What can an MD do without a residency?

[W19]

The answer your question, work as an assistant physician in either Arkansas or Missouri according to the new legislation in the past few years.


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From what I was told, not one license of AP has been issued in these states. They have problem implementing the law... OP needs at least 1 year post grad training.

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[libertyyne]

Here is a stupid question, is no one lobbying to provide MD's without residency the same privileges that NPs have?

 

[Stagg737]

The answer your question, work as an assistant physician in either Arkansas or Missouri according to the new legislation in the past few years.

These positions were meant as a way for those who don't match but desire to go into a primary field to do something productive during their "gap year" while providing care to underserved areas, not as a long term option for those not desiring to pursue residency. At least that's what the Missouri legislator that spoke to my class said about the program.

Here is a stupid question, is no one lobbying to provide MD's without residency the same privileges that NPs have?

No, because physicians don't have to have completed residency to practice independently. If you want to be a GP, then as far as I know you just have to pass Step 3 and you can practice independently. Problem is that no insurance companies or government entities will reimburse you, so you'd pretty much be limited to a cash only practice. While it's possible and I have seen 1 or 2 physicians who were GPs that didn't do residency, if you want to practice clinical medicine you're going to have to do a residency.

Others can correct me if I'm wrong in their state or if laws have changed, but I do know that there was a GP that never did residency in the town I grew up in.

 

[the argus]

No, because physicians don't have to have completed residency to practice independently. If you want to be a GP, then as far as I know you just have to pass Step 3 and you can practice independently. Problem is that no insurance companies or government entities will reimburse you, so you'd pretty much be limited to a cash only practice. While it's possible and I have seen 1 or 2 physicians who were GPs that didn't do residency, if you want to practice clinical medicine you're going to have to do a residency.

Others can correct me if I'm wrong in their state or if laws have changed, but I do know that there was a GP that never did residency in the town I grew up in.

Yes, physicians absolutely have to do some graduate medical training to practice independently. That GP in your town likely did an intern year, just not a full residency. This was very common back in the day.

As far as I'm aware, there are no states that will give a full license to a physician with no graduate medical training. The number of years required by each state usually depends on your grad status (USMD vs DO vs IMG). Often USMDs are required at least 1 year of residency, while IMGs are required 2-3 years. There are no states I'm aware of (other than the special instances as above) where you can practice without any training. The reimbursement issue exists, but thats not what technically stops a fresh medical school grad from opening their own practice. There's more to getting a license than just passing all the Steps.

 

[libertyyne]

These positions were meant as a way for those who don't match but desire to go into a primary field to do something productive during their "gap year" while providing care to underserved areas, not as a long term option for those not desiring to pursue residency. At least that's what the Missouri legislator that spoke to my class said about the program.



No, because physicians don't have to have completed residency to practice independently. If you want to be a GP, then as far as I know you just have to pass Step 3 and you can practice independently. Problem is that no insurance companies or government entities will reimburse you, so you'd pretty much be limited to a cash only practice. While it's possible and I have seen 1 or 2 physicians who were GPs that didn't do residency, if you want to practice clinical medicine you're going to have to do a residency.

Others can correct me if I'm wrong in their state or if laws have changed, but I do know that there was a GP that never did residency in the town I grew up in.

Yes, physicians absolutely have to do some graduate medical training to practice independently. That GP in your town likely did an intern year, just not a full residency. This was very common back in the day.

As far as I'm aware, there are no states that will give a full license to a physician with no graduate medical training. The number of years required by each state usually depends on your grad status (USMD vs DO vs IMG). Often USMDs are required at least 1 year of residency, while IMGs are required 2-3 years. There are no states I'm aware of (other than the special instances as above) where you can practice without any training. The reimbursement issue exists, but thats not what technically stops a fresh medical school grad from opening their own practice. There's more to getting a license than just passing all the Steps.

It seems Ludacris that insurers and reimbursement folks think an Np with a year less in training is a safer bet.

 

[deleted547631]

It seems Ludacris that insurers and reimbursement folks think an Np with a year less in training is a safer bet.

 

[Stagg737]

Yes, physicians absolutely have to do some graduate medical training to practice independently. That GP in your town likely did an intern year, just not a full residency. This was very common back in the day.

As far as I'm aware, there are no states that will give a full license to a physician with no graduate medical training. The number of years required by each state usually depends on your grad status (USMD vs DO vs IMG). Often USMDs are required at least 1 year of residency, while IMGs are required 2-3 years. There are no states I'm aware of (other than the special instances as above) where you can practice without any training. The reimbursement issue exists, but thats not what technically stops a fresh medical school grad from opening their own practice. There's more to getting a license than just passing all the Steps.

Apparently not in every state as of 2014, as several states requirements are simply "graduation from a board approved medical school" while most specifically list "graduation from a board approved medical school plus X years of post-graduate training":

http://www.visalaw.com/wp-content/uploads/2014/10/physicianchart.pdf

Maybe that's wrong, doesn't really matter either way though. To practice clinically and make enough to pay off loans it's still stupid not to pursue a residency.

 

[the argus]

Apparently not in every state as of 2014, as several states requirements are simply "graduation from a board approved medical school" while most specifically list "graduation from a board approved medical school plus X years of post-graduate training":

http://www.visalaw.com/wp-content/uploads/2014/10/physicianchart.pdf

Maybe that's wrong, doesn't really matter either way though. To practice clinically and make enough to pay off loans it's still stupid not to pursue a residency.

That chart is specifically for IMGs made by some random lawyer. I shouldn't have to say this, but don't believe everything you read on the internet.

There are no states where you don't need at least 1 year of post-graduate training to get a license. This is pretty common knowledge.

Think about it for a second. If there were states you didn't need graduate training to practice, why would those new assistant physician laws in Missouri/Arkansas be a big deal?

 

[W19]

Apparently not in every state as of 2014, as several states requirements are simply "graduation from a board approved medical school" while most specifically list "graduation from a board approved medical school plus X years of post-graduate training":

http://www.visalaw.com/wp-content/uploads/2014/10/physicianchart.pdf

Maybe that's wrong, doesn't really matter either way though. To practice clinically and make enough to pay off loans it's still stupid not to pursue a residency.

IMGs need 2-3 years post grad training

AMGs need mostly 1-2 year post grad training

https://www.fsmb.org/licensure/usmle-step-3/state_specific

 

[knv2u]

I work for the state government for PSLF making around only around 46k, but supposedly I'll jump to 55k next year and 70k in 5 years per classification jump system.

I handle policies and procedures relating to pharmacy based management. Got Carib MD with 500k loan. Apparently the loan forgiveness with compound interest is 1 million.

So I am making 46k+100k due to loan forgiveness. I also get to retire at 55 due to pension...

Also work life balance is great. 9-5 all day with no studying. All holidays off with even stuff like Columbus Day, and I get 24 vacation time per year. So get your MD at least.

Be ware of the tax man when the government writes off $1 million!

http://www.finaid.org/loans/forgivenesstaxability.phtml

 

[darkjedi]

Be ware of the tax man when the government writes off $1 million!

http://www.finaid.org/loans/forgivenesstaxability.phtml

I believe one of the benefits of PSLF is that there is no tax burden with that specific forgiveness. There is also a non-PSLF forgiveness plan after 20-25 years, depending on the repayment plan you are on, that does incur a tax liability however.

 

[SansaStarkMD]

There was talk on the radio about doing away with PSLF. Some government department miscalculated the cost by not factoring in inflation and the growing number of students. Government... go figure.

 

[deleted547631]

There was talk on the radio about doing away with PSLF. Some government department miscalculated the cost by not factoring in inflation and the growing number of students. Government... go figure.

Imagine all the thousands of pissed off law school graduates on track with their loan forgiveness if the government decides to pull the ol' switcharoo and kill PSLF just as the earliest of candidates become eligibile to apply. I don't think it would be wise for Congress to perturb that group.

 

[the argus]

There was talk on the radio about doing away with PSLF. Some government department miscalculated the cost by not factoring in inflation and the growing number of students. Government... go figure.

Imagine all the thousands of pissed off law school graduates on track with their loan forgiveness if the government decides to pull the ol' switcharoo and kill PSLF just as the earliest of candidates become eligibile to apply. I don't think it would be wise for Congress to perturb that group.

PSLF is written into the Master Promissory Note you sign when accepting loans. It's a legally binding document on both ends (loaner and loanee). It would be difficult legally for them to go back and change the terms for people who have already taken out loans. As you said, they would get sued by thousands of people, lawyers included.

Now they certainly could do away with the program for future loans.

 

[SansaStarkMD]

PSLF is written into the Master Promissory Note you sign when accepting loans. It's a legally binding document on both ends (loaner and loanee). It would be difficult legally for them to go back and change the terms for people who have already taken out loans. As you said, they would get sued by thousands of people, lawyers included.

Now they certainly could do away with the program for future loans.

Good point

 

[JAFERD]

They should give non residency trained MDs full practice rights. They already do that in 21 states for NPs, and newly graduated NP is less qualified than an MD graduate. If you believe otherwise, then medical school is a complete scam and should be shut down.

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No, they shouldn't. NPs don't usually practice independently directly out of NP school and when they do practice independently, it's almost exclusively primary care clinics that can't find docs to staff them (either due to salary, location, patient population, or other similar issues). The majority of NPs are working under / in collaboration with physicians. And while new grad docs have a much larger knowledge base than NP's, that doesn't mean they know how to practice medicine - that's what residency is for.

Despite what some NP's may have you believe, physicians and NP's are completely different and you can't compare the two. If you don't complete residency, you've wasted an awful lot of time in medical school. Medical school prepares you for residency, which in turn prepares you to be the leader of a multi-disciplinary health care team. Medical school does not prepare you to be an independent mid-level provider, nor should laws encourage them to. Wait until you're a resident, work for a couple weeks, and then tell me if you feel qualified to be seeing patients independently. I can tell you that you won't be, and this argument is independent of your view of the qualifications of mid-levels.

 

[JAFERD]

Then there's no reason for anyone to go to medical school. They are phasing out physician training as it currently exists by giving NPs complete autonomy.

To put it bluntly, you have no idea what you're talking about.