Very fair points. I suspect that hospitals will come up with a system to triage the less sick patients to the NP/PAs/fresh attendings. My institution already has something like that in place to make sure no one is in above their head.
The MS4s and residents I work with are quite bright. Of course, having trained here and stayed on, I'm somewhat obligated to say that
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To your other points:
i) there are state licensing requirements that do include certification exams; there can be debate about whether these are sufficient, but to say that they do not exist is patently false.
ii) to my knowledge, all of the degrees in question do require clinical hours. I'm open to education on this matter if you can provide facts. It's not a secret that fresh PA/NPs have less overall clinical experience than a MS4 (though our training is likely spread over more specialties compared to theirs). As with before, I also don't believe that they should have full autonomy starting out. But, once they gain sufficient experience, I don't see any reason why less complicated patients cannot be managed by them independently.
iii) Last I checked, our profession is not under any serious threat. The demand for physicians will always be there. Are there certain fields that may eventually become disfavored among medical students and/or "overtaken"/"supplemented" by NPs? Very likely, most likely primary care, but even then, my friends in those fields are having plenty of options, and this is unlikely to change any time soon based on their assessment. As a hospitalist who works regularly with PAs and NPs, I feel very comfortable that I will not be replaced any time soon as my expertise will always be needed for the more complicated patients. Much like any other field, medicine is dynamic. We can either cry and pout, or we can see things rationally and adapt as need be. Assuming you are still a resident, keep an open mind when you do practice, and maybe you'll see that the sky isn't falling.