Letter to congress

February 8, 2008 at 10:29 pm (1-800-IDEA-MAN)

Shortly after starting this blog I came up with 1-800-IDEA-MAN. My very first post was about letting fourth year medical students become PA’s once they have passed both Step I and Step II of the US Medical Licensing Exam. I decided to finally take some action on my idea by writing to my state’s representative and senator. Here is the letter that I sent to both of them.


Dear ____________,

I am writing to you today as a resident of District __ with my concerns about ______ health care. I am currently in my third year of medical school at the University of _____ and have witnessed firsthand the lack of proper resources to provide for the well-being of our citizens.

Solving healthcare woes is not only a priority of mine, but has become a major topic in this election year. While there are many ideas tossed around about how to provide greater access to care—such as malpractice reform and socialized medicine—I want to share a novel solution.

Currently, there exists a group of physician extenders known as physician assistants who work as mid-level providers to offer primary care and emergency services to many people. Physician assistants go through two years of training: one year of clinical course work, and one year of hospital experience. They then take a licensing exam to become certified here in the state of ______ as PA’s. Since they are not allowed to carry their own malpractice insurance, nor are they allowed to write unrestricted prescriptions, PA’s work under the guidance of a physician.

Now let’s consider medical school. To become an M.D., students must go through two years of clinical course work and two years of hospital experience. Before graduating, they must take two parts of the United States Medical Licensing Exam series. Even then, they are not licensed to practice as full physicians here in this state until they have completed one year of residency and passed part three of the series.

I propose that medical students who have completed their third year of training and who have successfully passed both Step I and Step II of the US Medical Licensing Exam should be automatically qualified to practice as physician assistants here in the state of ______. There would be several benefits.

First, they would reduce the burden on current physicians. The American Medical Association names ______ as a crisis state because of its medical malpractice woes. Many doctors have left the state and many more are limiting their practice, resulting in reduced access to health care. By having more physician assistants available, state residents would have greater access to primary care.

Second, medical students would enjoy the benefits of holding a job while in their final year of training. At my own university, many medical students graduate with over $200,000 in debt as a result of high tuition costs. By generating some income, medical students will be able to offset a small part of the financial burden of achieving their dreams to become doctors.

I’m not suggesting that these medical students/physician assistants will replace primary care doctors. They will continue to work under the guidance of current licensed physicians. Given the hiring rate of PA’s, I think it’s such a plan would work smoothly without causing any disruption to the job market.

I would appreciate your feedback on my idea. My proposal is certainly not going to completely fix the problem of healthcare access, but it will alleviate some of the strain without causing a rise in taxes or a reduction in physician autonomy.

Half M.D.


1 Comment

  1. MSG said,

    I personally think that this would be a good idea. After all, we have as much, if not more education and right to be acting as PAs and a source of income would be nice. Plus it would allow the anticlimactic 4th year to actually be worth something and not a brain sink.

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