Welcome to Back from the Abyss. I'm Dr. Craig Hecock.

This is the 2025 summer special, a little later than normal.

I apologize for that. Before we jump in, I wanted to read a listener letter that I got in May.

This is from Andrew Penn. Andrew Penn is a nurse practitioner on the clinical faculty at

UCSF. He's a big fan of the podcast. He and I

have been in touch about a number of topics and episodes, and I've really loved his feedback.

So he wrote a letter, actually a long, really interesting, powerful letter. I'm not going to

read the whole letter, but I'm just going to read some parts I think that are really relevant

and important. So this relates to the episode I did last spring on nurse practitioners.

So here's what Andrew said.

Hey, Craig, I appreciated you highlighting the nurse practitioner profession and all that you're

doing to support our education.

And as always, I think your podcast is amazing and I recommend it to all my students.

I did feel like your podcast overlooked a number of key things

that I would like to offer in the interest of balance. So here, Andrew goes on to make a number of

really good points, but I'm going to just choose three, which I think are most important and relevant

and I want to speak to these. At one point, Andrews says, I think it's really important to point out that

medical residency training is highly subsidized by the federal government, whereas nursing is not.

This was a key structural difference that was missing from your conversation, and really,

it's unfair to nursing. If we want to start making this better, we need to create systems that

make this more equitable.

For example, in teaching hospitals, protected time for teaching medical residents is paid for

...