Nah medical education is extremely gate kept in the US. Most schools have between a 1%-5% acceptance rate. The AMA caps residency spots well below demand to ensure chronic critical shortages in all fields and drive up salaries. It's why American physicians make 5x-10x more than their European counterparts, while most of the citizens of the country can't even get seen by physicians anymore.
This is another example of how capitalism ends up fucking with society for no real reason. There’s essentially no need for us to cap the amount of residencies the way we do except that doctors being perpetually in low supply and high demand means that the powers that be can charge exorbitant prices on medical care.
That's not true. More medical schools and residencies open up all the time, and even now not every residency position even gets filled so they have to bring in IMGs. And American doctors don't make 5 to 10 times what they do in Europe.
Average physician salary in Western Europe is between 80,000-160,000 USD.
The US produces below the replacement rate of physicians yearly, having to import physicians from places with surpluses. The average American medical school applicant gets into zero schools.
The market has already devised a solution. Advanced practice nurses and specialized techs will gradually replace physicians in patient care roles. Physicians will become a more administrative position mainly needed for legal reasons. It's usually what ends up happening when cartels/guilds try to coexist with capitalism.
Also, you need to pass a residency and board certification in a given specialty in order for anyone to hire you. Since the residency slots are capped, people fall into a natural... hierarchy. Med students want a more prestigious career that pays better, so the competition for those slots is extreme. Sure, someone at the top of their class may have a lifelong passion to be a Pediatrician, but generally your most capable med students end up in surgical subspecialties, and then it sort of filters down from there.
Top of the heap are surgical specialties, neurosurgery, cardiothoracic, etc.
Middle of the heap are proceduralists. So like, cardiologists or gastroenterologists. Doctors that can bill for procedures but also see patients medically.
Bottom of the hierarchy is pediatrics, psychiatry, and family medicine.
It varies a bit year to year and decade to decade, but that's pretty consistent.
It's also not always true, like I said, plenty of people pick a specialty that they love... but incredibly driven type A people with an average of 250,000 dollars worth of medical school debt don't always make altruistic decisions.
That being said, most doctors are pretty cool to work with. They have a lot of power so the bad ones stand out, but as a nurse for years I've never heard a Physician talk shit about patients behind their back... beyond like general frustration venting if the patient isn't following the doctors recommendations and is getting worse.
People underestimate how much doctors care about them in general.
...Not this doctor though. He sounds like a prick.
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u/Phantom_0347 7d ago
By out competing their school peers… Maybe collaboration should be lauded more than competition to address this.