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

Cheryl Clark, for HealthLeaders Media , July 11, 2014

HLM: Has any other state tried to do anything like this?

Nasca: No, and here's the irony: We've been asked by other countries to introduce our system of education and oversight because they aspire to have the quality and high levels of care that we have. We have other parts of the world saying, "We don't want this anymore." And here we have Missouri introducing this in United States.

That's irony in the extreme.

HLM: NYU Langone medical ethicist Art Caplan thinks the idea is OK for rural areas with few physicians.

Nasca: I have to quibble with Dr. Caplan. He's talking about this as a stopgap measure. But these people are going to be practicing for 40 years. The reality is, they're not going to get into a residency program. Because the next year, and the year after that, there are another 7,000 medical school graduates trying to get into residency programs.

The odds of getting into a residency slot after failing the first time goes down dramatically, and after two or three years, it's almost a given that you will not get in.

And the insinuation that primary care can be done by anybody is flawed.

HLM: Have you told the MSMA your view?

Nasca: No one has asked for my opinion.  But I think the AMA has done that in spades.

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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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