy, respect, progression, advanced scope and genuine interprofessional voice.
Research gaps
The main research gap is clear. The field needs linked, nurse-specific longitudinal data. A useful dataset would connect nursing education, nursing registration, nursing employment, medical school application, admissions decisions, medical school progression, remediation, failure, withdrawal, graduation, medical registration and eventual specialty choice. In Aotearoa New Zealand, one practical option would be to explore whether the Nursing Council of New Zealand workforce or annual practising certificate collection could include an optional variable on concurrent enrolment in another regulated health-professional programme, including medicine, with appropriate privacy and governance protections. Without linkage or a directly collected variables, nurses who continue to work nursing shifts while studying medicine remain invisible as a transition group.
The United Kingdom needs empirical research on healthcare professional entry medicine cohorts as they progress. Australia needs MSOD or admissions analyses that separate nursing from midwifery and distinguish registered nurses from degree holders. Australia currently has numerous established four-year graduate-entry medicine programmes, making multi-site analysis feasible (Australian Council for Educational Research, 2026). Aotearoa New Zealand needs public or research-access reporting on prior discipline among commencing medical students, particularly as the University of Waikato graduate-entry pathway develops. Ireland offers another mature graduate-entry comparison and could be included in future cross-national work (Irish Universities Association, n.d.). Future studies should also case-study current cohorts of nurses retraining in medicine and explicitly ask why medicine was chosen rather than nurse practitioner or other advanced nursing pathways. Qualitative work should examine guilt, status movement, identity concealment, former nursing colleagues, hidden curriculum, exposure to disrespect toward nursing, cognitive dissonance, medical resocialisation and the persistence of nursing values after medical qualification. Future quantitative studies should avoid collapsing nurses, midwives, paramedics, pharmacists, physiotherapists and biomedical science graduates into one broad group.
Limitations of this review
This is a rapid review with a scoping purpose rather than a full systematic review. It maps the available evidence and identifies major gaps but does not claim exhaustive database coverage or formal quality appraisal using a single critical appraisal instrument. The limitation is partly practical and partly methodological. The literature is inconsistently indexed, and the phenomenon is often hidden under broader categories that do not use nursing-specific search terms. A further limitation is that official datasets are only as useful as their public variables. Where reports do not identify nursing separately, or combine nursing and midwifery, this review cannot infer details that are not reported. Similarly, studies of health-related degree holders support the argument that prior clinical education may matter, but they cannot be treated as direct nurse-to-doctor evidence unless nursing is separately analysed.
This review also could not determine whether features of current nursing education and career structures in Australia and Aotearoa New Zealand predispose some nurses to seek medical training. Differences in undergraduate science exposure, access to advanced-practice education, availability of supervised nurse practitioner pathways, geographic distribution of roles, perceived limits on scope or progression and local professional culture may all matter, but the present evidence does not allow these factors to be tested. Relatedly, the literature provides almost no comparative information about why one nurse pursues medicine while another with similar ambitions chooses nurse practitioner or other advanced nursing practice.
CONCLUSION
The pathway from nursing to medicine is real, but the evidence base is thin. Direct qualitative evidence from Australia and Canada, together with closely aligned Aotearoa New Zealand research on registered health professionals entering medicine, shows motivations including expanded clinical scope, diagnostic authority, fresh challenge, service, frustration with hierarchy and a desire to practise medicine through values shaped by prior health-professional experience. Their transition involves complex professional identity work. Nursing identity may diminish, shift or be hidden, but it is not simply lost. The evidence also suggests that professional mobility should not automatically be treated as a one-way loss from nursing, because some individuals may have left nursing regardless and reverse movement between health professions also occurs.
Quantitative evidence is more cautious. Australian national data show a small, consistent group of final-year medical students with prior Nursing/Midwifery degrees, while New Zealand data show that previous tertiary qualification is common among commencing medical students. International studies suggest that health-related and nursing backgrounds may support some aspects of medical school performance, particularly clinical and professionalism-related domains. However, no robust public evidence currently provides nurse-specific application, admission, attrition, pass, fail, graduation or specialty outcome rates across the United Kingdom, Australia or Aotearoa New Zealand.
The strongest conclusion is restrained. Nurses becoming doctors should be studied as a distinct professional mobility pathway, not absorbed invisibly into broad graduate-entry medicine data. A major unresolved question is why some nurses seeking greater autonomy, diagnostic responsibility or career progression choose medicine rather than nurse practitioner or other advanced nursing pathways. The existing evidence suggests these students may bring valuable patient-centred, relational and systems-aware perspectives into medicine, but proper longitudinal, comparative and mixed-methods research is needed before anyone can make confident claims about numbers, success, failure, workforce impact or long-term medical practice outcomes.
Funding
None
Conflicts of interest
None