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CE COURSE: Terminal degrees
PhD, EdD, DNP — which one should you pursue?
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Delineating terminal degrees
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Kimberly D. Moss, PhD, RN, CNE, ODCP, is the organization and leadership development specialist at Gerald Champion Regional Medical Center in New Mexico and concurrently works as faculty for the MSN program at Liberty University. She moonlights as an independent consultant on team-building and leadership development, as well as professional growth and career coaching.
The only thing worse than wasted money is wasted time. Add wasted effort to those and you might get a glimpse of what several nurses across the country are feeling; they have worked tirelessly …
for the wrong degree
A key recommendation of the
Institute of Medicine
(IOM) expressed in The Future of Nursing report is to double the number of doctorate-prepared nurses by 2020.1 The recommendation stems from the need to increase the number of nurses eligible to fulfill roles as faculty and researchers, and calls for a significant intensification in learner recruitment, funding opportunities, and retention in doctoral programs. Naturally, the satisfaction of this single recommendation has positive downstream effects on other key recommendations of the FON report: increase nurse commitment to lifelong learning, empower nurses to spearhead changes across the profession, and enable nurses to collect and analyze data pertinent to healthcare.

In theory, this is a win-win situation: a highly educated nurse and an advancing profession. In reality, it is not quite as simple as it sounds — the recommendation assumes the doctorates earned by nurses align with their professional goals and will thereby yield fruitful benefits for nursing as a whole. Degree alignment with professional goals and passions is crucial to meeting the needs of the nursing profession outlined in the FON report. The big question is: Is it just about checking the box by getting the degree, or
does the type of doctoral degree really matter
? Currently, there are two terminal nursing degrees awarded in the United States: Doctor of Philosophy and Doctor of Nursing Practice. Although Doctor of Education is not a terminal nursing degree, it is another option frequently considered by nurses when evaluating a potential career path. While nurses can pursue doctoral degrees in a variety of content areas that complement nursing practice, this educational activity will focus on PhD, DNP, and EdD.

Confusion exists among nurses as to which of these degrees is most fitting for the various career paths. This confusion leads hard-working nurses toward frustration, wasted time, money, and effort, and a limited ability to contribute meaningfully to the profession in a way that fuels their personal passions and satisfies their professional goals. In December 2015, the IOM published a follow-up report that assessed the nation’s progress toward each FON recommendation.2 In response to the latest data, published in 2010,3 indicating less than 30,000 RNs in the United States have completed doctoral nursing degrees, the report emphasized the need for continued production of doctorate-prepared nurses and predicted an increasing demand for terminal preparation.

Specifically, the report underscores the importance of PhD preparation to advance the nursing profession through building the body of literature and informing health policies to improve patient care. Importantly, the committee called for increased clarification of the roles and responsibilities associated with terminal preparation.

The following discussion differentiates among the doctorates relevant to nursing and demystifies the process, benefits, professional responsibilities, and typical career progression associated with each credential. After outlining your career goals, read about the following terminal degrees relevant to nursing to determine which educational pathway matches your professional aspirations.
As of 2013, 1.68% of the United States population had earned a PhD,4 which is 0.4% of the nursing workforce.5 A PhD is a study-based, research-focused academic degree that focuses on independent inquiry and scholarly research. It is the oldest of the terminal degrees discussed in this article. The traditional PhD degree was initially awarded in the United States by Ivy League institutions in the 1800s and has since continued to garner interest and prestige.6

The term
was derived from the Latin
, or “teacher,” and the Latin
or “philosophy” was defined as “the pursuit of wisdom.” Each of these contributory original meanings aligns with the degree’s requirement to contribute an original discovery to the field via a thesis or dissertation.6-8 This professional contribution to the field is the first demonstration of the PhD’s lifelong commitment to learning and scholarly discovery. A report published by
National Science Foundation
(NSF) illustrates a consistent upward trend of about 3.4% in the number of earned research doctorates in the United States each year since 1974.9 In particular, the number of PhDs in life sciences (including nursing) is rising sharply. PhDs directly relevant to nursing include those specializing in Nursing Administration, Nursing Education, Nursing Systems, Health Policy,
Nursing Research
, and several others. A significant barrier to such a venture is that earning a PhD is a lengthy process averaging about eight years.9-11
Time and financial investment estimate:
Recent decades have seen a significant increase in time commitment to complete the PhD journey. An increased number of PhD candidates, faculty shortages that limit program enrollment, and an influx of learners enrolled part-time — all contribute to that change.
The NSF reports the time to earn a doctoral degree, calculated from the time the learner enters graduate school to awarding of the degree, can be an average of six to eight years; however, realistically, a PhD can take four to eight years.9 Programs typically begin with a couple of years of coursework followed by two to four years of research. The objective of the PhD is to learn how to produce new or original knowledge using the highest category of Bloom’s Taxonomy of Educational Objectives and to publish evidence to be used as the basis for nursing practice.12,13
Earning power:
Typically, PhD-prepared nurses earn higher salaries than those prepared at other levels; however, there are exceptions and regional trends that play a major role in salary competitiveness. The specific job role and company size are also variables. Th
e wide range of employment options results in a wide variety in salary range. NSF reports the average salary for a doctorate in life sciences, excluding bonuses and research stipends, to be around $90,000 to $100,000 per year for careers in the field; about $80,000 per year for employment in government positions; and more than $60,000 per year for careers in academia.9 A primary argument against attaining the PhD degree is that master’s-prepared nurses can earn a comparable salary; however, in just as many cases, the PhD is required for consideration in applying for those roles.

As the emphasis of the IOM FON recommendation pertaining to the promotion of terminal degrees, the PhD enables nurses to work toward the traditional aspiration for the PhD-prepared nurse: academic faculty at the college and university levels. However, there are few full professorships available and evidence suggests that less than 50% of PhDs will attain such a position within five years of earning their degree.14 Many faculty hopefuls have an unrealistic view of wh
at a position in academia entails, and are surprised when they learn of the several weighty expectations on tenured professors. To manage the expectations and mitigate the shock that may be experienced by those interested in tenure-track positions, it is important to clarify the duties associated with that role.

Such responsibilities include advising graduate students, serving on university committees and research councils, competing for research grants, helping students one-on-one, collaborating with other faculty, and conducting research.

This list, combined with the scarcity of tenured professorships, has resulted in nonacademic careers becoming increasingly common for PhD-prepared nurses. However, professors awarded tenured positions enjoy a brand of job security that enables professional growth through exploration of new educational methodologies, which in turn enables them to grow into better educators.

This safe space surrounding tenured faculty also limits the reasons for which a professor can be dismissed from a job, which can be considered a plus in a fluctuating economy. Moreover, this security is coveted during a time of a generational shift when several experienced faculty are looking over their shoulders wondering which young adjunct is eyeing their job. Although the list of professional responsibilities of tenured professors is lengthy, it is vital to understand not only the particular expectations of various universities but also the connection to the teaching-learning process that attracted teachers to their roles in the first place. The goal of this module is not to discourage professorship pursuits, but to clarify that role as well as illuminate some of the associated professional obligations. For some prospective PhD candidates, the position aligns nicely. Employment for the PhD is not limited to the elusive tenure-track professorship. Some choose to launch independent consulting firms to guide healthcare businesses toward strategic excellence or through difficult issues. Such consultants may coach on teamwork, collaboration, communication, litigation, and other topics as healthcare organizations must adjust to maintain financial wellness amidst a changing healthcare reimbursement environment.

Other roles w
ithin reach of the PhD-prepared nurse include independent researcher; researcher for government agencies, nonprofit organizations, and independent companies or institutions (including research and development); nursing leadership; and business owner. As a declared expert in his or her field, a doctorate-prepared nurse is poised to make money on that expertise.

Professional responsibilities:
Continual research and publication are
unspoken professional responsibilities of the PhD. The duty transcends the level of job-associated duties in favor of service to the profession of nursing. It is the assumption behind the FON recommendation to double the number of PhD nurses by the year 2020: why encourage the degree unless there is some benefit to the profession of nursing?

American Association of Colleges of Nursing
(AACN) posits “rigorous scientific inquiry … provides the scientific basis for the practice of the profession … shape[s] health policy, and impact[s] the health of people in all countries.”15 The urged increase in the number of PhD-prepared nurses underscores the expectation of those PhDs to contribute to the existing body of knowledge relating to nursing practice, whether or not it is included in the job description.
Some PhDs have careers that allow research to happen during the workday, enabling them to fulfill daily responsibilities and conduct research at the same time. However, others work in positions that do not allow time for research, meaning it must happen on the side, in addition to, and off the clock.

Although that rubs some people the wrong way, it underscores the importance of aligning research and passion — that way, it won’t feel like a chore, but rather a privilege or indulgence. If you aren’t sure about your research area, it is wise to wait to begin a PhD program until you are (at least somewhat) confident in a subject matter or research topic direction that will bring you joy.
The big question is: Is it just about checking the box by getting the degree, or does the type of doctoral degree really matter?
Role in evidence-based practice (EBP):
Evidence-based practice
is a set of methods that have been proved through research to elicit the most positive patient outcomes. The evidence, or research, directly informs healthcare delivery, community care, healthcare policies, public health, and the way tasks and procedures are performed at the patient’s bedside.

A PhD-prepared nurse plays an integral behind-the-scenes role in conducting the research that informs
nursing best practice. The professional responsibility and expectation of a PhD is frequent contribution to the existing body of literature via original research and publication. This discovery of new and better ways to help patients is in direct support of patient care and dramatically furthers the profession of nursing. Just as there are infinite areas of patient care, there are equally as many subjects of a nurse researcher. In many cases, nurse PhDs can dictate their research direction in response to evolving interests and expertise. There are, however, some positions that demand certain research output subject matter and frequency.

Research done by a tenured professor usually allows a degree of academic freedom, as well as scheduled time to conduct studies. That freedom and allotted time is typically augmented following the award of research grants and federal funding due to increased visibility of the institution.

In contrast, research from a PhD nurse in other roles, such as an independent consultant or paid researcher, may provide a less flexibility because contracts will dictate the research needs. It is worth a mention, however, that independent consultants tend to choose research jobs that align with their passions, interests, and expertise; therefore, do not begrudge the contracted tasks.
Why a PhD?
When considering a PhD, the vital question you will need to answer for yourself and that will dictate your satisfaction once achieved is, “Why get a PhD?” If the answer is to capture an elusive tenure-track professorship, you may be disgruntled at the wait, perceived delay in career advancement, and numerous other expectations for professors. On the other hand, if you want to earn a PhD for the pursuit of knowledge, to be trained in the research process, to master the art of educating adults, to become an expert in a particular area, and/or for the love of discovery, you will likely feel fulfilled in any of the previously mentioned roles suitable for a PhD-prepared nurse.
When considering setting out on the DNP quest, it is important to assess your alignment with that role. Ask yourself, “Why get a DNP?” If the answer is because there is a BSN-DNP program nearby that takes just as long as an MSN credential, it may be wise to reconsider in light of the career direction and professional expectations of a DNP nurse. However, if you are interested in pursuing a DNP to learn how to use research to improve bedside processes and patient outcomes, evaluate outcomes and publish recommendations, or to use doctoral knowledge to lead clinical institutions toward higher-quality care, then the DNP credential may align with your professional goals.
Clinical vignette
Start questions
John is a master’s-prepared RN with several years of experience as the infection control and patient safety officer at his mid-sized acute care hospital. Although he no longer provides direct patient care, he enjoys reading research studies and educating nurses on best practices to implement on patient care units. He routinely collects data to determine the facility’s progress regarding incidence of hospital-acquired infections.

John read the Institute of Medicine (IOM) recommendation to double the number of doctorate-prepared nurses by the year 2020 and decided to pursue a terminal nursing degree. In deciding which program to pursue, he identified his professional goals: to explore trends related to patient safety, conduct original research, and publish data that influence best practices in nursing.
What is the IOM’s Future of Nursing recommendation regarding
terminal preparation of nurses?
Create 200,000 doctorate-prepared nurses by the year 2020
Triple the number of master’s-prepared nurses by the year 2020
Double the number of doctorate-prepared nurses by the year 2020
Educate nurses about the importance of higher education by the year 2020
What type of terminal nursing degree is most appropriate to meet John’s professional goals?
Doctor of Philosophy (PhD)
Doctor of Nursing Practice (DNP)
Doctor of Education (EdD)
Doctor of Medicine (MD)
What did John correctly assess before choosing a doctoral program to pursue?
Potential salary of each degree
Degree of influence of each credential
His professional goals
Length of time to degree for each credential
After further thought, John decides his professional goals going forward are to include translating clinical research into patient care methods and leading clinical teams toward best practices. Which terminal nursing degree is John likely to find most satisfying?
Doctor of Philosophy (PhD)
Doctor of Nursing Practice (DNP)
Doctor of Education (EdD)
Doctor of Medicine (MD)
The IOM’s Future of Nursing report recommendation No. 5 is to “double the number of nurses with a doctorate by 2020 to add to the cadre of nurse faculty and researchers.”
As a professional who is no longer providing direct patient care, a PhD aligns with John’s professional goals to conduct and publish original research.
Before choosing an education program, prospective doctoral candidates must assess their professional goals to ensure the credential aligns with those goals. All other information should be secondary to that alignment to ensure a fruitful educational pursuit.
The DNP preparation would align with John’s professional goals in translating research into bedside practices as well as leadership in healthcare settings. The PhD would not align best as it is research focused and not typically associated with direct patient care. The EdD would align least as it prepares learners to apply research to solve problems within the education system.
There are a several similarities between a PhD in nursing education and an EdD in nursing education; however, there are some distinct and fundamental differences between these degrees and career pathways. The EdD is a teaching-focused professional degree that concentrates on practical application of concepts to the practice of education. It is the second oldest terminal degree discussed in this module, and was first awarded in 1921 by Harvard University.6

This hands-on degree aims to develop strong leadership and decision-making skills in the education system. In many cases, an EdD is the choice doctorate for emerging or potential leaders in the educational arena who want to drive change through the application of research. The professional focus of this doctorate makes it ideal for nurses with a great deal of experience in leadership and the field of education or nursing education. For example, professional experiences within the education system — teacher, department chair, curriculum committee member, administrator — help to direct the emphasis and progression of the final project and ultimately, a career.

The goal of this degree is to learn how to use research to influence the practice of education and inform the teaching-learning process, as a practitioner or as an education administrator. While the PhD prepares the learner to conduct original research, the EdD teaches learners to apply existing research to solve a problem in education or education systems.

Employment, professional roles, and earning power:
Prospective doctoral candidates are attracted to the EdD because it typically takes less time to complete than the PhD (about three years). Typical career progressions of EdD nurses include scholarly practitioner roles with direct leadership and management obligations. Such professional roles include direct leadership and management such as education executive, superintendent, or university leader. Other professional roles of the EdD nurse have direct impact on student achievement and the teaching-learning experience in positions such as chief learning officer or curriculum designer.

In most cases, EdDs earn an average salary of $95,577 and work within education settings; however, it is not unusual for them to work in civil service or training supervisors in the corporate setting.19 As with the previously mentioned terminal degrees, annual salaries may vary depending on geographic location and the size of the hiring institution. (Note: a relatively new specialized EdD recognized in the United States and a growing list of countries is the Doctorate of Educational Leadership (EdLD), which will not be discussed in this CE module.)
Professional responsibilities and role in EBP:
The unspoken professional obligation of EdD nurses is to continue applying research to solve real problems within the nursing education system. This means EdD nurses are expected to research the teaching/learning process and its facilitation, as well as solutions to issues identified in the nursing education system. Beyond conducting research, the expectation of EdDs is publication that propels positive change in the nursing education arena. EdDs are solicited to lead the charge in applying research to improve the education space. As such, EdD programs focus primarily on the application of EBP to the education process and setting.
Time and financial investment estimate:
Completing an EdD typically takes about three years. As with the other degrees, the time and financial cost to degree completion is dependent on several factors, including previous applicable coursework, full-time or part-time study, particular program requirements, tuition costs, and whether or not employment is an option during the EdD pursuit.

As the terminal degree under discussion requiring the least number of terms in general to complete, it is reasonable to suppose an overall lower cost with this degree. However, understandably, the length of time in the pursuit dictates the overall cost of the degree: the more terms enrolled, the more tuition is owed.

EdD programs begin with one to two years of coursework followed by a year or two of research on an issue in education. Program culmination is similar to PhD programs in that an oral defense of a dissertation is required to a committee of experts to demonstrate competence — the EdD candidate must demonstrate the ability to apply research to solve an issue plaguing the education space.
When considering earning an EdD, the question whose answer will help guide your choices regarding that credential is, “Why get an EdD?” If the answer is that it is needed for a coveted position, it is important to consider the likelihood of not making it through the process to become eligible for said position. On the other hand, if the answer is because you want to apply knowledge gleaned from existing research to improve the teaching/learning dynamic and facilitate student achievement in the classroom, you may be more likely to sustain the motivation necessary for completing the doctorate in education.
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T |
E |
Passion meets preparation: Delineating terminal degrees for a fruitful pursuit
By Kimberly D. Moss, PhD, RN, CNE
This course is 1.2 contact hours
Courses must be completed by January 31, 2019
Goals and objectives:
The goal of this educational activity is to delineate the roles and responsibilities associated with three terminal degrees relevant to nursing practice — PhD, DNP, and EdD — in terms of typical scope, purpose, and career progression. After studying the information presented here, you will be able to:
  1. Distinguish among three terminal degrees relevant to nursing (PhD, DNP, and EdD)
  2. Discuss the value of PhD, DNP, and EdD degrees relevant to the field of nursing
  3. Explain the varying approaches to evidenced based practice through doctoral degrees earned by nurses
  4. Differentiate between the varying career and research responsibilities of doctorate-prepared nurses educational activities are provided by OnCourse Learning. For further information and accreditation statements, please visit
. The planners and authors have declared no relevant conflicts of interest that relate to this educational activity. OnCourse Learning guarantees this educational activity is free from bias. See
“How to Earn Continuing Education”
to learn how to earn CE credit for this module or visit
Doctor of philosophy
Doctor of nursing practice
Doctor of education
Why an EdD?
The basis of the FON recommendation to double the number of doctorate-prepared nurses by the year 2020 was the expectation that nurses prepared at the terminal level would drive the evolution of the nursing profession through the creation and/or application of new knowledge. Unfortunately, not all PhD, EdD, and DNP nurses fulfill their professional responsibilities because they are not aware of them or they are misaligned with their career objectives. That is why it is crucial to learn the typical career progression and professional responsibilities associated with each doctoral degree; alignment of those elements with the vocational aspirations of the prospective doctoral learner will yield a fruitful pursuit. Whether the career objective is to become a ground-breaking scholar with a PhD, a scholarly practitioner or executive in education with an EdD, or a scholarly clinical practitioner with a DNP, it is essential to take an inventory of professional goals, anticipated career progression, and degree of willingness to put forth the effort it takes to meet the professional expectations of nurses with each credential.

A fitting academic pathway will emerge after thorough self-reflection regarding professional goals, passions, and desired career progression. Intense review of the expectations of each role and opportunities in your area will ensure time and efforts in a doctoral program are purposeful, meaningful, and enable profound contribution to the evolution of nursing science and practice. The goal of this educational activity is to fuel the evolution of the nursing field by clarifying roles, responsibilities, and expectations associated with terminal preparation, and guide professional nurses toward a degree that suits their ambitions. Alignment of career aspirations with a higher education pathway will support the recommendations of the IOM Future of Nursing report as well as increase the likelihood of achieving professional goals and remaining satisfied in your work as a doctorate-prepared nurse. Primary differences among the three terminal degrees discussed here are highlighted in the following table. Note the degree focus is drastically different for each degree as well as several of the career paths and professional obligations. Although salary is not typically a driving force in career planning, that information is also provided to help manage expectations around the earning potential of each path.
A DNP is a clini
cal practice-focused professional degree that focuses on applying learned concepts to nursing practice. DNP learners develop skills to translate evidence-based practice and nursing theory into improvements in direct patient care quality and safety. DNP hopefuls with a systems leadership perspective and an eye on indirect care learn to improve healthcare systems through innovation, policy writing, administration, and scholarship-supported decision-making.

Overall, DNP nurses apply research developed by PhD nurses to improve bedside care, patient outcomes, healthcare policies, and healthcare systems. Although it is a focus of PhD nurses to generate new knowledge in the field, DNPs are not excluded from this type of contribution, as they frequently develop new interpretations of research to guide innovative bedside practices or to improve the quality of nursing processes. DNPs interested in positions requiring formal research will likely require additional study. The DNP is the newest of the terminal degrees discussed in this module. In 2004, the AACN began endorsing the DNP as the preparation required for advanced practice nurses (APRN) interested in leadership roles.16 This endorsement was intended to produce clinical experts able to adapt to a changing healthcare environment, to build the cadre of clinical faculty, and to stimulate the requirement of a doctoral degree for entry into practice for nurse practitioners by 2015.10

Since its endorsement, DNP programs have garnered a more rapid enrollment surge than research doctorates, as well as a dramatic increase in the number of program offerings in the United States. However, MSN-preparation is still the most common credential for practicing APRNs (certified nurse-midwives, certified registered nurse anesthetists, clinical nurse specia
lists, and nurse practitioners).

And, due to the lack of evidence that DNP preparation significantly impacts patient or system outcomes, the MSN is likely to remain a key player in the advanced practice arena.10 However, we do know that DNP practitioners can provide accessible, high-quality, and affordable care for patients who would not otherwise receive care.17
Time and financial investment estimate:
The DNP journey typically takes anywhere from three to five years, depending on the program, whether study is full or part time, and whether previously earned graduate program credits apply. The curriculum is guided by the DNP Essentials document,18 which identifies core competencies of DNP practitioners. Beyond the foundational competencies, specialty competency outcomes must be demonstrated for full preparation of the learner in the DNP scope of practice. Such a demonstration is not via a dissertation defense, as with the PhD and EdD, but instead is frequently through a culmination practice project that exhibits a clinical improvement using EBP.
Earning power, employment, and professional roles:
DNP practitioners earn about $8,576 more than master’s-prepared practitioners.16 Employment for DNP-prepared nurses typically focuses on clinical care quality improvement. Roles suitable for a DNP include: clinical leadership, clinic
al NP roles with a commitment to practice improvement, executive leadership of healthcare facilities or nursing education programs, clinical education, community health leadership, or faculty in healthcare education programs.

DNPs interested in a professorship are recommended to invest in additional study to add pedagogical understanding to their clinical expertise. Once hired as university faculty, they are competitive for the same formal teaching perks, such as tenure and promotion.
Professional responsibilities and role in EBP:
A common assumption is that DNPs are limited to direct-care roles; however, the degree continues to evolve to include indirect-care roles such as nursing administration, executive leadership, and nursing education. Although there are significant differences in the daily operations of a direct-care and indirect-care DNP, the professional responsibility for both is continued application of the latest research and evidence-based practices to the healthcare setting.

While DNP nurses do not necessarily need to conduct research, they are integral in translating the research into practice and facilitating the evaluation of those applied changes. And, similar to the professional responsibility of the PhD-prepared nurse, DNP nurses who choose to work in academia are expected to become well versed in teaching pedagogies to enable them to further the nursing profession by teaching.11 The key distinction of a DNP practitioner is his or her expertise in synthesizing research into practice and applying evidence in ways that advance nursing practice.
Why a DNP?
Summary of distinction between terminal
degrees relevant to nursing
Time to degree*
Four to eight years
Typical career
University faculty, researcher for corporations, government agencies, nonprofit organizations, research consultant

Professional obligations

Create new knowledge through original research; study impact of healthcare policies and procedures on community; leadership in healthcare policy creation and revision; publish via professional journals and conferences

Average salary for registered nurses working as

Assistant professor: $94,37120 Associate professor: $105,20920 Professor: $133,39120

Average NP salary


Degree focus
Clinical practice, healthcare system leadership

Time to degree*

Three to five years
Typical career
Clinical practice, clinical care quality improvement, clinical leadership positions, clinical educator, executive leadership of acute care facilities, community health leaders, faculty in clinical care programs

Professional obligations

Apply the research and evidence-based practices to the clinical setting; evaluate outcomes and impact on community and public health; leadership in healthcare policy creation and revision; publish via professional journals and conferences

Average salary for registered nurses working as

Data unavailable

Average NP salary

Degree focus
Teaching, educational leadership

Time to degree*

About three years

Typical career

University faculty, education executive/leader, superintendent, principal, curriculum designer

Average salary for registered nurses working as

Data unavailable
Average NP salary
Degree focus

Professional obligations

Apply existing research to solve current educational system problems; improve education available to community; publish via professional journals and conferences
*Time to degree listed is the practical and typical for each degree. These numbers differ from those presented by the National Science Foundation9 because the data include the time from graduate program entry to the completion of the post-graduate degree; as such, the estimates are lengthened in comparison to “actual” time to degree.
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