The path to becoming a Nurse Practitioner begins with completing your four year degree, typically in nursing. The person who goes on to become a nurse practitioner will typically need to practice in an acute care setting for some period of time as a registered nurse. At this point, you apply to graduate school, in an in a masters in nursing program. In the masters in nursing program you can either go on to do general practitioner work, or you can further specialize, and become a pediatric nurse practitioner, or a nurse midwife, or some other specialty. The master's degree program is an additional two years of formal training. Beyond that, nurse practitioners, with masters in hand must also typically complete some post-masters work. This is typically work supervised by a physician to ensure competency in their area. Once they are fully certified, and have their competencies prepared, they can practice independently as a nurse practitioner, the scope of which is very similar to an independent practitioner, with the difference being that you must always work under the supervision of a physician.