Here's the go-to that I send people to when this comes up: https://skeptics.stackexchange.com/questions/4561/does-the-a...

Unfortunately this didn't really clear up my confusion. In particular, the points brought up by the second answer there seem relatively unresolved. Why should DO graduates be growing significantly faster in number (proportionately) than MD graduates, when traditionally an MD degree is more desirable than a DO degree, despite both being mostly equivalent?

A few possible conclusions. I don't have enough knowledge to pick one. Some of my speculation might even be wrong.

(A) DOs and MDs filter through different or mostly different residency pipelines. Thus, residency limits for MDs don't affect DOs, so the DO population can grow more quickly.

(B) DOs and MDs do filter through mostly the same residency pipeline, and the increasing number of DO graduates is causing an increasing number of residency applicants to not be admitted to any residency program. (This malicious situation would be similar to the situation with law schools, which admit and graduate far more lawyers than the industry can possibly sustain and support in its current state.)

(C) There's enough non-government funding of residency slots that residencies are not as bottlenecked as the first answer claims. If so, this re-raises the question on whether MD admission is being rate-limited to increase scarcity and thus salaries.

(D) Perhaps something else I'm not thinking of.

tl;dr Federal health spending is the limiting factor.

Question: Why do we need the government to fund residents? The fact that every single going-to-be physician must do so through government funding boggles my mind.

On top of that, depending on the number of hours worked, many residents barely make minimum wage.

It's needed because the private sector isn't paying for it.

There's no law that says private hospitals can't fund residency slots - in fact they fund many of them - but, as the source you're commenting on says; "[medicare is] the principal source of residency funding".

And the "private sector" is the existing physicians. Every dollar they pay a resident can't be used to buy their spouse more Prada or new tires for the Porsche. But the AMA had kept the valve throttled so long, society was desperate. Seeing a bunch of short-term greedy louts who apparently didn't study much math (don't get me started), the government seized the opportunity to pay for residencies, which created a Venturi effect where they can suck up not just the MDs, but added the flow from two other pipelines: the DOs and IMGs. And the flow has been so vigorous and steady that additional medical schools have opened outside the US borders (the Caribbean, Middle East, etc) to support the flow.

I suspect that this is the "companies don't want to train workers" problem, the same one that makes employers demand 10 years of Java experience for crap jobs, writ large.

Classic. They moved a big ship and then tried to move it back and hysteresis took hold. This is what unions do. They're like giants without brains, pulling and pushing levers they do not understand. They're driven by short-term fear and reactive behaviour. The fact that they hold any sort of power here is an outrage.

It's quite clear to me what needs to be done here. America needs to import medical professionals. They're out there, they're needed here.

Oh yea? A lot of them can barely pass STEP 2 CS which just tests your ability to communicate in English and whether you can make two empathetic statements per patient encounter. You think FMG are on the same level as American educated MD/DOs? Some are and some are better, but as a cohort they are mediocre.

Well, considering there's a damned army of them, we can just filter them down to the top few (which will be a massive set on America's scale).

There are a ton of them, that's true. I do have one issue with a lot of them though. Many of them try to come into the US system just for the pay and they don't have a debt burden at all. For example, many of the FMG I have spoken with actually have their medical education subsidized by their home country, and then they leave for the US. I feel like doing that is unethical. Their home countries are making a direct investment via their taxpayers' dollars to educate medical doctors for their underserved populations. And then the FMGs try to leave as soon as they can without ever serving the communities that need them.

I have 250k in debt from undergrad+medical school, almost all of it loaned to me by the department of education. If I saw some international position open that was high paying and I could just desert my debt and the US, would that be right? I don't think so, that seems like a morally bankrupt thing to do.

The why is complicated, it seems obvious enough that more doctors would be a good thing.

Or at least, more practitioners. We don't need doctors with huge amounts of training to do every evaluation.

True, but the AMA seems to fight enabling other professions (nurses, pharmacists) from taking on roles traditionally held by doctors.

I rather wish software engineering had a professional association with the lobbying power of the AMA.

It would be a damned nightmare. The practitioners are dying of overwork, their patients are dying due to being treated by people who can barely stand after 36-hr days, and meanwhile the professional association comes up with a worker wellbeing plan.

Incompetence on a national scale.

Ironically, I went there to find the link to the USA Today article that I quoted.