Part of the problem with the current monopoly is that we're already assuming our choices are NPs vs MDs, as opposed to some other professional identities, with

Part of the problem with the current monopoly is that we're already assuming our choices are NPs vs MDs, as opposed to some other professional identities, with other educational paths, that don't exist because of the monopoly. It's distorted the discussion by shaping our expectations about what's possible. In any event, med schools are now moving towards 1.5 or even 1 year of course training, there's pressure to compress background as much as possible. The difference between, say, a PA with four years of practice and a second year resident is increasingly difficult to distinguish. This is increasingly reflected in staffing demands. I don't think the MD model is obsolete, but I do agree that the current anticompetitive system is.