A blog post that recently appeared on a popular website compelled me to counter false information and clear up the inaccuracies littered throughout.
On a sunny day in May 2014, I walked the stage and received my medical degree, earning the title "doctor." But two months before, there was another day that determined my future. It's what we call Match Day, when fourth-year medical students find out where they will be going for residency and in which field of medicine they will train. During residency, doctors are employed by hospitals, working in general medicine before specializing in their field of choice. Without this additional training, a doctor cannot be licensed to practice.
But Match Day can be a nightmare for some. It's held on a Friday in March. On the Monday prior, an email goes out to med students around the country to inform them of their fate. Mine said "Congratulations, you have matched!" It would be another four days until I found out where I would be going for residency, but I could rest easy, knowing that I had a job next year and a path to licensure. Unfortunately, some of my peers weren't so lucky. They received emails that said exactly the opposite. They didn't match.
That's when panic set in. Imagine being $250,000 in debt with no job, no medical license, and no hope of practicing what you've spent so long training to do.
So, the state of Missouri has stepped in and proposed that doctors who don't match into residency should act in the capacity of an "assistant physician," under the supervision of residency-trained doctors. In other words, they would be midlevel providers, unable to work alone, but allowed to see patients with a fully-licensed doctor overseeing them, much like a physician's assistant (PA) or nurse practitioner (NP) does. But for some reason, this idea was met with protests. I truly don't understand why.
We're talking about people who have gone through four years of undergraduate studies, four years of medical school, have passed every exam, including two eight-hour national board exams, and graduated with an M.D. or D.O. degree. These are people who have logged more training hours than newly-graduated PAs and NPs, both of whom we already accept as midlevel providers.
So why does it spur controversy?
Even the AMA ejected the concept, despite the fact that newly-graduated PAs, who have two years of graduate education, seem to be growing in number and typically have less experience than a United States medical school graduate. Perhaps the AMA is upset that Missouri's bill doesn't make an exception for those who might train at overseas unaccredited medical schools (which it should). I don't know. Regardless, I can respect the AMA's rejection and further ponder the consequences of such a bill because the argument is about facts not misstatements.
However, what I can't take seriously is the blog post linked above, which inaccurately diminishes a medical school graduate's qualifications and propagates the fairytale that med school is about dissecting frogs (sorry, that was eighth-grade biology) and learning organic chemistry (sophomore year of undergrad).
Let's understand medical education. It begins with undergraduate education. Those who want to attend medical school are required to take courses in general chemistry, organic chemistry, physics, and biology, and more and more schools are tacking on biochemistry and genetics. After all that, they take the Medical College Admissions Test, a five-hour exam that tests all that information. Once they get to medical school, they will spend two years studying gross anatomy (with cadavers, at every U.S. med school), physiology (how the body works), pathology (what happens when something goes wrong), pharmacology (medications), immunology, biochemistry, and genetics. After those two years, they transition to clinical work, seeing patients in hospitals, taking histories and doing physicals, charting on those patients, and coming up with treatment plans with their supervisors. At my school, we spent eight weeks in internal medicine, eight weeks in family medicine, eight weeks in surgery, working side by side with the surgeon, four weeks in obstetrics and gynecology, and four weeks in psychiatry. In fourth year, we spent four weeks in the emergency room, four weeks in cardiology, and another four weeks in family medicine. The rest of the time was used for electives, which I used for neurology, psychiatry, and neuropsychiatry.
By the time we graduate medical school, we have an extra year of classroom learning AND an extra year of hospital rotations compared to midlevel healthcare workers. That's twice as many years in school, not to mention two or three times as much paid in tuition. Yet, midlevels are ready to work upon graduation. So why aren't medical school graduates qualified to work in the same capacity?
Clearly, in my opinion, they are. I am open to opinions that may disagree, though, so long as they're well-informed. The problem is, when you argue against this legislation because you think a medical school graduate's knowledge of anatomy is limited to dissecting a frog, you lose credibility and with it, you lose the argument. At least in my book.