No Residency? No Problem!

[LutGholein]

---

Members do not see this ad.

I wonder how the NP PACs and lobby groups feel about this-- literally encroaching on their turf.

I support this.

 

[WingedOx]

I mean, isn't it an accepted fact that the resident salary & hours are basically institutionalized hazing?

no.

 

[zero0]

Love this. I've been saying for a while now that medical students who choose not to pursue, or can't get, a residency should be allowed to practice as physician's assistants and this basically lets them. Lord knows they're more qualified than PAs or NPs. I wonder what one of these assistant physicians can expect to make.

 

[LutGholein]

So?

They will have the same practice rights as Physician Assistants and Nurse Practitioners.

This should be the law in all fifty states. But the AMA and the other shill groups will oppose it because then some graduates will forgo residency altogether and just jump into a $100K+ primary care job working functionally as a PA or NP. It will be a small percentage of course, but even 2% of graduates becoming so-called Assistant Physicians would be a nightmare for the corrupt AMA and AAMC. Would create big problems for entities that rely on grossly underpaid residents.

Potentially it will create upward pressure on resident wages, forcing individual hospitals to actually give residents higher wages and better benefits. Of course, someone will point out that resident salaries are funded by medicare. There is no prohibition against programs/hospitals forking over their own money to increase that base pay (which has been unchanged for several decades now).

There is no legitimate reason why a newly graduated NP or PA should be making 2-3 times as much as a newly graduated MD when they are working less than half the number of hours with half the education.

Interestingly enough it looks like the AOA has semi-pushed back on this piece of legislation by asking to limit license renewals for those receiving "Assistant Physician" licenses. Ironically enough the man who sponsored the bill is State Rep. Keith Frederick(R) an orthopedic surgeon who graduated from Chicago College of Osteopathic Medicine.

(source: AOA: Cap assistant physician license renewals at 2 | The DO )

"Last month, the AOA joined with the Missouri Association of Osteopathic Physicians and Surgeons (MAOPS) and other health care organizations to send the board a comment letter recommending a limit of two license renewals"

"MAOPS members have expressed concerns about DO graduates choosing to work as assistant physicians indefinitely instead of going on to pursue residency training, he says."

 

[Nucleus Accumbens]

I mean, would you rather have NPs practicing in those areas?

Meh, it entirely depends. Some FMGs are from really respectable institutions in their home countries and are spectacular physicians. They just couldn't perform super competitive on the Steps likely bc of a language barrier. In that regard, gimme the doctor over the NP.


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[RogueBanana]

no.

I'm not gonna start a residency debate here, but one of the most commonly cited reasons I've seen from the "keep residency brutal" crowd is : "I did it, so should you"

Obviously I'm not saying residency shouldn't be tough, but a decent paycheck should be standard.

Interestingly enough it looks like the AOA has semi-pushed back on this piece of legislation by asking to limit license renewals for those receiving "Assistant Physician" licenses. Ironically enough the man who sponsored the bill is State Rep. Keith Frederick(R) an orthopedic surgeon who graduated from Chicago College of Osteopathic Medicine.

(source: AOA: Cap assistant physician license renewals at 2 | The DO )

"Last month, the AOA joined with the Missouri Association of Osteopathic Physicians and Surgeons (MAOPS) and other health care organizations to send the board a comment letter recommending a limit of two license renewals"

"MAOPS members have expressed concerns about DO graduates choosing to work as assistant physicians indefinitely instead of going on to pursue residency training, he says."

Perhaps The AOA is concerned that a decent number of DO graduates becoming AP(?)s forever would feed into the public bias that DOs are inferior providers to MDs?

Obviously DO and MD are essentially equal nowadays, but that bias lingers.

 

[Nucleus Accumbens]

I'm not gonna start a residency debate here, but one of the most commonly cited reasons I've seen for the "keep residency brutal" crowd is : "I did it, so should you"

Obviously I'm not saying residency shouldn't be tough, but a decent paycheck should be standard.


Perhaps The AOA is concerned that a decent number of DO graduates becoming AP(?)s forever would feed into the public bias that DOs are inferior providers to MDs?

Obviously DO and MD are essentially equal nowadays, but that bias lingers.

The entire MD profession is grossly hypocritical if you ask me. I started med school and they said to remember to provide compassionate care to all patients. These days it seems we can't even provide it towards other colleagues. Sad state of affairs indeed


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[ridethecliche]

Love this. I've been saying for a while now that medical students who choose not to pursue, or can't get, a residency should be allowed to practice as physician's assistants and this basically lets them. Lord knows they're more qualified than PAs or NPs. I wonder what one of these assistant physicians can expect to make.

So now we're saying that IMG's, including those from the carib who couldn't get into a US MD/DO school, are more qualified than NP's and PA's that went through what is probably a more rigorous admissions process and were likely held to higher standards during their education.

Please, go on...

 

[libertyyne]

So now we're saying that IMG's, including those from the carib who couldn't get into a US MD/DO school, are more qualified than NP's and PA's that went through what is probably a more rigorous admissions process and were likely held to higher standards during their education.

Please, go on...

I didn't realize NPs and PAs took Step exams.

 

[Nucleus Accumbens]

So now we're saying that IMG's, including those from the carib who couldn't get into a US MD/DO school, are more qualified than NP's and PA's that went through what is probably a more rigorous admissions process and were likely held to higher standards during their education.

Please, go on...

Yes. Bc learning to be a doctor and then proving you understand how to be a doctor (via the steps) trumps NP/PA curriculum.


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[RogueBanana]

I didn't realize NPs and PAs took Step exams.

Also, even though Carib Med is inferior to us MD, at least they can't do it online like NP....

 

[ScottTenorman54]

I feel like I've seen this idea tossed around a lot, but it always seems to be on the cusp of being introduced, or being implemented "in the near future". Personally I don't think the 'Assistant Physician' title properly reflects the breadth of knowledge required for the job. It should be Doctor of Assistant Physician (DAP).

 

[ridethecliche]

Yes. Bc learning to be a doctor and then proving you understand how to be a doctor (via the steps) trumps NP/PA curriculum.
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So you've compared curricula from the top ranked PA schools and the carib schools as well as the entrance stats for those entering?

Also, even though Carib Med is inferior, at least they can't do it online....

You're an accepted med student, right? So you haven't started yet, correct. Here's a newsflash. The vast majority of USMD students do their coursework 'online'.

This entire fight to reaffirm a hierarchy is pretty misplaced to me. Do I think NP's/PA's are equivalent to MD's? Nah. Do I see how a state taking this position could make their rhetoric more complicated? Sure, and that's awesome.

But in reality, I think the AMA really needs to grow some balls or there needs to be alternative medical association that's prepared to actually put in the work to establish things and get them done. The AMA is too worried about stepping on toes to be of much use in this arena imho.

Personally I don't think the 'Assistant Physician' title properly reflects the breadth of knowledge required for the job. It should be Doctor of Assistant Physician (DAP).

Well played.

 

[WingedOx]

I didn't realize NPs and PAs took Step exams.

Umm, not to defend the state of NP education, but Step exams really have jack all to do with one's ability to practice clinical medicine.

 

[RogueBanana]

Umm, not to defend the state of NP education, but Step exams really have jack all to do with one's ability to practice clinical medicine.

Well that's a comforting thought...

 

[libertyyne]

Umm, not to defend the state of NP education, but Step exams really have jack all to do with one's ability to practice clinical medicine.

Well then I will defer to to you to determine if online NP programs are superior to carribean MD programs.

 

[RogueBanana]

So you've compared curricula from the top ranked PA schools and the carib schools as well as the entrance stats for those entering?



You're an accepted med student, right? So you haven't started yet, correct. Here's a newsflash. The vast majority of USMD students do their coursework 'online'.

This entire fight to reaffirm a hierarchy is pretty misplaced to me. Do I think NP's/PA's are equivalent to MD's? Nah. Do I see how a state taking this position could make their rhetoric more complicated? Sure, and that's awesome.

But in reality, I think the AMA really needs to grow some balls or there needs to be alternative medical association that's prepared to actually put in the work to establish things and get them done. The AMA is too worried about stepping on toes to be of much use in this arena imho.



Well played.

What specific things would you like to see the AMA start stepping up on? What ways do you think it's failing to do those things? Not necessarily just in this arena.

Honest question

 

[Lawpy]

Well then I will defer to to you to determine if online NP programs are superior to carribean MD programs.

I can actually agree with it, mainly because I think Caribbean schools are garbage but online NP programs are still something. I have no idea how NP accreditation works and how it views online NP programs though.

At worst, online NP programs and Caribbean schools are both equally terrible and would prefer something else.

 

[ridethecliche]

Umm, not to defend the state of NP education, but Step exams really have jack all to do with one's ability to practice clinical medicine.

Well that's a comforting thought...

You didn't know this? The MCAT isn't a great predictor of anything either...

 

[libertyyne]

You didn't know this? The MCAT isn't a great predictor of anything either...

It's a predictor of passing medical school.

 

[RogueBanana]

You didn't know this? The MCAT isn't a great predictor of anything either...

I know that residency, at least according to attendings that I know, is where you really learn to be a doctor.

Isn't there some data that says there is a moderate correlation between MCAT & Step? I know it's not a strong correlation but it exists.

 

[WingedOx]

Well that's a comforting thought...

knowledge base and practical ability are two separate skills. Steps test the former. You don't really have the latter with an MD.

 

[RogueBanana]

knowledge base and practical ability are two separate skills. Steps test the former. You don't really have the latter with an MD.

That makes sense

 

[WingedOx]

What specific things would you like to see the AMA start stepping up on? What ways do you think it's failing to do those things? Not necessarily just in this arena.

Honest question

funny you should reference them... I saw these earlier this week. It's ummm, an interesting marketing strategy.

 

[RogueBanana]

funny you should reference them... I saw these earlier this week. It's ummm, an interesting marketing strategy.

😵

 

[LutGholein]

I feel like I've seen this idea tossed around a lot, but it always seems to be on the cusp of being introduced, or being implemented "in the near future". Personally I don't think the 'Assistant Physician' title properly reflects the breadth of knowledge required for the job. It should be Doctor of Assistant Physician (DAP).

With that title you would be encroaching on the new doctoral physician assistant degree ---Doctor of Medical Science (source: LMU ANNOUNCES A NEW MEDICAL DEGREE: DOCTOR OF MEDICAL SCIENCE - Lincoln Memorial University )

 

[Lawpy]

knowledge base and practical ability are two separate skills. Steps test the former. You don't really have the latter with an MD.

That makes sense

Wait the boards test knowledge base? I thought they test more than just that and focuses on applied knowledge, critical thinking etc. with questions of various levels of complexity. That's why people over on Step 1 forums say knowledge base alone isn't sufficient to do well on the exam.

This is also why doing well on the MCAT correlates to doing well on Step exams. Critical thinking, test taking skills, innate intelligence etc. transfer between standardized tests easily.

 

[RogueBanana]

With that title you would be encroaching on the new doctoral physician assistant degree ---Doctor of Medical Science (source: LMU ANNOUNCES A NEW MEDICAL DEGREE: DOCTOR OF MEDICAL SCIENCE - Lincoln Memorial University )

You've got to be kidding me

 

[WingedOx]

😵

I know, right?

They also appear to have bought the full rights to adversing in that station, so every ad in the station is for the AMA. Admittedly their HQ is only a few blocks away, but the Chicago red line is one of the busiest non-transfer stations in the CTA and probably gets more tourists than any other station, so they likely paid a pretty penny to put those up.

 

[Nucleus Accumbens]

I can actually agree with it, mainly because I think Caribbean schools are garbage but online NP programs are still something. I have no idea how NP accreditation works and how it views online NP programs though.

At worst, online NP programs and Caribbean schools are both equally terrible and would prefer something else.

That's not even a fair assessment unless you've
A) gone to a Caribbean school
B) enrolled into an online NP program
C) can generalize both program types to include all institutions in that category

A-C likely don't apply to your statement, so let's just keep our non-generalizable statements to reflect our opinions, and OURS alone shall we?


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[Lawpy]

That's not even a fair assessment unless you've
A) gone to a Caribbean school
B) enrolled into an online NP program
C) can generalize both program types to include all institutions in that category

A-C likely don't apply to your statement, so let's just keep our non-generalizable statements to reflect our opinions, and OURS alone shall we?


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Personal experience isn't necessary. Both of them can be assessed objectively with facts and evidence on the matter.

 

[Nucleus Accumbens]

Personal experience isn't necessary. Both of them can be assessed objectively with facts and evidence on the matter.

Well neither of those were provided, so were back to square one lol

Edit: I don't doubt there are some online NP programs that are literal trash, but we can't discount the lion share of online programs and call them ALL trash bc some chose to operate a certain way. Same goes for Caribbean MD schools. If we sit here and say all Caribbean programs provide no medical education for their students, then we would be saying that 50k+ physicians who are practicing now from the Caribbean aren't real doctors. Or dare I say, inferior to NP's lmao

 

[Lawpy]

Well neither of those were provided, so were back to square one lol

I have a list somewhere showing why Caribbean is a terrible idea. Online NP programs are mentioned in the first page of the thread to trivialize the profession. I think both are terrible and like I said in my first post, I'm all for the Assistant Physician idea if it's given only for US medical graduates that failed to match somewhere. US medical education is a lot more verifiable for sure.

 

[RogueBanana]

I have a list somewhere showing why Caribbean is a terrible idea. Online NP programs are mentioned in the first page of the thread to trivialize the profession. I think both are terrible and like I said in my first post, I'm all for the Assistant Physician idea if it's given only for US medical graduates that failed to match somewhere. US medical education is a lot more verifiable for sure.

US MD has the advantage of being LCME Accredited...

 

[Lawpy]

US MD has the advantage of being LCME Accredited...

Yeah so it's verifiable. Caribbean schools aren't. And I have no idea about NP accreditation and their view on online NP programs. Apparently when comparisons of Caribbean > online NP are made, I'd bet they are pretty bad even though I softly disagree.

 

[Nucleus Accumbens]

I have a list somewhere showing why Caribbean is a terrible idea. Online NP programs are mentioned in the first page of the thread to trivialize the profession. I think both are terrible and like I said in my first post, I'm all for the Assistant Physician idea if it's given only for US medical graduates that failed to match somewhere. US medical education is a lot more verifiable for sure.

Caribbean route is a bad idea bc of a number of mitigating factors in our NRMP selection schema, however I'm not quick to say that a Caribbean doctor is not a doctor or inferior in medical acumen compared to their US-MD/DO counterparts. They earned their stripes so I don't think its fair to consider an NP in the same breath as a Caribbean doctor who was US-Residency trained like everyone else.

 

[Lawpy]

Caribbean route is a bad idea bc of a number of mitigating factors in our NRMP selection schema, however I'm not quick to say that a Caribbean doctor is not a doctor or inferior in medical acumen compared to their US-MD/DO counterparts. They earned their stripes so I don't think its fair to consider an NP in the same breath as a Caribbean doctor who was US-Residency trained like everyone else.

I'm referring to medical graduates who fail to match. US medical school education has great education quality because their regulatory bodies require it (otherwise they will be put on probation and shut down). Can the same be said for Caribbean schools whose focus is on prioritizing profits over education?

The people who graduate from Caribbean and match into US residency has an advantage over midlevels for sure. They succeeded in the most difficult and grueling process possible. But what about those who failed to match or got weeded out early?

 

[LutGholein]

I have a list somewhere showing why Caribbean is a terrible idea. Online NP programs are mentioned in the first page of the thread to trivialize the profession. I think both are terrible and like I said in my first post, I'm all for the Assistant Physician idea if it's given only for US medical graduates that failed to match somewhere. US medical education is a lot more verifiable for sure.

So even the more established caribbean schools shouldn't have this option?

I get why SGU, Saba, etc. has a bad rep but if an IMG from the Caribbean successfully passed step 1&2 a part of me feels like they deserve a fair shake if they could not match even though they passed all appropriate crucibles. I think assistant physician licenses is a step in the right direction for these folks.

 

[Lawpy]

So even the more established caribbean schools shouldn't have this option?

I get why SGU, Saba, etc. has a bad rep but if an IMG from the Caribbean successfully passed step 1&2 a part of me feels like they deserve a fair shake if they could not match even though they passed all appropriate crucibles. I think assistant physician licenses is a step in the right direction for these folks.

But how is their education verified? For US, we have LCME/COCA that are strict about education quality. What is it for Caribbean schools and especially for the so-called "top Caribbean schools" like SGU, Saba etc.?

 

[LutGholein]

But how is their education verified? For US, we have LCME/COCA that are strict about education quality. What is it for Caribbean schools and especially for the so-called "top Caribbean schools" like SGU, Saba etc.?

I can't say--I know it's bad decision to attend one but I just feel somber knowing that debt is crippling a lot of folks who have no options to pay it back even after completing medical school and the appropriate exams.

 

[Trogghunter]

Ok so WAMC in Missouri as a
US MD without residency or
DO without residency or
Caribbean grad without residency or
Foreign grad 10 years out of practice in 3rd world....

 

[RogueBanana]

Caribbean route is a bad idea bc of a number of mitigating factors in our NRMP selection schema, however I'm not quick to say that a Caribbean doctor is not a doctor or inferior in medical acumen compared to their US-MD/DO counterparts. They earned their stripes so I don't think its fair to consider an NP in the same breath as a Caribbean doctor who was US-Residency trained like everyone else.

This entire conversation is in the context of NON-Matched Carib docs.

Everyone here agrees that anyone who completes a US Residency has earned their stripes. Nobody is suggesting otherwise. 🙂

 

[Nucleus Accumbens]

This entire conversation is in the context of NON-Matched Carib docs.

Everyone here agrees that anyone who completes a US Residency has earned their stripes. Nobody is suggesting otherwise. 🙂

My bad! I didn't actually follow the entire convo haha thanks for clarifying


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[RogueBanana]

My bad! I didn't actually follow the entire convo haha thanks for clarifying


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Happy to help!

Yeah we may be greenhorn Newly Accepteds, but even we wouldn't dare say a licensed US Attending lacks clinical acumen based on their home institution!

 

[zero0]

So now we're saying that IMG's, including those from the carib who couldn't get into a US MD/DO school, are more qualified than NP's and PA's that went through what is probably a more rigorous admissions process and were likely held to higher standards during their education.

Please, go on...

Yup, that's what I'm saying. Really not much to add. Don't have time to argue about nothing online either. God bless you folks who do though, idk how you do it.

 

[WingedOx]

I have a list somewhere showing why Caribbean is a terrible idea. Online NP programs are mentioned in the first page of the thread to trivialize the profession. I think both are terrible and like I said in my first post, I'm all for the Assistant Physician idea if it's given only for US medical graduates that failed to match somewhere. US medical education is a lot more verifiable for sure.

I mean... it's not like there's more than a small handful of these that even exist. And a lot of the ones that do... yeesh.

 

[ridethecliche]

Isn't there some data that says there is a moderate correlation between MCAT & Step? I know it's not a strong correlation but it exists.

Does the MCAT predict medical school and PGY-1 performance? - PubMed - NCBI

http://www.internationalgme.org/Resources/Pubs/Donnon et al (2007) Acad Med.pdf

Weak to moderate. Meh.

Wait the boards test knowledge base? I thought they test more than just that and focuses on applied knowledge, critical thinking etc. with questions of various levels of complexity. That's why people over on Step 1 forums say knowledge base alone isn't sufficient to do well on the exam.

This is also why doing well on the MCAT correlates to doing well on Step exams. Critical thinking, test taking skills, innate intelligence etc. transfer between standardized tests easily.

Re bold: not really. See above.

Also, why are you arguing with someone that knows more about this than you do based on experience and based on the data above.

There is no multiple choice option when you have a patient in front of you and you have no idea wtf is going on.

I don't understand why folks find this so hard to understand... i.e. there is a difference between doing well on a test and being able to apply that information in practice. Often folks can do both, but that doesn't mean that they're the same.

I don't have the data at hand, but I'm still interested in the entrance statistics for folks in carib vs well established PA programs in the US. My friends from college that went to PA/NP school did so by choice. I have no doubt that many of them would have gotten into medical school if they had decided that it's what they wanted to do. I also think that the training that well founded US PA/NP programs offer far better training to their students than carib schools. Passing step doesn't mean much of anything in this context.

Yup, that's what I'm saying. Really not much to add. Don't have time to argue about nothing online either. God bless you folks who do though, idk how you do it.

I do enjoy watching hierarchy dominate thought processes.

I'm interested in data if and when it presents itself. Oh wait... here it is.

SGU: School of Medicine - Frequently Asked Questions | St. George's University
A.The average cumulative GPA a 3.4 and the average Science GPA a 3.4. The average total MCAT score is a 26. These are our averages, we do not have minimums. The Committee on Admission also takes into consideration students who maintained jobs and/or extra curricular activities which may have impacted their grades.

Ross: University Facts & Figures
MCAT 24
GPA 3.22
Pre req gpa 3.08

Yale PA program: Admissions Statistics > Physician Associate Program | Medical Education | Yale School of Medicine
Total applications 1063
Total interviewed 160
Total matriculants 37
Average overall GPA 3.72 (range 3.30 – 4.00)
Average overall science GPA 3.73 (range 3.15 – 4.00)
Mean GRE percentiles Verbal - 80
Quantitative - 67
Analytical - 75
Average healthcare hours 2294


Womp. Maybe someone's intelligence and ability isn't dictated solely by their chosen profession within healthcare. The horror...

I don't know the hierarchy of Carib md schools. Feel free to add more info here as you see fit. Lets compare the best of the Carib with the best of US MD and NP programs.

 

[cbrons]

Does the MCAT predict medical school and PGY-1 performance? - PubMed - NCBI

http://www.internationalgme.org/Resources/Pubs/Donnon et al (2007) Acad Med.pdf

Weak to moderate. Meh.



Re bold: not really. See above.

Also, why are you arguing with someone that knows more about this than you do based on experience and based on the data above.

There is no multiple choice option when you have a patient in front of you and you have no idea wtf is going on.

I don't understand why folks find this so hard to understand... i.e. there is a difference between doing well on a test and being able to apply that information in practice. Often folks can do both, but that doesn't mean that they're the same.

I don't have the data at hand, but I'm still interested in the entrance statistics for folks in carib vs well established PA programs in the US. My friends from college that went to PA/NP school did so by choice. I have no doubt that many of them would have gotten into medical school if they had decided that it's what they wanted to do. I also think that the training that well founded US PA/NP programs offer far better training to their students than carib schools. Passing step doesn't mean much of anything in this context.



I do enjoy watching hierarchy dominate thought processes.

I'm interested in data if and when it presents itself. Oh wait... here it is.

SGU: School of Medicine - Frequently Asked Questions | St. George's University
A.The average cumulative GPA a 3.4 and the average Science GPA a 3.4. The average total MCAT score is a 26. These are our averages, we do not have minimums. The Committee on Admission also takes into consideration students who maintained jobs and/or extra curricular activities which may have impacted their grades.

Ross: University Facts & Figures
MCAT 24
GPA 3.22
Pre req gpa 3.08

Yale PA program: Admissions Statistics > Physician Associate Program | Medical Education | Yale School of Medicine
Total applications 1063
Total interviewed 160
Total matriculants 37
Average overall GPA 3.72 (range 3.30 – 4.00)
Average overall science GPA 3.73 (range 3.15 – 4.00)
Mean GRE percentiles Verbal - 80
Quantitative - 67
Analytical - 75
Average healthcare hours 2294


Womp. Maybe someone's intelligence and ability isn't dictated solely by their chosen profession within healthcare. The horror...

I don't know the hierarchy of Carib md schools. Feel free to add more info here as you see fit. Lets compare the best of the Carib with the best of US MD and NP programs.

Most of medical school is self-learning to get through exams. The exams and crucially the board exams are much more comprehensive at medical schools than at NP schools, online or otherwise.

This is an idiotic discussion. Seems everytime its possible to mention Carribbean schools, some pre-med jackanape has to come in and derail the entire thread with their uneducated drivel about Caribbean schools. Why are you getting baited by them?

The issue is about Assistant Physician legislation, not quality of Carribbean schools or how your PA school friends "could've gotten into med school if they wanted." Just stop.

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[cbrons]

Benefits to the Assistant Physician (AP) legislation:

Benefit #1 - Creates competition with encroaching mid-level "providers"
Right now with the "Doctor" of Nursing Practice, the effort has been to expand scope-of-practice to that of board-certified physicians. In other words, the nursing lobby is competing directly with the AMA over the exact same role.

By creating a new brand of mid-level, it gives the nursing lobby a brand new enemy, and one with which they will directly compete for jobs. Do you think the MBAs and the multi-millionaire schmucks who run the hospital give a damn who it is that is providing healthcare so long as the patients are happy to receive and pay for it? An AP will be no different to them than an NP or a PA. Just another piece of labor they will try to pay as little as possible for.

The amazing thing about this strategy is that it won't hurt board-certified physicians one bit, since the Assistant Physicians will be under the direct control of the board of medicine and require supervision by law (same as PAs). It will exclusively hurt those who require supervision of a board-certified physician.

If you don't think this strategy will send the AANP into total panic mode, just look at what happened when the American Society of Anesthesiologists tried to get Anesthesia Assistants legalized in every state. The CRNAs went into complete meltdown across the country, since it was a direct threat to their economic interests. It also hurt the CRNA scope of practice expansion push by virtue of creating an entirely new battlefront which their lobbyists had to fight. For a while it no longer became about "CRNA vs. Anesthesiologist" (or "MDA"), but "CRNA vs. new mid-level anesthesia providers."

As more evidence - did you ever notice how Nurse Practitioners almost uniformly oppose scope-of-practice expansion for PAs?

Lastly, think about this for a second. The AANP is going full-time at this narrative about board-certified physicians/attendings being no better than NPs. But their strategy so far as been to use severely flawed observation studies as evidence of this equivalence. Their argument has never been to compare their own training with that of attendings. In fact, they are very careful to avoid going down that road because it is such a huge discrepancy that even the average idiot on the street wouldn't buy it.
By creating the "Assistant Physician" role, it forces the new narrative across that Non-residency trained physicians are just as qualified as newly graduated NPs. The great thing is that the AANP can't really say it isn't true without attacking medical education itself. They can't really say, "Well those doctors didn't do a residency so they're not qualified" since obviously they don't do residencies.

Benefit #2 - Helps delegitimize propaganda efforts aimed at making the public believe all "providers" are equal
Another benefit is the press coverage itself. Stories on the issue will by necessity educate the ignorant public of the vast differences between board-certified physicians and other healthcare "providers." The "Doctor" of Nursing Practice degree was created in large part to confuse people about what the term "doctor" means in a health care setting. But if stories like this start appearing around the country, why that could be very bad for the so-called Doctor of Nursing Practice. Might be that the average schmuck starts asking what kind of doctor they're actually seeing, what with all them news articles about undertrained doctors being allowed to treat folk.

Benefit #3 - Upward pressure on resident salaries/benefits
People are falsely thinking the true benefit of the law will be that those who fail to match get a job. That isn't true. The benefit will be that those who choose not to match get a job.

The people who (for whatever reason) don't want to work 80+ hours per week at the hourly equivalent of minimum wage decide instead to just function as a mid-level for 2-3x the salary/benefits (in other words, what NPs/PAs make right after they graduate).

This will create some small measure of competition between the Match/ACGME/AMA/Anti-Trust-exempt monopoly system and the "Assistant Physician" route. Right now, resident salaries are price-fixed. There is no financial incentive for programs to offer better benefits or salary. There is no incentive for them to provide affordable health insurance. But offering a financially viable alternative to residency will pressure the Monopoly System to offer more, even if it is not much more.

Bumping this reply

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[ridethecliche]

Most of medical school is self-learning to get through exams. The exams and crucially the board exams are much more comprehensive at medical schools than at NP schools, online or otherwise.

This is an idiotic discussion. Seems everytime its possible to mention Carribbean schools, some pre-med jackanape has to come in and derail the entire thread with their uneducated drivel about Caribbean schools. Why are you getting baited by them?

The issue is about Assistant Physician legislation, not quality of Carribbean schools or how your PA school friends "could've gotten into med school if they wanted." Just stop.

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Hah. Fair enough. Thanks.