Assistant Physicians (AP) are Medical Doctors (MD) and Doctors of Osteopathy (DO) who graduate from a 4-year medical school program but do not complete a residency program. Residency that traditionally follows a physicians path to licensure prepares them to work in a specific specialty such as Internal Medicine or Cardiology. MDs and DOs who do not complete residency become licensed as Assistant Physicians and work under supervision of a collaborating physician. APs are often confused with Physician Assistants (PAs); However, APs have an additional 2 years of extensive clinical training which covers all areas of medicine. This training allows APs to practice primary care with collaboration of a Supervising physician. This collaboration allows for a higher level of service than working alone.
APs are tested on their clinical competency, in each medical speciality throughout training, giving them a breadth of experience and knowledge. In addition to hand's on clinical experience, APs must complete the additional required United State Medical Examinations (USMLE) to obtain their Assistant Physician Medical License. Like board certified physicians, AP's must complete extensive continuing medical education throughout their careers.
Why don't Assistant physicians complete residency? There are too many medidcal school graduates and not enough residency positions. This profession was created due to a significant amount of unmatched medical school graduates in the United States. These include US medical school graduates (AMG), US citizen graduates that attended Caribbean schools (IMG), and Foreign Medical Graduates (FMG). Every year since 2015 about 12,000 MDs and DOs do not match.
The graph below, from the 2018 National Residency Matching Program shows this disparity.
Figure 1: 2018 statistics for number of medical school graduates versus residency positions
How are Assistant Physicians Different from Physician Assistants or Nurse Practitioners?
AP's are Medical Doctors (MD) and Doctors of Osteopathy (DO) who graduate from a 4-year medical school program but do not complete a residency program. In general, residency training sharpens the skills learned in medical school into a specific specialty, similar to Cardiology or General Surgery.
APs have an additional 2 years of medical training versus Physician Assistants. APs are tested on their clinical competency in each medical specialty throughout training, and must complete the additional two United State Medical Examinations (USMLE) to obtain their Assistant Physician Medical License. Physician assistant take one standardized test to obtain their license.
Nurse Practitioners (ARNP) schools have a large discrepancy in training criteria. There is no national accreditation body like the United States Medical Licensing Exam (USMLE) or the Accreditation Counsel for Graduate Medical Education (ACGME) that oversees advanced nursing profession schools or creates national standards for clinical experiences. Without a similar structure to the ACGME, it is impossible to assess the quality of the education across these various schools. Once they graduate ARNPs are not monitored by any of the State Boards of Medicine.