I actually do like the idea there should be more ladder and less silo. Im not sure how it could be implemented tho. I’m just reacting to the idea that mid level

I actually do like the idea there should be more ladder and less silo. Im not sure how it could be implemented tho. I’m just reacting to the idea that mid levels are anywhere near as skilled (meaning training) as most physicians. The hurdles I see are: There’s a reason doctors have really intense study time before residency, and you’d have to replicate that. There’s also a reason residency is so intense, you’re not going to get anything like resident experience doing ordinary mid level work. You’d need to hybrid model, but who is going to agree to something like: instead of working as a nurse 40 hours per week, you’re going to work 40hrs/wk and study 40hrs/wk, for 8 years, and if you pass the tests you’ll move on to the next level. This could work but basically sounds like part-time med school. Part time residency would be even less appealing, it would take you like 10+ years to get the amount of cases a resident has if you were only doing it part time