MD & DO PA/NP RESIDENCY at UNC????

[nimbus]

How is it my responsibility to teach them? They keep preaching equivalence and superiority to doctors, yet they can't even train their own? lololol.
And cmon dude, the fact that you're advocating to train your replacement shows how out of touch with reality you are.


Ah... so you're the generation who ruined It.

No one is asking you to teach anything to anybody. I was replying to your complaint that your attendings were teaching midlevels. That’s their choice. I’m in private practice. I don’t teach anybody and I do all my own cases. You don’t have to either. Just don’t sign up for a job that requires it then complain about it later.

And ruined what? Medicine is awesome.

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[hallowmann]

SDN has a major fixation with procedures. So strange because 98% of procedural specialists become fantastic at procedures regardless of their training environment and the other 2% are just hopeless.

The likelihood of doing some procedures outside of residency is directly affected by exposure in residency. Its not about becoming experts at it to the point that all you do is the procedures, its about learning the basics of it so that you could if you wanted to.

A lot of displaced anger in this thread. Should people be also be getting upset that RNs make more than residents? The fact that residents make so little is something that the medical profession has to address and getting angry at everyone else is not going to solve anything.

I agree that the salary isn't the issue. They should get paid more, and so should we. The issues I see are perceived value of those residents and the loss of training opportunities.

For the record, I got paid $28000 as an intern in nyc in 1992 and it was plenty. I know an older surgeon who got paid nothing but was provided room and board at Bellevue while he was doing q2 call.

You realize that the money you were making is practically the same as what many residents make now right? Inflation is a thing afterall. That's also in the setting of higher loan payments. I honestly am not sure what your trying to say here. Yeah, resident salaries have been bad for a while. I agree.

 

[nimbus]

You realize that the money you were making is practically the same as what many residents make now right? Inflation is a thing afterall. That's also in the setting of higher loan payments. I honestly am not sure what your trying to say here. Yeah, resident salaries have been bad for a while. I agree.

Yes and I’m saying it’s plenty unless you have a spending problem or made irresponsible decisions.

 

[hallowmann]

Yes and I’m saying it’s plenty unless you have a spending problem or made irresponsible decisions.

Just curious, how much loan money did you have then? What was your monthly payment? Did you get free food at the hospital? We already established that inflation evens the salaries. Those things alone should give you some idea of what additional financial hardships are faced by a lot of residents now.

I think you're using your experience, which with all due respect was 30 yrs ago, and comparing it to now. I don't know that that's a great comparison. Kind of like me comparing my hours and sleep deprivation in residency to yours.

 

[ace_inhibitor111]

No one is asking you to teach anything to anybody. I was replying to your complaint that your attendings were teaching midlevels. That’s their choice. I’m in private practice. I don’t teach anybody and I do all my own cases. You don’t have to either. Don’t sign up for a job that requires it then complain about it later.

And ruined what? Medicine is awesome.

Many current jobs didn’t have midlevel teaching responsibilities until recently. Do you expect everyone who doesn’t approve of these changes to just uproot themselves and change jobs?

I really hate this “not my problem” mentality. Great, so midlevel encroachment isn’t affecting you. Let’s just ignore it and let the next generation deal with it. Maybe when you retire, you can sell your private practice to the first CMG who offers.

 

[nimbus]

Just curious, how much loan money did you have then? What was your monthly payment? Did you get free food at the hospital? We already established that inflation evens the salaries. Those things alone should give you some idea of what additional financial hardships are faced by a lot of residents now.

I think you're using your experience, which with all due respect was 30 yrs ago, and comparing it to now. I don't know that that's a great comparison. Kind of like me comparing my hours and sleep deprivation in residency to yours.

I had $60000 debt. Not much. Paid it off in 2years. But as you alluded, the stakes are different now and EVERYBODY knows that going in. This is a thread about midlevels. Sometimes if you don’t get into a medical school that you can afford, the wiser decision is to do something else like PA school. Nobody is forced to go to medical school. Don’t whine about it after the fact. Take some responsibility for your own choices.

 

[nimbus]

Many current jobs didn’t have midlevel teaching responsibilities until recently. Do you expect everyone who doesn’t approve of these changes to just uproot themselves and change jobs?

I really hate this “not my problem” mentality. Great, so midlevel encroachment isn’t affecting you. Let’s just ignore it and let the next generation deal with it. Maybe when you retire, you can sell your private practice to the first HCA who offers.

We’ve entertained offers from multiple national groups and decided not to sell. Self governance is priceless.

 

[MedicineZ0Z]

I had $60000 debt. Not much. Paid it off in 2years. But as you alluded, the stakes are different now and EVERYBODY knows that going in. This is a thread about midlevels. Sometimes if you don’t get into a medical school that you can afford, the wiser decision is to do something else like PA school. Nobody is forced to go to medical school. Don’t whine about it after the fact. Take some responsibility for your own choices.

Most of us came into medical school expecting a reasonable medical education and to have first priority in learning as residents and med students. Not to be passed over cause some pseudoprofessionals want to practice medicine without medical school; and having our so called instructors favor them over us.

You make it seem like it's some well known fact that you will have to share your educational opportunities with those not even in your field. Not only is it absurd and insane, but you're preaching that premeds should take ownership and be fully aware of it.

 

[hallowmann]

I had $60000 debt. Not much. Paid it off in 2years. But as you alluded, the stakes are different now and EVERYBODY knows that going in. This is a thread about midlevels. Sometimes if you don’t get into a medical school that you can afford, the wiser decision is to do something else like PA school. Nobody is forced to go to medical school. Don’t whine about it after the fact. Take some responsibility for your own choices.

Ahh, I see, you are a bit out of touch then. I don't know a medical school in the country you could graduate from today paying something like $60k for tuition alone. I would wager that the inflation equivalent is still probably less than the tuition+COL for any med school outside the cheapest quartile. The current average medical student debt is >$200k. So I guess at least half the current grads should have just gone to PA school .

If you don't mind, I'm going to continue to push for an increase in resident salary or a decrease in tuition costs, which are increasing at a level of almost double inflation at a lot of schools.

You can act like expecting a reasonable wage is whining all you want. Arguing and demanding reasonable conditions and wages from administrations and corporations are why benefits even exist, why vacation days exist, hell even why child labor laws exist.

 

[nimbus]

Most of us came into medical school expecting a reasonable medical education and to have first priority in learning as residents and med students. Not to be passed over cause some pseudoprofessionals want to practice medicine without medical school; and having our so called instructors favor them over us.

What’s a pseudo professional? They’re professionals.

 

[MedicineZ0Z]

Ahh, I see, you are a bit out of touch then. I don't know a medical school in the country you could graduate from today paying something like $60k for tuition alone. I would wager that the inflation equivalent is still probably less than the tuition+COL for any med school outside the cheapest quartile. The current average medical student debt is >$200k. So I guess at least half the current grads should have just gone to PA school .

If you don't mind, I'm going to continue to push for an increase in resident salary or a decrease in tuition costs, which are increasing at a level of almost double inflation at a lot of schools.

You can act like expecting a reasonable wage is whining all you want. Arguing and demanding reasonable conditions and wages from administrations and corporations are why benefits even exist, why vacation days exist, hell even why child labor laws exist.

He's that doc who sold out the profession for an extra buck. You won't get any rational responses.

 

[nimbus]

Ahh, I see, you are a bit out of touch then. I don't know a medical school in the country you could graduate from today paying something like $60k for tuition alone. I would wager that the inflation equivalent is still probably less than the tuition+COL for any med school outside the cheapest quartile. The current average medical student debt is >$200k. So I guess at least half the current grads should have just gone to PA school .

If you don't mind, I'm going to continue to push for an increase in resident salary or a decrease in tuition costs, which are increasing at a level of almost double inflation at a lot of schools.

You can act like expecting a reasonable wage is whining all you want. Arguing and demanding reasonable conditions and wages from administrations and corporations are why benefits even exist, why vacation days exist, hell even why child labor laws exist.

The medical school I attended is now tuition free. All the public medical schools in my current state are about $30k/yr for tuition. Most schools expect some family contribution. My family paid for the bulk of my education. I currently write the checks for all of my daughter’s education so I am not out of touch.

 

[nimbus]

He's that doc who sold out the profession for an extra buck. You won't get any rational responses.

You are unbelievably clueless.

 

[hallowmann]

The medical school I attended is now tuition free. All the public medical schools in my current state are about $30k/yr for tuition. Most schools expect some family contribution. My family paid for the bulk of my education. I currently pay for all of my daughter’s education so I am not out of touch.

There's like 3 med schools in the country that are tuition free (all just recently mind-you). I guess you really are suggesting that anyone who's parent's can't shell out 6-figures or who don't get into the lowest quartile tuition med schools should just be a PA. I got it, in your eyes >50% of physicians graduating today shouldn't be physicians, but rather physician assistants. I see why you don't see any of this as a problem. I think we're too far apart on this one, so I'm gonna bow out. I hope your daughter gets good training and doesn't have to worry about competing with PAs.

 

[MedicineZ0Z]

You are unbelievably clueless.

What a well articulated response. Your wisdom really speaks through your words.

 

[nimbus]

What a well articulated response. Your wisdom really speaks through your words.

Okay how about this. I’m one of a small minority of doctors in my specialty who doesn’t work with any midlevels and who hasn’t sold out to a national roll up despite many offers to do so. I’m literally one of the few remaining non-sellouts.

 

[MedicineZ0Z]

Okay how about this. I’m one of a small minority of doctors in my specialty who doesn’t work with any midlevels and who hasn’t sold out to a national roll up despite many offers to do so. I’m literally one of the few remaining non-sellouts.

I was speaking more to the fact that you're preaching talking points from the last generation and being dismissive of the current generation's real problems.

 

[nimbus]

There's like 3 med schools in the country that are tuition free (all just recently mind-you). I guess you really are suggesting that anyone who's parent's can't shell out 6-figures or who don't get into the lowest quartile tuition med schools should just be a PA. I got it, in your eyes >50% of physicians graduating today shouldn't be physicians, but rather physician assistants.

Practically speaking, if being a physician will cause you misery, then yes. And according to the experts on this thread, PA residents get better pay and better teaching. Right?

 

[slowthai]

If it bothers you that much, make the switch.

I put the /s there to signify that it was a joke

And most people that think they could easily switch into finance and make beaucoup bucks are kidding themselves.

 

[sliceofbread136]

I had $60000 debt. Not much. Paid it off in 2years. But as you alluded, the stakes are different now and EVERYBODY knows that going in. This is a thread about midlevels. Sometimes if you don’t get into a medical school that you can afford, the wiser decision is to do something else like PA school. Nobody is forced to go to medical school. Don’t whine about it after the fact. Take some responsibility for your own choices.

Lul, ok boomer

 

[libertyyne]

How do you expect midlevels to improve their “poor judgement” if nobody teaches them?

they should go to 4 years of medical school followed by a minimum of three year residency to improve their poor judgement.

 

[curbsideconsult]

Nobody is forced to go to medical school. Don’t whine about it after the fact. Take some responsibility for your own choices.

I used to sing this same chorus, but now I take a more nuanced approach to this. I do say this about all the pre-meds whining about how they can't get in and how hard the application process is and that's when I say hey, you don't have to do this. Just walk away now.

But once we're in and, especially have made it to submitting ERAS applications, we have every right to complain about what's happening with the encroaching of physician jobs. One of the biggest concerns I have about midlevel "residents" training alongside residents is that physicians are still responsible for most of the liability once getting into attendinghood. Who's the last call when the **** hits the fan? The attending. But if the attending hasn't had enough procedures to do because non-physicians were taking their procedures during residency (yes, it's a zero sum game when it comes to procedure numbers), patients are harmed and the physician is still liable.

It's funny how no one ever tells police officers, firefighters, EMTs, military, teachers, etc. that "no one forced" them to go into their profession, that they should "take some responsibility" for their own choices when they have legitimate complaints about their job regarding pay, safety, training, and so on.

 

[ciestar]

A lot of displaced anger in this thread. Should people be also be getting upset that RNs make more than residents? The fact that residents make so little is something that the medical profession has to address and getting angry at everyone else is not going to solve anything.

RNs? No. They’re not trying to act like they’re on equal footing as a physicians. If i was expected to have the same role as an RN, absolutely would be upset.

I also remember i have a lot more upward movement as an attending as far as salaries go. Either way, theyre not comparable situations.

 

[Iz_FtB]

There is a narrow-mindedness among some of the senior stewards of the profession that is allowing the current trends in medicine to continue unchecked, which will ultimately leave their juniors, and potentially patients, in a more vulnerable position. The senior, well-established, and least vulnerable among us will forgive their juniors, I hope, for looking towards the future and gauging the political and administrative winds as being not in our favor.

When it comes to midlevel encroachment, commentating on isolated events is not sufficient. It becomes too easy to dismiss the significance of the encroachment when discussing a single news story. A broader view of the national currents moving midlevels forward is necessary for placing into context singular events like this UNC business.

The NP lobby is pressing their advantage lobbying for independent practice and winning, and this is forcing PA leadership to play catch up lest they be left behind in terms of job opportunities and professional advancement. Everything the political leadership and lobbying groups representing midlevels are pursuing, and the tactics they are employing can be viewed through the prism of a Napoleon complex. Insidious language like "provider" eliminates the real differences in what is offered by physicians and midlevels, and only serves to promote a false image of equivalency that can be leveraged into political language to pass independent practice bills. "Fake it 'till you make it" seems to be the guiding strategy for their lobbyists, and it is working.

In regards to this PA "residency", I am certainly not against giving midlevel graduates more training in the field of their choice, with the obvious caveat that it does not come at the expense of resident training. What needs to be appreciated, though, is that training programs like this WILL be used against us. Midlevel lobbyists are going to point to PA/NP "residencies" and say to legislators "we have board certified graduates of advanced residency programs and are equipped for independent practice in the same way physicians are". This is why I hate calling these programs "residencies", because words matter and efforts to create false equivalency through language will only serve to benefit the lesser party at the expense of the higher. It's another form of the "provider" poison infecting the way we speak about and to one another.

The point I'd most emphasize to present and future physicians is that we're the only credible check against this encroachment. No one else is qualified or positioned to discuss authoritatively the dangers of unchecked midlevel expansion. If we abdicate that responsibility and don't make our voices heard on the matter, there will be absolutely zero resistance on the race to the bottom toward the cheapest, least trained, most dangerous healthcare options.

 

[Mass Effect]

Not sure what you’re trying to say here. I know a pediatric neurologist who switched residencies 3 times, spent 11 years on training and is now paid 140k a year. Surely we should be emulating their great financial wisdom.

I think the most alarming thing in that post is that he switched residencies 3 times and spent 11 years on training.

 

[Mass Effect]

The medical school I attended is now tuition free. All the public medical schools in my current state are about $30k/yr for tuition

Considering the average med school debt is 200K nowadays, your state is a unicorn.

Most schools expect some family contribution. My family paid for the bulk of my education. I currently write the checks for all of my daughter’s education so I am not out of touch.

Then that's the problem with out-of-touch school admins who "expect" family contribution. I can just imagine how that would have played out in my family.

"Hey, Dad, I know you drive a taxi cab 7 days a week to keep sandwiches on the dinner table and help me pay for undergrad, but would you mind shelling out another 200K so I can go to med school?"

Give me a break!

The problem with med school is they take advantage of the government. I've said it before and I'll say it again, if the feds knew what was happening in med schools and the amount of debt students incur with advisors during orientation telling us not to worry about it and just enroll in PSLF, there would be changes before you could say tomorrow.

 

[nimbus]

Considering the average med school debt is 200K nowadays, your state is a unicorn.

That’s what’s so strange to me. People complain that my state is a sh*thole with fires, homeless and high taxes and would never live here. But I do live here with sunshine and cheap world reknown public universities, and I think it is fantastic.

 

[rosegoldkitten]

The medical school I attended is now tuition free. All the public medical schools in my current state are about $30k/yr for tuition. Most schools expect some family contribution. My family paid for the bulk of my education. I currently write the checks for all of my daughter’s education so I am not out of touch.

I'm sorry but what is this statement? "My family paid for the bulk of my education" and "Sometimes if you don’t get into a medical school that you can afford, the wiser decision is to do something else like PA school. Nobody is forced to go to medical school. Don’t whine about it after the fact."

Is this not gatekeeping the MD profession to those whose families can afford to help them pay for medical school? If I want to be an MD, why should money be the thing that stops me? Why should people of low SES who don't get into medical schools that are cheaper, in state, can't or don't want their parents to contribute financially, or don't get the majority of their COA given to them loan free have to go to PA school if they want to enter the medical field..?

 

[libertyyne]

I'm sorry but what is this statement? "My family paid for the bulk of my education" and "Sometimes if you don’t get into a medical school that you can afford, the wiser decision is to do something else like PA school. Nobody is forced to go to medical school. Don’t whine about it after the fact."

Is this not gatekeeping the MD profession to those whose families can afford to help them pay for medical school? If I want to be an MD, why should money be the thing that stops me? Why should people of low SES who don't get into medical schools that are cheaper, in state, can't or don't want their parents to contribute financially, or don't get the majority of their COA given to them loan free have to go to PA school if they want to enter the medical field..?

Thats not the point. The point was you are an adult making adult decisions. No one held a gun to someone's head to go to a 100K / year medical school. The person could have just opted to do something else.
That being said, its a little ridiculous to state that we should have known NPs were going to be given preference or equality to our training considering this development was not clearly evident even to the most astute of applicants, and furthermore blames the people being displaced , the residents, rather than the people making terrible choices for the profession .

 

[deleted407021]

A lot of displaced anger in this thread. Should people be also be getting upset that RNs make more than residents? The fact that residents make so little is something that the medical profession has to address and getting angry at everyone else is not going to solve anything.

This is the correct take.

 

[deleted480308]

The medical school I attended is now tuition free. All the public medical schools in my current state are about $30k/yr for tuition. Most schools expect some family contribution. My family paid for the bulk of my education. I currently write the checks for all of my daughter’s education so I am not out of touch.

That’s not at all how loans are structured for med school. There is no requirement at all for parental funds. The student is liable

 

[nimbus]

Lul, ok boomer

I’m actually gen x but thanks.

 

[deleted480308]

I'm sorry but what is this statement? "My family paid for the bulk of my education" and "Sometimes if you don’t get into a medical school that you can afford, the wiser decision is to do something else like PA school. Nobody is forced to go to medical school. Don’t whine about it after the fact."

Is this not gatekeeping the MD profession to those whose families can afford to help them pay for medical school? If I want to be an MD, why should money be the thing that stops me? Why should people of low SES who don't get into medical schools that are cheaper, in state, can't or don't want their parents to contribute financially, or don't get the majority of their COA given to them loan free have to go to PA school if they want to enter the medical field..?

They are wrong about how loans work for med school. Anyone with reasonable credit can get the loans with an acceptance

 

[nimbus]

That’s not at all how loans are structured for med school. There is no requirement at all for parental funds. The student is liable

All the more reason for students to make sound financial decisions. Apparently for some, the best decision is not to go to medical school. You of all people can understand personal responsibility. Not everyone gets a trophy, right?

 

[ooh a bean]

I’m actually gen x but thanks.

by definition, you're a boomer if you don't get the joke

 

[libertyyne]

A lot of displaced anger in this thread. Should people be also be getting upset that RNs make more than residents? The fact that residents make so little is something that the medical profession has to address and getting angry at everyone else is not going to solve anything.

This is the correct take.

I dont think anyone has been upset that RNs get paid more than residents. They are fully trained professionals doing their thing, and the market is paying them what they bring to the table.
I do think that people are right to be pissed about Midlevels "residents" detracting from physican residency training while simultaneously paying them more.

Its like someone with less training gets the same job as you and gets paid more while doing the same job, its insulting , and frankly embarrassing. Not even mentioning the fact that these "residencies" are more fodder for those same midlevels to claim parity with attending physicians in those fields and demands that they have equal footing going forward.

 

[deleted480308]

All the more reason for students to make sound financial decisions. Apparently for some, the best decision is not to go to medical school. You of all people can understand personal responsibility. Not everyone gets a trophy, right?

I’m totally with you on the notion that not all degrees make sense as a ROI

 

[nimbus]

by definition, you're a boomer if you don't get the joke

I have a 12 yo nephew. I get the joke.

 

[boolin_1]

For the record, I got paid $28000 as an intern in nyc in 1992 and it was plenty. I know an older surgeon who got paid nothing but was provided room and board at Bellevue while he was doing q2 call.

this is the some of the most boomer-ass-**** I have ever read

 

[nimbus]

this is the some of the most boomer-ass-**** I have ever read

You may not like it but that’s the truth.

 

[nimbus]

I’m totally with you on the notion that not all degrees make sense as a ROI

Including ridiculously priced private medical schools.

 

[deleted407021]

The boomer discussion going on now is great

 

[Alkaidius]

So if I’m reading this stuff online right...while there is a governing body (ARC-PA) that can accredit programs, program accreditation is voluntary and a majority of them aren’t. So. That can’t possibly backfire and create programs of dubious quality.

If there wasn’t a cherry on top.

 

[rosegoldkitten]

They are wrong about how loans work for med school. Anyone with reasonable credit can get the loans with an acceptance

My issue is less with deciding to take tons of loans out and more with the idea that "well your parents can't help you, your loans are super high, you might as well just give up on becoming an MD and pursue something different because it's 'wiser' to do so." If that's the case, then the outcome is that the majority of MDs end up being from upper-class/rich families or the majority of lower-income students have to become midlevels even if they want to become physicians. That should be seen as a problem.

I hate turning it into an SES issue but it's true. But everyone is entitled to their opinion so I'll leave it at that.

But anyways

 

[OnePunchBiopsy]

OK, so I was curious, so I dug around a bit and searched a few places. I actually couldn't find many, and I didn't spend much time on this, but it seems to vary significantly program-to-program and many pay them about the same. I wonder if this is directly related to PA salary. PAs don't require a residency, so training them would probably require paying them slightly below what they would get out in practice.

ArrowHead Regional Medical Center - Colton, CA - EM PA and EM PGY-1s get paid the same ($55k)
St. Luke's Hospital - Bethlehem, PA - EM PA gets $59k and EM PGY-1 gets $58k
Johns Hopkins Bayview Hospital - Baltimore, MD - EM PA gets $48k and EM PGY-1 gets $55k
Mayo Clinic Minnesota - Rochester, MN - EM PA gets $60k and EM PGY-1 get $57.6k
NYU Langone Health Advanced Practice Provider Fellowship in Emergency Medicine - NY - salary not easily found, vague reference to "competitive" salary for the PAs
University of Iowa - Iowa City - EM PA and EM PGY-1s get paid the same ($57.8k)... although the FM PA residents get paid $70k
University of New Mexico School of Medicine - Alberquerque, NM - EM PA gets $57k and EM PGY-1 gets $54k
UCSF Fresno - EM PA gets $60k/yr and EM PGY-1s get $59k

I honestly don't care if they get paid more. We should also get paid more sure, but I think that's a separate argument. What I do care about is if they get paid more and they get more access to training (e.g. priority for procedures, etc.). They shouldn't be getting trained at the expense of medical resident training.

As an outsider in surgery, this really just makes me question how resident salaries are funded by this institution.

I know medicare provides the funds for resident salaries, but when the institution get the check, how much does the residency pull out before passing it on to the resident?

Who is funding the training salary for these EM PA/NP “residents?” Are they giving more money? Is the hospital garnishing from these wages more or less than they are garnishing from the salary of actual EM residents?

Just some factors to consider.

 

[libertyyne]

Im curious as to what this brings to the programs that have been opening this?

Do they not see midlevel encroachment as an issue in their specialty?
Are they blind to all the legislative efforts to have parity between MDs and midlevels?
Do they not care?

My issue is less with deciding to take tons of loans out and more with the idea that "well your parents can't help you, your loans are super high, you might as well just give up on becoming an MD and pursue something different because it's 'wiser' to do so." If that's the case, then the outcome is that the majority of MDs end up being from upper-class/rich families or the majority of lower-income students have to become midlevels even if they want to become physicians. That should be seen as a problem.

I hate turning it into an SES issue but it's true. But everyone is entitled to their opinion so I'll leave it at that.

But anyways

No. People from lower SES have a harder time getting into medical school rather than the ability to pay for it, considering loans will cover everything including cost of living. So stop trying to shoehorn SES issues into every discussion. The point was you as an adult make the decision if something is worth it for you. Even if the ROI was not great.

 

[libertyyne]

As an outsider in surgery, this really just makes me question how resident salaries are funded by this institution.

I know medicare provides the funds for resident salaries, but when the institution get the check, how much does the residency pull out before passing it on to the resident?

Who is funding the training salary for these EM PA/NP “residents?” Are they giving more money? Is the hospital garnishing from these wages more or less than they are garnishing from the salary of actual EM residents?

Just some factors to consider.

I think its more of a function of , you were going to pay the PA/ NP 100k to work in the ER and you were going to have to train them anyway, this way they take a lower starting salary for a year while you can train them so you can employ them.

I guess i just answered a question i had above.

 

[Giovanotto]

I think its more of a function of , you were going to pay the PA/ NP 100k to work in the ER and you were going to have to train them anyway, this way they take a lower starting salary for a year while you can train them so you can employ them.

On the job training: medicine edition. The "free" market has spoken.

 

[rosegoldkitten]

Im curious as to what this brings to the programs that have been opening this?

Do they not see midlevel encroachment as an issue in their specialty?
Are they blind to all the legislative efforts to have parity between MDs and midlevels?
Do they not care?



No. People from lower SES have a harder time getting into medical school rather than the ability to pay for it, considering loans will cover everything including cost of living. So stop trying to shoehorn SES issues into every discussion.

If you'll read my comment, I said the issue wasn't with taking out the loans. It was with the idea that if your loans will be that high or your parents can't help then you might as well move on.

Regardless, back to the issue. I think hospitals see themselves as possibly standing to gain an employee that knows the ropes there and can start practicing ASAP. They deal with less acclimation time and get to pay the PA or whatever less while they essentially onboard them, especially if a lot of their residents don't stay at the hospitals they train at.

 

[libertyyne]

If you'll read my comment, I said the issue wasn't with taking out the loans. It was with the idea that if your loans will be that high or your parents can't help then you might as well move on.

Regardless, back to the issue. I think hospitals see themselves as possibly standing to gain an employee that knows the ropes there and can start practicing ASAP. They deal with less acclimation time and get to pay the PA or whatever less while they essentially onboard them, especially if a lot of their residents don't stay at the hospitals they train at.

The point is that going to medical school can be a bad financial decision, and it may be more prudent to go to PA or NP school financially. But that is just one aspect of the decision to go into any field. Just like getting a degree in Art may not be the most prudent of financial decisions but people do it every day and nothing wrong with that as long as they know what deal is.

Bad financial decision=/= telling someone to move on.