As the healthcare landscape evolves, demand for nurse practitioners is growing.
Factors like increased autonomy and high earning potential make becoming a nurse practitioner appealing — and becoming an FNP-C or an FNP-BC is a popular choice.
Right now, over 385,000 nurse practitioners are licensed in the U.S., according to the American Association of Nurse Practitioners. Of those, 70% are certified as family nurse practitioners (FNPs) with the ability to provide primary healthcare services to patients of all ages.
If you’re interested in becoming an FNP, you first must make a choice. Within the FNP profession, two certifications exist — FNP-C and FNP-BC.
Though both certifications allow nurses to practice as family nurse practitioners, there are differences in the two paths.
What is an FNP-C and what is an FNP-BC?
The acronym FNP-C stands for Family Nurse Practitioner-Certified and FNP-BC stands for Family Nurse Practitioner-Board Certified. The main difference in the certifications lies in the two separate issuing organizations.
The American Academy of Nurse Practitioners Certification Board, a subset of the American Association of Nurse Practitioners (AANP), issues FNP-C certifications.
FNP-BC certifications are granted by the American Nurses Credentialing Center (ANCC), a subsidiary of the American Nurses Association that issues a variety of nursing certifications.
Both certifications are a testament to the advanced education, clinical training, and expertise of NPs who specialize in family care. However, the path to each certification and the focus of their respective exams can differ significantly.
The differences in FNP-C and FNP-BC exams
The FNP-C exam is known for its clinical focus. It tests candidates on their ability to assess, diagnose, plan, and evaluate patient care. Thequestions cover various competencies such as anatomy, physiology, pathophysiology, pharmacologic therapies, and more.The exam also covers both prenatal and newborn age groups.
While the FNP-BC exam also includes clinical questions, it also tests on policy, advanced research, and nursing theory. Like the other exam, this exam also tests candidates on their ability to assess, diagnose, plan, and evaluate patient care — but it also includes a section on implementation.
The FNP-BC exam places less emphasis on the immunological and hematopoietic systems but covers all major body systems and patient age groups starting from infant through frail elderly.
The FNP-C certification has been drawing in more students than the FNP-BC certification in recent years. In 2022, 68% of total FNP candidates opted for the FNP-C exam. However, the FNP-C exam has seen its pass rate decline by more than 10% in the past five years.
FNP-C Exam
| Exam cost | $240 for AANP members and $315 for non-members |
| Pass rate in 2023 | 73% |
| Number of questions | 150 total (135 are scored and 15 are pretest questions) |
| Time limit | 3 hours |
FNP-BC Exam
| Exam cost | $295 for American Nurses Association members and $395 for non-members AANP members pay $340 and student members pay $290. |
| Pass rate in 2023 | 85% |
| Number of questions | 175 total (150 are scored and 25 are pretest questions) |
| Time limit | 3.5 hours |
Should you choose FNP-C or FNP-BC?
The choice between FNP-C and FNP-BC certifications depends on your career goals, the focus of your practice, and sometimes, the facility in which you plan to work.
If you have a strong interest in clinical practice and patient care, the FNP-C may be more aligned with your goals. Nurses with this certification typically work directly with patients in healthcare clinics, private practices, or hospitals.
If you're passionate about policy, theory, administration, or leadership, the FNP-BC might be the better option. This certification can be good for nurses planning a career in academics as a professor or researcher.
Both certifications are highly regarded, and neither is universally considered “better” than the other, Alice Benjamin, MSN, ACNS-BC, FNP-C, and Chief Nursing Consultant at Nurse.com, said.
Benjamin, also known as “Nurse Alice”, has experienced both certifications being equally respected throughout her 25-year career in healthcare.
When deciding to become an FNP, Benjamin opted for the FNP-C certification.
“I chose the FNP-C certification because of its strong clinical focus, which aligns with my career goals and practice style,” she said. “As a family nurse practitioner, my primary interest lies in providing direct patient care and utilizing practical, hands-on clinical skills. The FNP-C exam's emphasis on clinical scenarios and patient management matched my professional aspirations and the type of care I wanted to deliver.”
She also felt that the certification process by the AANP and its certification board was straightforward and aligned with her preparation and study resources.
“Ultimately, the decision between FNP-C and FNP-BC is a personal one, and I encourage fellow nurses to consider their career goals, preferred exam focus, and any regional or employer preferences when making their choice,” Benjamin said. “Both certifications are esteemed and provide valuable credentials for advancing one's career as a family nurse practitioner.”
FNPs in the real world
Due to the variety of jobs certified FNPs can hold, it isn’t clear if one certification leads to higher paying jobs than the other. However, the average salary of a FNP in the United States is $121,712 per year, according to Glassdoor.
The two exams also differ in renewal requirements. The ANCC requires the completion of 75 continuing education hours (including 25 hours of pharmacology) to renew the FNP-BC.
The AANP requires 100 continuing education hours (including 25 hours of pharmacology) and at least 1,000 practice hours to renew the FNP-C. However, nurses can opt to recertify by taking an exam instead.
If you're considering a career as a family nurse practitioner, understanding these distinctions is crucial in making an informed decision about your professional future. No matter which path you choose, both certifications pave the way for a rewarding career in healthcare.
