[jmde]

... and/or deregulation (reregulation?) to open up competition. Often if not usually, the same task could be just as skillfully by done, or even more skillfully or appropriately done, by someone with a different educational route, with or without training beyond what is now typical (e.g., NPs, nurse anesthetists, PAs, optometrists, psychologists, pharmacists, RNs, you name it).

PAs provide an instructive example, but there are many others of different sorts. Often, PA schools have stricter prerequisite experience requirements, and PA students often take the bulk of their courses with the MD students, and have maybe a semester less of courses, before clinical training. So the end effect is that a PA's actual experience is often the comparable to an MD's after a couple of years of practice. Hospitals and health care systems know this, and have been gradually replacing MDs in many areas with PAs because they're cheaper but provide similar care.

We can't afford to maintain this fiction that the only way to have something skillfully done is by the MD training model.

[thechao]

Bar none, the happiest group of graduate students I ever worked with (at a hospital, or not) were the PAs. The education is focused, fulfilling, demanding without being exhausting. The pay is great (I know a number of guys who did a path of: high school flunkout -> GED -> nurse -> PA). Furthermore (at least 15 years ago), they don't have to deal with the vast majority of the insurance BS... they basically get to help & heal.