Is It Time To Shut Down Medical Schools In Favor of Nursing School?

Dr Rich gives his in depth analysis of the news behind the AMNews.

While apparently Mary Mundinger (DrPH, RN, dean of the Columbia University School of Nursing, President of CACC, and bugaboo of physicians everywhere) did not make herself available to the AMANews for a direct response, she was quoted in an earlier article as saying, “If nurses can show they can pass the same test at the same level of competency, there’s no rational argument for reimbursing them at a lower rate or giving them less authority in caring for patients.”

If students of nursing can pass the same competencies, in their entirety, as their MD  counter parts, they should receive the same rights as physicians to practice in equivalent scopes of practice.  Which means they should take the certification presented by the  American Board of Internal Medicine.  And if the ABIM is shown to be too difficult, physicians should certify by the standards established by their counterpart nursing boards.    

Having  two different certification standard to practice in the same scope of practice is simply irrational.  

With equality defined in internal medicine, DNPs should also be allowed to pursue specialized training, should they desire, in new specialized tracks of training, called Doctor of Nursing Cardiology, Doctor of Nursing Gastroenterology, Doctor of Nursing Endocrinology, Doctor of Nursing Nephrology ( you get the point).  And once complete with their training, they should be allowed to sit for the certification exams presented by the American College of Cardiology, Gastroenterology, Endocrinology, Nephrology and on and on.  If these exams are shown to be too difficult for doctor nurses,  medical doctors of cardiology, gastroenterology, endocrinology and nephrology should be allowed to certify by the standards established by the doctor of nursing specialty societies in order to allow doctor nurses equality of standards. 

Given the mantra of equal training,  and showing that nurse training is equivalent in scope and practice to the specialty of internal medicine, cardiology, gastroenterology, endocrinology and nephrology, nurses  should also be allowed to pursue a new doctor of surgical nursing degree.   Proving once again that a higher nursing education is equivalent to medical education, they should be allowed to prove competency by sitting for board certification presented by the  American College of Surgeons, becoming equals with their MD surgical counterparts.

You see, there is nothing inherently different between the American College of Cardiology, the American College of Surgery and the American Board of Internal Medicine.  They are all certifiers of physicians in their field of expertise.   Each a speciality in their own right.   If nurses believe they can practice internal medicine in its entirety with their nursing degree, there is no reason for me to believe they don't also believe they can also practice cardiology and surgery, in its entirety with their nursing equivalent degree.    

Whether they choose to or not is irrelevant.  Should a nurse wish to pursue specialized training in cardiology or surgery and become certified as equals as their MD counter parts, I believe America owes it to patients and nurses alike to offer them this opportunity.  

Which is why I favor closing all medical schools immediately and broadly expanding nursing admissions to provide for the new wave of doctor nurses who can provide full scopes of internal medicine, cardiology, gastroenterology, endocrinology, nephrology and surgery.  To deny doctor nurses the opportunity to certify as equals in all these fields would be denying patients and doctor nurses alike the rights earned by nature of their training to practice in scopes determined to be equal as their MD counterparts.

If the educational outcome is the same, then as a country, we should be paying for the cheaper education.  That means it's time to shut down all medical schools for good and use the nursing model of care as the only model of care to evaluate and manage patient illness.