Wait wait wait
You think an MS4 and an NP both going to the same ortho residency won't be equivalent after finishing residency?
Surgery in MS3 and MS4 is not great in many many places and rotation sites
I feel like I am in the Twilight Zone. You are arguing, as a physician, that medical school is not superior to NP school? There is being a realist, then being a cynic, then being a cynic among cynics (SDN baseline), then like 10 levels of delusion, before you end up at a place where you are arguing that orthopods are so far removed from medicine that they could bypass medical school entirely and are the equivalent of NP's plus a residency.
I can't believe I am defending ortho like this but you and others in this thread seem to know very little about the field. If I put on my armchair physiologist hat, some people in this thread seem to be salty/jealous that ortho is making $600k+ for "dumb" work while the "real" MD's in internal medicine are only making $200k with their big brains.
Let's look at the facts. M4's applying to ortho do a minimum of 2 sub-I's during which they are working 80-100 hrs/week for 4 weeks each. 3-4 sub-I's is more common than 2. This is on top of honoring M3 core surgery, which is the bare minimum to get your application looked at. Add to that the expectation that you need to have a few publications or research. Now, does doing a ton of research as an attending make you a great surgeon? Probably not, but that stuff is expected for medical students so that they can stay up to date on advancements in the field and know how to read papers, evaluate the studies quality, etc.
That will make them better surgeons. So just with 3 sub-I's and honoring an 8 week core surgery rotation we are looking at 20 weeks of surgery training at 80 hours/week. That is 1,600 hours of relevant experience.
The most rigorous NP programs require 1500 clinical hours TOTAL. And I can assure you that the expectations for a student NP are MUCH lower than an M4 on an away ortho rotation. I have worked with M4's applying to ortho and they are expected to at the very least know MSK anatomy at a level where they could teach it from memory to NP's students.
So in summary:
M4 applying to ortho:
- 640 hours of general surgery/sub-speciality surgery as an M3
- 960 hours of ortho as an M4
- research experience
- >3,000 hours clinical exposure in other fields
NP:
- 500-1500 clinical hours in NP school
- variable experience as an RN
The thing I would like to highlight the most is that
the expectations for medical students and NP students and licensed NP's are wildly different. Or in other words, the quality of those hours is much higher for medical students, especially the M4 hours. Now, you could argue that you can just require NP's to get ortho work experience and some research before applying to their "residency." But at that point you are just recreating medical school with a different name.
Finally, another example of people not being aware of the depth of other specialities, especially when they seem to want to dismiss them as "dumb" specialities for unknown reasons, there actually can be a decent amount of basic science in ortho. Much of the foundational and latest research (for example what type of grafts work best for ACL repair) requires you to understand the basics of MSK physiology, pathology, pharmacology, etc. None of that is taught in enough detail in NP school. An M4 applying to ortho can hit the ground running. An NP would need months of book learning alone to catch up.
Finally finally for the record, I am not applying to ortho. I personally think it is way too MSK focused with not enough "medicine" like general surgery. But I am also not so arrogant to think I am better than orthopods just because I don't know that much about their field.