In India, training of a physician involves 4½ years of medical school followed by 1 year of internship. This is followed by 3 years of training in internal medicine and another 3 years of fellowship in pulmonary medicine before he or she can perform flexible bronchoscopy skillfully. In these 12 years, a physician is trained in various aspects of medicine (eg, etiology, pathogenesis, clinical features, diagnostic approach) apart from performing diagnostic procedures. The training program for NPs in India involves 3 to 4 years of training in various aspects of nursing care, with only an overview of anatomy, physiology, and other subjects. At least in India, the training schedule of a physician differs vastly from that of an NP. Whether the training program of a NP in the United States is different from other places is not clear.