Depressing NP-related nonsense

[Piebaldi]

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If we start cutting out our years of training, we won't be much different from the NPs who are lacking it.

Not really no. Undergrad is a complete and total waste of time.

 

[Doctorows]

Not really no. Undergrad is a complete and total waste of time.

That's one opinion.

 

[tr]

Undergraduate medical degrees are generally 6 years, so one could consider that the US system includes about 2 y worth of premed requirements plus 2 years of general education, so 8 years from HS to medical degree vs 6 years in the direct system.

Personally I think there is value in the additional time to explore, including internships and volunteer work. I did part of HS in Europe and part in the US, and I have a number of European friends who feel their lives might have been quite different if they hadn't been forced to choose their life direction at 18 with no practical experience of anything. Most people in the US who say they want to be doctors when they are in high school don't actually end up in that profession.

 

[Splenda88]

Undergraduate medical degrees are generally 6 years, so one could consider that the US system includes about 2 y worth of premed requirements plus 2 years of general education, so 8 years from HS to medical degree vs 6 years in the direct system.

Personally I think there is value in the additional time to explore, including internships and volunteer work. I did part of HS in Europe and part in the US, and I have a number of European friends who feel their lives might have been quite different if they hadn't been forced to choose their life direction at 18 with no practical experience of anything. Most people in the US who say they want to be doctors when they are in high school don't actually end up in that profession.

These are the two extremes... There can be a middle ground here, which is 3 yrs prereqs without committing yourself to med school and 3 yrs med school. The latter being is being adopted by a few US med school now.

The world was not coming to an end when pharmacy was 5-yr and then 2+4...

 

[Nines]

My partner is currently in medical school in a 3 year primary care track program, shaving off a year from the med school/residency process. I really think there should be more of these programs. I know that NYU has a program like this that isn’t limited to primary care. Maybe if these programs expanded and became widely popular they could serve as a model for reform and reducing med school to 3 years.

 

[tr]

I also did med school in 3 years plus 2 months because I was in an MD-PhD program and all the extra time went into the PhD. It was only possible because I knew I was going into either neurology or psychiatry so I did those two rotations immediately and then applied for residency. I entered residency super burned out on the heels of finishing up MCY with my surgery rotation and medicine sub-I. It's not an approach I would recommend generally. I was super jealous of my straight-MD classmates who got to have their fourth year.

 

[FatherPsychiatry]

My partner is currently in medical school in a 3 year primary care track program, shaving off a year from the med school/residency process. I really think there should be more of these programs. I know that NYU has a program like this that isn’t limited to primary care. Maybe if these programs expanded and became widely popular they could serve as a model for reform and reducing med school to 3 years.

Curious where they cut from? No MS4 year or do they take months from other years?

I agree med school seems like it could be considerably shorter (at least one year). MS1-2 years seem to be overinflated with basic science, which although much of it is foundational (despite groans from med students in the thick of things), there is a point where I think someone needs to look at how valuable it is memorizing which chromosome Neurofibramotosis Type 2 is associated with. I think it could be done in 1.5 years (in fact, I think there are some med schools that do this already). They also should really look at MS3 and bring it in to the 21st century, like maybe less OB-GYN / surgery weeks, and replace them with some radiology weeks and rotations on how to deal with NPs and how to manage your student loans and invest for your financial future. And that's not even touching MS-4 year, which, aside from maybe 2-3 sub-I months, is $60k+ to binge Netflix and "find yourself" via travel and Yoga prior to your self being destroyed and reformed intern year. NPs are icky people and their required amount of training is hilarious but maybe let's try to acknowledge, maybe just a little bit, that we might be spending just a little too much time in training. And calling most of MS4 "training" is a stretch. Chromosome 22 btw.

 

[craigkutgolf]

I'm at an academic center, and our outpatient clinic is very midlevel heavy. MDs are used more in a consultative role - e.g., a patient is not responding to the first few medication trials, is sent to a MD for a "consult," and the MD provides recommendations that the midlevel then theoretically executes - or for complex/difficult cases.

As with all things, the quality of midlevels can vary significantly. Some are great. Some are horrible. Some clearly demonstrate that they're thinking about the case in their documentation and can pick up on subtle, atypical aspects of the case that warrant a different approach, others can't write a note that makes sense to save their life. I'm not a fan of the expanding role of essentially independent midlevels, but now that that train has left the station I don't think there's any going back - there's too much incentive for healthcare systems (midlevels are cheaper and theoretically can do 90% of what MDs do) and now that relatively autonomous midlevel practice has been in place, I can't imagine that most midlevels are going to be interested in anything less than that.

Are these mid-levels a mix of both PA's and NP's or one more than the other? Is it mostly the "PMHNPs"?