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This is a redirecting of a conversation that started in another thread.
I've heard this "an EXPERIENCED PA....beats a... whatever" argument more than a few times.
Everyone needs to remember this: experience is not a function of degree. Experience is experience. You can re-write the above sentence to read "an EXPERIENCED EM physician", and the statement holds true. You're always going to want an experienced individual making the calls over an inexperienced individual.
The dove-tail argument here is that being an MD and completing an EM residency gives you more experience by definition as a sheer function of hours spent in training. Period.
My two-cents is as follows: Is there a lot of completely irrelevant nonsense taught in medical school? You bet. Nobody cares about things like JAK-STAT pathways and naming the cofactors in the oxidative phosphorylation. Can medical school be streamlined to create better physicians in less time? Sure; I'm doing my 'academic project' on how a lot of med-school material is just useless and shouldn't be taught. However, I've also taught a number of PA-school lectures, and there's no comparison. MDs know more because they learn more material; MDs have a broader and deeper understanding of pathophysiology. Period. Graduate an MD and a PA at the same time; and you're going to have two individuals with an equal number of years of experience as they both go on. One is always going to know more.
I disagree with the bolded section. I rediscovered the utility of knowing those cofactors in a project I'm working on as a marker of disease. A couple of fellows in my program tested drugs that take advantage of JAK-STAT pathways in SCC. We should not downplay the general preparation and wide information base the MD provides, just because every doc doesn't use 100% of it. You will not know when one of those random facts becomes relevant.
I welcome your criticism, as its good for my project.
Counterargument: While your projects are important (and sound very cool) you're doing academic research; not clinical medicine. Until it becomes clinically applicable medicine; it could be left out of medical school and save we clinicians a lot of suffering and time. The vast majority of MDs out there never do what you're doing, and as a result don't care and don't need to care. I propose keeping "medical school" for clinicians, and streamlining the process to get more docs out there, faster, with better clinical acumen. That's what the nation needs right now.
Your research sounds cool; but its PhD work; not MD work. If we cut out the PhD work; you can spend more time learning clinical medicine and coming out of school more competent. If the knowledge is very specialty-specific (say, the SCC that you mention); then it can and should be learned in that specific residency/fellowship. Your average say, Anesthesiologist is never going to use that data; so why torture him/her by making him learn it?
This all stemmed from the following phenomenon, which I know wasn't unique to me. During my intern year, I found myself able to recite all sorts of USELESS knowledge about PKB and signaling pathways; and was mystified by the 'routine' things that went into clinical decision-making. All the nurses knew that you had to double-cover for Pseudomonas, but why didn't I? I spent a large portion of medical school forcefeeding myself clinically useless junk. Bogus. I felt like I was robbed of time. Make me a better clinician; I thought that's what you learned in medical school.
More comments/criticism welcome.
Heh, how else would we know who deserves to be the neuro surgeons? From my perspective it seems those in power will never get rid of a way to stratify individuals, unless you provide an alternative.