It's a way of forcing ungraduated docs to pay to work. No joke - you have to pay to attend residency and work. And this isn't covered by student debt/government assistance programs.

I know of several doctors who are in _significant_ debt despite working for the public sector for years. Their loans are forgiven, but the residency sits and accumulates interest that they can't quickly pay off because that same public sector work doesn't pay as well.

It's not-quite slave labour.