In this article, I have traced some of the evolutionary threads that have contributed to current patterns of doctoral education in nursing. Although current programs may differ in the title of the degree offered, all are structured as research doctoral programs. Because they try to be all things to all people, they fail to prepare either competent researchers or applied practitioners. Cluttered with too much general content and not enough content specific to the particular career track of the student, they fail to provide an adequate foundation for future career pathways. As a result, preparation of leaders for academic and administrative roles, clinical teachers, practitioners, and researchers is limited. Nursing has a vital contribution to make to the health of the American people. To do so we must ensure that our researchers are providing a substantive knowledge base for the field, that our leaders in academic and practice fields have a solid knowledge base of nursing coupled with administrative preparation and applied research skills, and that our clinical teachers and practitioners are skilled in their clinical specialties and in applied research in their fields. Finally, we need expert practitioners who deliver and manage truly comprehensive, quality health care services for persons in all stages of the health-illness continuum.