3 ms·

I suppose they could expand medical school admissions for Americans, why don’t they? It’s not for lack of talented people, the class size quotas are an archaic

by nis0s 11mo ago

I suppose they could expand medical school admissions for Americans, why don’t they? It’s not for lack of talented people, the class size quotas are an archaic classist and partly racist way of thinking that have nothing to do with meritocracy, but instead are imposed to make sure that more undesirables don’t join the “elites” of society.

cj 11mo ago
Some quick Googling surfaces the number of residency slots as being another limiting factor to medical school admissions. Apparently, federal funding caps the maximum number of residency slots which creates a bottleneck in the system. It's most likely the case that there are multiple different bottlenecks. It's not just 1 person in a room somewhere saying "we need to make protect the elite!" - it's more likely just a lot of people continuing the status quo and few people fighting the change it.
- nis0s 11mo ago
  See this from another comment by someone else > The AMA pushed for limited residency slots ~20 years ago, as they feared too many doctors would cut their own incomes.
alistairSH 11mo ago
The AMA pushed for limited residency slots ~20 years ago, as they feared too many doctors would cut their own incomes. For some reason, residencies are paid by the federal government. Not sure of the history there - I find it hard to believe a resident doctor is a net-loss for the hospital system. Either way, I can't find any legal cap on number of residents - only a cap on funded slots (ie, a hospital could hire more residents and pay them out of pocket).
- paleotrope 11mo ago
  The residency system itself is a relic and represents a sort of trapped labor system.
  - alistairSH 11mo ago
    That might be true, but at the same time, do we really want doctors who haven't completed some form of apprenticeship? The hours/shift were sliced in 2003 and again in 2011. Though they're still much higher than what's normal in the EU. What I can't quite figure out is patient outcomes... morbidity appears to have increased (very slightly) as resident working hours were reduced (possibly more risk from handoffs than tired MDs?) - how does the EU compare in this regard? Somebody must have done a study... Anyway, some form of on-the-job training seems reasonable here. But the current residency system in the US definitely appears broken, for several reasons.
deleted 11mo ago
[deleted]

by nis0s 11mo ago

cj 11mo ago

Some quick Googling surfaces the number of residency slots as being another limiting factor to medical school admissions. Apparently, federal funding caps the maximum number of residency slots which creates a bottleneck in the system. It's most likely the case that there are multiple different bottlenecks. It's not just 1 person in a room somewhere saying "we need to make protect the elite!" - it's more likely just a lot of people continuing the status quo and few people fighting the change it.

nis0s 11mo ago
See this from another comment by someone else > The AMA pushed for limited residency slots ~20 years ago, as they feared too many doctors would cut their own incomes.

alistairSH 11mo ago

The AMA pushed for limited residency slots ~20 years ago, as they feared too many doctors would cut their own incomes. For some reason, residencies are paid by the federal government. Not sure of the history there - I find it hard to believe a resident doctor is a net-loss for the hospital system. Either way, I can't find any legal cap on number of residents - only a cap on funded slots (ie, a hospital could hire more residents and pay them out of pocket).

paleotrope 11mo ago
The residency system itself is a relic and represents a sort of trapped labor system.
- alistairSH 11mo ago
  That might be true, but at the same time, do we really want doctors who haven't completed some form of apprenticeship? The hours/shift were sliced in 2003 and again in 2011. Though they're still much higher than what's normal in the EU. What I can't quite figure out is patient outcomes... morbidity appears to have increased (very slightly) as resident working hours were reduced (possibly more risk from handoffs than tired MDs?) - how does the EU compare in this regard? Somebody must have done a study... Anyway, some form of on-the-job training seems reasonable here. But the current residency system in the US definitely appears broken, for several reasons.

deleted 11mo ago

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