[stephencanon]

Residency at an ER isn't necessary for someone to become a pediatrician. Pediatricians do a pediatric residency. You seem to be very, very confused.

> Why have you elevated some bottleneck guild requirement into a general license to write prescriptions? Or sign-off on an STD test? Or allow patients to get blood tests? Or to inform them of said test results?

Literally everything you listed here can be done by a mid-level (i.e. non-MD), and commonly is (though the scope of prescriptions they can write is limited by states, IIRC).

> by reducing the argument to this level you are only suggesting you have no adequate response to the actual problem

I have no idea what you're talking about; I posted a minor factual correction to someone else that has nothing to do with this point. Again, you seem to be very, very confused.

----

In your edit you say:

> I would actually think that "residency" is a poor way of measuring competence in that field as well

Residency is not a tool for measuring competence. It is the means by which that competence is acquired[1]. You demonstrate competence by passing the written and oral boards in your specialty.

> "residency" hasn't been necessary for almost any of the medical care I have received.

May this continue to be true. If everyone were so lucky, the medical system would be much, much simpler.

[1] Foreign doctors who may already be competent are required to go through residency in the US as well; there probably should be a way to short-circuit that and allow them to demonstrate competence.

[phil21]

> Residency at an ER isn't necessary for someone to become a pediatrician.

You may simply be talking past each other here. All of my (now doctor) friends who went through residency pulled at least one, and usually more than that, rotations through ED. I can't imagine all 3 hospitals had wildly different residency programs than the rest of the nation, so I imagine 3-6mo of ED rotation is quite common during residency.

[stephencanon]

Yes, a 3-6 mo ED rotation is quite common for medicine docs (so is an ICU rotation for surgeons), but that's wildly different from an actual emergency medicine residency.

[blusterXY]

> In recent years, the number of medical residents has become so restricted that even the American Medical Association is pushing to have the number of slots increased.

This does not sound like a system where students can fulfill their residency requirements working at general care facilities with trained doctors who have years of experience.

> The major obstacle at this point is funding. It costs a teaching hospital roughly $150,000 a year for a residency slot.

So why exactly is there a slot shortage if people can literally fulfill their residency requirements pretty much anywhere? There are plenty of hospitals that could easily use the labor.

[stephencanon]

I didn't write either of the quotes you're replying to, so I'm not sure why you're replying on this thread.

[blusterXY]

Scroll up, Stephen. These quotes are in the thread at the heart of this discussion, and they are pulled directly from the article.

I mean... I appreciate getting downvoted for reading the article and addressing it directly, but if there are indeed adequate residency spots then you are disagreeing with the article and would be better served to focus on what it gets wrong instead of attacking me for making rather rudimentary observations that follow from its core premise.

[stephencanon]

Right, but I never said there were adequate residency spots. In fact, I think that there aren't[1]. So again, why are you replying to this thread in particular?

[1] however, from what I've seen it isn't a critical issue for US healthcare; we need more mid-levels and to expand their scope of practice more than we need residents. For residents, it would be far more effective to reduce the span of pre-residency training somehow, so that people aren't starting residency with $300k in debt.