I thought you might be interested in this paper..... http://www.dh.gov.uk/PublicationsAndStatistics/Publications/PublicationsPolicyAndGuidance/PublicationsPolicyAndGuidanceArticle/fs/en?CONTENT_ID=4123769&chk=YE6wNc This link takes you to a paper that is "in consultation" at the moment about the proposition in the UK to train the equivalent of the US Physician Assistants. Not a nurse and not a Doctor. Is there room for a third profession? There certainly is the work for them but is this the right way? The nursing profession is a very different beast than it was a decade ago and so indeed are paramedics. I am undecided about the MCP (or even the surgical equivalent - also proposed). It doesn’t take a Professor to diagnose an appendicitis neither does it take a Doctor to diagnose/treat an infected in growing toenail. How much training/experience is enough? An SHO isn’t as trained/knowledgable as a SpR but regarded as safe enough to treat most ailments. So how did this level get to be decided other than a general evolving acceptance? How much training is enough for a MCP to diagnose and treat and know when to refer? The Physician assistant has been working well for years in the States so perhaps if we follow/adapt their model we shouldn’t worry? Sorry it’s a little off subject but it’s pertinent…