Are you seriously asking residents to subsidize their own training working 60-80 hours a week [1] and being paid maybe $20-25/hr for 3-7 years while the hospitals make money from their services?

If that were the case, then the only ones who would put up with such a system would be those who have rich families to back them up.

I came from a blue collar background and my family could not help subsidize my training and I could not afford to live, make rent, or afford food if I had to pay for my training as well.

There are so many other things that you are completely glossing over including annual income between generalists vs specialists, pediatricians vs non-pediatricians, reimbursement inequality from Medicare (has not kept up with inflation and is ~40% below inflation), Medicaid pays at best 10-15% on the dollar, and so on.

American physicians also work almost teice as many hours as their European counterparts which would increase their incomes.

[1] it’s considerably more because if you report it then the program can be in danger and lose its credentialing