Reclassifying Nursing as a Non-Professional Degree: Policy, Power, and Implications for Advanced Nursing Practice

Abstract

In 2024–2025, the U.S. Department of Education (DOE) initiated a reclassification effort that excluded nursing from its list of “professional degree” programs used to determine federal student loan eligibility. This policy shift has generated widespread concern among nursing organizations, educators, and practicing clinicians. Critics argue that it undermines professional identity, limits access to graduate education, exacerbates workforce shortages, and threatens patient care—particularly in underserved communities where advanced practice nurses (APNs) are essential providers. This scholarly analysis reviews the policy, examines its implications, expands on the underlying power dynamics between medicine and nursing, and provides actionable steps for civic engagement.

Introduction

Professional classifications shape how societies define, support, and regulate specialized fields. Nursing, historically grounded in both science and humanistic care, requires intensive training, supervised clinical practice, licensure, and ongoing competency maintenance. Advanced practice nursing—spanning nurse practitioners, nurse anesthetists, nurse midwives, and clinical nurse specialists—consistently demonstrates high-quality, cost-effective care and remains a cornerstone of modern healthcare delivery.

Despite this, in late 2024 the U.S. Department of Education introduced a reclassification that excludes graduate-level nursing programs from the federal category of “professional degree.” This change signals a regression in how the federal system conceptualizes nursing, triggering wide-ranging concerns related to educational access, professional autonomy, and public health.

Policy Reclassification and Federal Rationale

The DOE’s decision occurred under the Trump administration as part of a broader legislative restructuring informally referred to in media reports as the “One Big Beautiful Bill.” The DOE’s revised list of professional degree programs includes medicine, pharmacy, dentistry, veterinary medicine, optometry, podiatry, and law, but excludes nursing, physician assistant programs, physical therapy, audiology, and occupational therapy (Laws, 2025; Meeker, 2025).

Federal explanations revolve around aligning categories with “legacy definitions” and controlling graduate student loan borrowing. However, these justifications appear inconsistent with modern realities of nursing education, which has evolved over decades into a rigorous profession requiring advanced scientific and clinical expertise.

Impact on Nursing Education, Workforce Development, and Patient Care

Graduate nursing education is essential for expanding access to care. Nurse practitioners, for example, provide primary care services in rural and underserved communities where physician shortages are most acute. Reductions in federal loan eligibility may deter students from pursuing advanced degrees, diminish the supply of nurse educators, and intensify the nurse workforce crisis.

Evidence consistently shows that nurse practitioners deliver care equivalent in quality to physicians, with high levels of patient satisfaction (Buerhaus et al., 2021). If fewer nurses can enter advanced practice roles, patients may encounter longer wait times, reduced access to preventive care, and worsening disparities in mental health and chronic disease management.

The effects ripple further into academic settings. Without enough doctoral-prepared faculty, nursing schools cannot expand enrollment to meet projected shortages—leading to systemic bottlenecks that exacerbate the crisis across healthcare.

Power Dynamics Between the Nursing and Medical Professions

The Department of Education’s reclassification must be understood within a broader historical and sociopolitical context shaped by longstanding tensions between the nursing and medical professions. These tensions revolve around autonomy, authority, and control over healthcare delivery.

For more than a century, medicine has held formal structural dominance in the U.S. healthcare system, reinforced by institutional hierarchies, regulatory authority, and political influence. Although nursing has evolved into an evidence-based, research-driven, autonomous profession, regulatory and policy structures have often lagged behind this evolution.

As nurse practitioners gain full practice authority in 27 states, the landscape of healthcare delivery is shifting toward greater interprofessional collaboration and shared decision-making. This expansion of autonomy challenges traditional models of physician oversight and has prompted robust political activity from physician-led organizations, particularly the American Medical Association (AMA).

Historically, the AMA has opposed expansions in nurse practitioner and advanced practice nursing scope of practice, arguing concerns for patient safety despite extensive scientific evidence demonstrating comparable outcomes between NPs and physicians (Buerhaus et al., 2021). While the DOE’s reclassification does not explicitly mention physician influence, its timing and effect align with longstanding patterns of resistance to nursing autonomy.

From the nursing perspective, the reclassification can be interpreted as a symbolic and structural attempt to diminish professional standing. Removing nursing from the “professional degree” category devalues the extensive academic preparation required of advanced practice nurses and subtly reinforces the notion that nursing is subordinate to medicine. This is particularly concerning in light of the profession’s critical contributions during the COVID-19 pandemic, where nurses demonstrated leadership, expertise, and resilience amid unprecedented strain.

Moreover, the decision has gendered implications. Nursing remains a predominantly female profession, whereas many of the disciplines preserved under the new definition—medicine, dentistry, law—are historically male-dominated. This disparity raises important questions about equity, representation, and the valuation of “women’s work” within policy-making structures.

Ultimately, from a nursing standpoint, the DOE’s policy reflects not only a misunderstanding of nursing’s scientific and practical rigor but also a continuing struggle for recognition within a system that often privileges medical hierarchies. The reclassification, therefore, is not merely an administrative decision but part of an enduring negotiation over power, professional identity, and the future of healthcare delivery in the United States.

Alignment of Nursing Education With Professional Degree Standards

Nursing education aligns closely with, and in many respects exceeds, the criteria used to define a professional degree within the United States. Professional degrees are typically characterized by advanced disciplinary knowledge, intensive clinical or experiential training, licensure requirements, and direct preparation for essential societal roles. Graduate nursing programs—whether at the master’s, doctoral, or post-graduate certificate level—fulfill each of these characteristics with a level of rigor comparable to fields such as medicine, pharmacy, dentistry, and law.

Graduate nursing curricula incorporate advanced biomedical and social science coursework essential to safe and independent clinical practice. Courses in advanced pathophysiology, advanced pharmacotherapeutics, and diagnostic reasoning require students to develop a sophisticated understanding of human physiology, disease mechanisms, medication management, and clinical decision-making. These subjects are foundational in medicine, reflecting that advanced nursing education draws from the same scientific knowledge base used by physicians in direct patient care. Furthermore, nurse practitioner and doctoral nursing programs include training in health assessment, epidemiology, population health, leadership, research methodology, and evidence-based practice. These domains are essential to the application of scientific knowledge in real-world clinical and administrative contexts and mirror the competency frameworks of other recognized professional fields.

In addition to didactic instruction, nursing programs incorporate extensive supervised clinical training, which is a hallmark of professional degree education. Nurse practitioner and advanced practice nursing students must complete hundreds of clinical hours under preceptorship in primary care, psychiatry, pediatrics, women’s health, geriatrics, acute care, anesthesia, or other specialty settings. These supervised experiences require students to synthesize theory with clinical judgment while managing increasingly complex patient presentations. This experiential learning model is consistent with professional preparation across medicine, dentistry, physical therapy, and similar fields, underscoring the intensive practice-readiness built into nursing education.

Professional licensure and certification further affirm nursing’s alignment with professional degree requirements. Advanced practice nurses must pass national certification examinations administered by recognized bodies such as the American Nurses Credentialing Center (ANCC), the American Association of Nurse Practitioners (AANP), or specialty organizations governing nurse anesthesia and midwifery. State licensure boards require ongoing continuing education, adherence to ethical standards, and maintenance of clinical competency, all of which are characteristic expectations of professionals in regulated fields. These requirements support public safety and reinforce the high level of accountability expected of advanced practice nurses.

Accreditation standards solidify nursing’s position as a professional discipline. Graduate programs must meet rigorous criteria set by accrediting bodies such as the Commission on Collegiate Nursing Education (CCNE) and the Accreditation Commission for Education in Nursing (ACEN). These standards govern curricula, faculty qualifications, assessment methods, clinical placement quality, and program outcomes. Accreditation ensures that nursing programs maintain consistent, evidence-based educational practices and demonstrates that the discipline adheres to national expectations for professional-level training and quality assurance.

Nursing also contributes to the national research enterprise, another key indicator of professional status. Doctor of Nursing Practice (DNP) programs emphasize advanced practice leadership, quality improvement, and translational research, equipping graduates to implement and evaluate evidence-based innovations in healthcare systems. PhD in Nursing programs prepare nurse scientists to conduct original research that advances knowledge in fields such as symptom management, health policy, population health, informatics, and health equity. This emphasis on scholarly contribution parallels research expectations in other professional degrees, including MD, PharmD, and JD pathways, and positions nursing as both a clinical and scientific profession.

Finally, the societal impact of nursing further underscores its alignment with professional degree standards. Nurses serve in critical roles that directly affect public health, safety, and well-being. Nurse practitioners are increasingly the primary point of access to care in rural, underserved, and marginalized communities. Advanced practice psychiatric nurses play essential roles in addressing mental health crises and behavioral health shortages. Nurse anesthetists deliver safe anesthesia care across a range of surgical settings, often independently in rural hospitals. These responsibilities parallel those of physicians, pharmacists, and dentists—professions recognized by the Department of Education as meeting the criteria for professional degree status.

Taken together, the scientific foundation, experiential rigor, licensure requirements, accreditation standards, research contributions, and societal responsibilities inherent in advanced nursing education clearly demonstrate that nursing meets or exceeds the benchmarks used to define professional degree programs. Excluding nursing from professional classification fails to reflect the discipline’s true complexity, preparation, and value within the healthcare system.

Civic Engagement: Contacting Massachusetts Federal Legislators

Nurses, students, educators, and citizens in Massachusetts can take immediate action by contacting their federal legislators. Advocacy is essential to ensuring the Department of Education reconsiders its reclassification and restores professional recognition and federal support for nursing education.

Massachusetts Senators

Senator Elizabeth WarrenShare your opinion: https://www.warren.senate.gov/contact/shareyouropinion

Senator Edward MarkeyShare your opinion: https://www.markey.senate.gov/contact/share-your-opinion

Massachusetts House of Representatives

Constituents may locate their district at: https://www.house.gov/representatives/find-your-representative

1st District – Rep. Richard NealContact available through his official website.

2nd District – Rep. James McGovernContact available through his official website.

3rd District – Rep. Lori TrahanContact available through her official website.

4th District – Rep. Jake AuchinclossContact available through his official website.

5th District – Rep. Katherine ClarkContact information available through House.gov and her official congressional website.

6th District – Rep. Seth MoultonContact available through his official website.

7th District – Rep. Ayanna PressleyContact available through her official website.

8th District – Rep. Stephen LynchContact available through his official website.

9th District – Rep. William KeatingContact available through his official website.

Engaging with elected officials ensures that nursing voices remain central in shaping federal policy. As constituents and healthcare professionals, nurses play a vital role in informing legislators of the real-world consequences of federal decisions that affect the workforce, public health, and access to care.

Conclusion

The U.S. Department of Education’s exclusion of nursing from professional degree classifications represents a significant regression in the federal recognition of nursing’s scientific rigor and societal importance. This policy threatens educational equity, destabilizes the nursing workforce pipeline, and risks worsening national healthcare disparities. The reclassification must be understood not only as a bureaucratic decision but as part of a longstanding pattern of undervaluing nursing within a medically dominated policy environment.

Restoring nursing’s professional status is essential for advancing healthcare quality, supporting the nursing workforce, and ensuring equitable access to graduate-level education. Nurses and citizens alike must continue advocating for policy reforms that reflect the true complexity, autonomy, and expertise of the nursing profession.

References

American Association of Colleges of Nursing. (2025, November 7). AACN alarmed over Department of Education’s proposed limitation of student loan access for nursing. https://www.aacnnursing.org/news-data/all-news/article/aacn-alarmed-over-department-of-educations-proposed-limitation-of-student-loan-access-for-nursing

Buerhaus, P. I., DesRoches, C. M., & Donelan, K. (2021). Nurse practitioners and primary care: Evidence and policy implications. Health Affairs, 40(6), 1016–1023. https://doi.org/10.1377/hlthaff.2021.00085

Indeed Editorial Team. (2023). What is a professional degree? Indeed Career Guide. https://www.indeed.com/career-advice/finding-a-job/what-is-a-professional-degree

Laws, J. (2025, November 20). Nursing is no longer counted as a “professional degree” by Trump admin. Newsweek. https://www.newsweek.com/nursing-not-professional-degree-trump-admin-11079650

Meeker, Z. (2025, November 21). Nursing no longer classified as a professional degree: What’s at stake? Nurse.com. https://www.nurse.com/blog/nursing-no-longer-classified-as-a-professional-degree-whats-at-stake/

Oliver. (2025, November 23). New bill linked to Donald Trump sparks outrage by excluding nursing as a “professional” degree. CWRTNYC Education. https://www.cwrtnyc.org/new-bill-linked-to-donald-trump-sparks-outrage-by-excluding-nursing-as-a-professional-degree/

Wojciechowski, C. (2025, November 21). Educators concerned over proposed nursing categorization changes. NBC Chicago. https://www.nbcchicago.com/news/local/nursing-exclusion-from-professional-degree-list-could-impact-healthcare/3854433/