National Board of Physicians and Surgeons (NBPAS)

[VA Hopeful Dr]

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Yeah, that's what EM needs: a longer and harder training regimen, in a specialty that's already under-manned, less sought after by graduating students, and infiltrated with a plethora of mid-levels.

Wow . . . how stupid are we?!

So one of the things I had read said that this was part of a plan to get rid of some of the weaker EM residencies.

Make it 4 years but really ramp up the requirements for residents to graduate. Should get rid of a bunch of the newer HCA programs which will help with the oversupply issue and some of the poor quality graduates that are starting to show up.

 

[DrMetal]

So one of the things I had read said that this was part of a plan to get rid of some of the weaker EM residencies.

Make it 4 years but really ramp up the requirements for residents to graduate. Should get rid of a bunch of the newer HCA programs which will help with the oversupply issue and some of the poor quality graduates that are starting to show up.

Whatever the case, if the end result is a smaller # of EM physicians . . . the already-short staffed and slammed ERs of America will hire more mid-levels for coverage.

This is what we physicians can't seem to understand: the medical-industrial complex will find ways to circumvent the physician , if he/she is too scarce, too difficult to pay, or too difficult to maintain.

We compound the problem by doing stupid things, like making residencies longer and thus further depleting the workforce.

Maybe that's the right answer for EM, a specialty that's mostly low-acuity medicine (Level 1's and traumas are handled by surgical teams, let's be honest).

 

[VA Hopeful Dr]

Whatever the case, if the end result is a smaller # of EM physicians . . . the already-short staffed and slammed ERs of America will hire more mid-levels for coverage.

This is what we physicians can't seem to understand: the medical-industrial complex will find ways to circumvent the physician , if he/she is too scarce, too difficult to pay, or too difficult to maintain.

We compound the problem by doing stupid things, like making residencies longer and thus further depleting the workforce.

Maybe that's the right answer for EM, a specialty that's mostly low-acuity medicine (Level 1's and traumas are handled by surgical teams, let's be honest).

I mean, to be a Level 1 trauma center you have to have a trauma team in house 24/7 so that's a non-issue. Its the acute complicated stuff that they're the best at. And cheaper than staffing the ED with every specialist who would otherwise be needed to replace 1-2 EPs.

I can't speak for everywhere, but where I've worked ortho doesn't want to sit in the ED for every injury that comes in. Same with OB for every miscarriage or cardiology for every chest pain.

 

[DrMetal]

ortho doesn't want to sit in the ED for every injury that comes in. Same with OB for every miscarriage or cardiology for every chest pain.

They get consulted by the ED physician anyways. The ED physician rarely takes care of these things by him/herself . . . they love to spread the liability. An ER nurse could place same consults.

Emergency medicine, as a specialty, was doomed from the beginning. Still, I don't think lengthening their residency is the right answer.

 

[VA Hopeful Dr]

They get consulted by the ED physician anyways. The ED physician rarely takes care of these things by him/herself . . . they love to spread the liability. An ER nurse could place same consults.

Emergency medicine, as a specialty, was doomed from the beginning. Still, I don't think lengthening their residency is the right answer.

That has not been my experience

 

[HemeOncHopeful19]

Emergency medicine, as a specialty, was doomed from the beginning. Still, I don't think lengthening their residency is the right answer.

Disagree tbh I think in other countries Gen Surg and IM / Hospitalists just rotate who is covering the ER? Sounds awful to me

 

[DrMetal]

Let's keep it rollin

 

[DrMetal]

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[Splenda88]

Why don't they change the whole system all together? 2-yr of prereqs, 3-yr med school and 2-6 yrs residency.

UofA offers 3-year medical degree to tackle Arizona’s doctor shortage

UofA is now offering a 3-year med school program to fast-track primary care doctors and address Arizona’s shortage of 600+ physicians, aiming for 2,000 by 2030.

www.azfamily.com

 

[NotAProgDirector]

Inertia, politics, legal issues (all of the laws that would need to be changed to accommodate this). The major benefit would be cost savings to the students - which is certainly a plus. But AZ's 3 year medical school, or changing all medical schools to 3 years, won't change the doctor shortage. If you have a 3 year medical school with 100 students per year, or a 4 year with the same number per class, either way you graduate 100 docs a year. And the number of docs is controlled by residency spots, not medical school spots. More US medical students will simply displace IMG's from residency spots.

So far, the 3 year programs encourage grads into primary care - but they can apply to anything. Sometimes they are guaranteed a spot at the local program. But whether this will actually increase interest in primary care, or keep people in AZ, is anyone's guess.