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Comment by maxerickson | Hacker News Reader

There's medical school graduates that can't get into residency programs. The bottleneck in the US right now is residency slots.

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And the reason for that is that Medicare (CMS really) pays for all the residency slots. There is pressure to keep the Medicare budget from growing too fast which translates to slow/no growth in residency openings.

That's an explanation, not a reason.

Providers with billions of revenue could easily afford to fund slots. They'd probably even benefit financially from it.

The words "reason" and "explanation" are nearly synonymous. (I went to http://www.merriam-webster.com/dictionary to be certain of this.) If anything, an explanation is built from a set of reasons.

So refurb gave a reason for a bottleneck, and now we need to figure out why providers apparently aren't taking steps that address it.

The same reason IT guys oppose H1B visas? They like their earnings right where they are thank you.

reason(1), explanation(2).

Hmm...Why are there no privately funded residency slots?

Good question. You'd think private hospitals could use it to recruit full time physicians (i.e. we'll pay for your residency, but you need to stick around for X years as employee).

I don't know enough about how hospitals operate to understand why that's a good/bad idea.

I just found out that because of this bottleneck foreign trained doctors who are otherwise completely qualified and have taken all tests to transfer qualifications cannot get residencies. I know of a foreign trained doctor who has been waiting 15 years. He has been doing EKG monitoring while he has been waiting.

All residency slots naturally go to US medical school graduates.

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