[kyouens]

I am a doctor and I run a graduate medical education program. The constraining resource is generally funding, not limits imposed by ACGME. For example, my program is ACGME-approved for two trainees per year, but we have funding for one.

[resource_waste]

Why is the government paying for graduate education? I paid for my own graduate education.

[maxwell-neumann]

The costs would be utterly extortionate otherwise.

[resource_waste]

No. Don't let the cartel propagate this lie.

[ambicapter]

Who decides the funding?

[kyouens]

Funding is mostly controlled by the federal government, via Medicare and Medicaid, and if I am not mistaken the funding levels are set by Congress.

[nradov]

You are not mistaken. Contrary to the conspiracy theories you see on here about the AMA, lately they have been lobbying Congress to increase funding for residency programs because that is the primary bottleneck to producing new physicians.

https://savegme.org/

[lesuorac]

So after studying for a decade a soon-to-be physician needs to go through a government funded job in order to qualify as a physician?

Why don't the hospitals just pay the cost of their staff like every other apprenticeship program? (or add it into the list of student debt that doctor requires).

[nradov]

Anyone who graduates from medical school with an MD / DO degree needs to complete several years of graduate medical education (residency) at a teaching hospital in order to become a physician legally authorized to practice medicine. Most residency slots are funded by Medicare, although some are funded by other sources. Teaching hospitals are usually run by non-profit corporations, or by state or local governments. While internal accounting is always a bit fuzzy and opaque they simply don't have the money to pay residents directly. Most residents generate less revenue than they cost to train. And hospitals don't have the freedom to raise prices to cover the cost of running residency programs. Thus the need for subsidies.

If we force prospective doctors to take on even more debt then we'll likely end up with an even worse shortage. Current levels of student debt are already unsustainable, at least for many specialties.

[lesuorac]

> Most residents generate less revenue than they cost to train.

Is this just a thresholding issue? What substantially changes about the resident from year 1 to 3? Can you chop residency up into different tiers where they don't need somebody watching them do stitches once they're no longer the lowest tier?

I find it extremely suspicious that a sector with so much money in it can't figure out how to make apprenticeships profitable but an electrician can.

[resource_waste]

Uh... You are talking about the highest paid profession in the US.

There is no debt problem.

I joke about how bad doctors are at math, but this is a pretty obvious case when Physicians are making 200-500k/yr and complaining about 300k of debt.