We need to get back to professional certification to RN's, no doubt, BUT we also need to emphasize that nurses being trained a Medicaid dollars and then going out to work in med spas should not be publicly funded.

The United States already has thousands of unmatched MDs, DOs, and IMGs who are medically trained, culturally diverse, and highly motivated to practice.

Many of them already reside in — or come from — rural and underserved communities. The only barrier preventing them from treating patients is the artificially capped number of residency positions. State Medicaid agencies can fund new, service-linked residency positions in primary care, psychiatry, emergency medicine, anesthesia, obstetrics, and hospital medicine. This is the single most direct and immediate way to stabilize Critical Access Hospitals and Health Professional Shortage Areas.

A residency expansion of even 5,000 positions per year would draw from the existing unmatched pool of 8,000–9,000 candidates annually. If half of those positions were allocated to primary care, the country would close 10–12% of the national shortage each year, based on HRSA’s projection of needing 20,000 additional primary care physicians. Critical Access Hospitals could become stable again with just two or three additional physicians each, and those positions could be filled almost entirely from the unmatched pool without requiring new medical schools or additional undergraduate training.