ACGME Chief Sees 'Huge' Risk of Error in Proposed Assistant Physician Licensure

Cheryl Clark, for HealthLeaders Media , July 11, 2014

Here, edited for clarity, is what Nasca has to say about the assistant physician role:

HLM: The proponents of this legislation say it's a plausible and creative solution for a doctor shortage in a region that is one of the 10 most medically underserved states in the country. It would put to work some of the 7,000 to 8,000 medical school graduates who otherwise would be cooling their heels waiting to get into a residency slot. What's the truth?

Nasca: The vast majority of these 7,000 to 8,000 graduates who didn't get a residency slot are graduates of osteopathic or allopathic medical schools outside the United States. There are very few graduates of domestic schools who do not get residency positions. About 40% are U.S. citizens who went to medical school outside the U.S. because they couldn't get into medical school in the U.S.

So I'm very concerned about what's going on in Missouri. What's proposed is precedent-setting, and very concerning, on a number of fronts.

The question for the public is, do we want to be in a circumstance where we are back in the 1950s? With physicians caring for patients without accredited U.S. graduate medical education? That's the fundamental question.

I believe that the American public does not want physicians who have not been formally trained to practice medicine.  Even with a limited license. The American public does not deserve second class care.

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16 comments on "ACGME Chief Sees 'Huge' Risk of Error in Proposed Assistant Physician Licensure"


Tim Fontaine (12/3/2015 at 5:17 PM)
It is so obvious that the CEO is fear-mongering by stating that one of his concerns would be that Assistant Physicians/MD may make drug interaction mistakes...REALLY? What the general public does not know is that all doctors either use medication interaction apps on their laptop or phones, or consult a hard text reference source in order to not make these mistakes. Trained pharmacists are the only professionals I have ever spoken with that know most of the drug interactions per rote memory. Moreover, most hospitals/clinics are on or will be going to EMR/EHR [INVALID]ems - they have built-in drug interaction settings which automatically alert you if a dangerous interaction could occur. The CEO is creating a paper tiger. If you look at what the CEO and the ACGME has to lose when MO starts licensing APs and other states start following suite, then you will see why he states what he does. Thanks, Tim F.,MD,MPH,CT(ASCP)

dana (12/9/2014 at 7:09 PM)
I live in USA from 10 years,I'm an US citizen,,,I have passed all USMLE steps but couldn't get a residency spot. I don't have a job ,I'm a saty at home mom.I was a reputable physician in Europe but I cannot use my knowledge to help American people,Very sad!!!!!

Andrews C Ninan, MD, MS, FRCS (12/7/2014 at 2:12 PM)
There is yet another side of this equation. There are legal citizens in this country, people who have been qualified and worked abroad (U.K. and India) after doing their residency abroad in specialities (for over 20 years in both countries) but not had the chance to be included into any residency programs in this country due to being "overqualified". These people, like myself, are wasting their time when their knowledge could be utilised without any fear of not having had any supervised training in this country.

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