>To be honest, it's really residency training programs that have become too long
This is true, but it would also be a good idea to move toward a more European-style system that creates an alternate path to the M.D. by making the first two years of med school equivalent to an undergrad major. So a student at, say, the University of Washington could do their first two years of med school from 20 – 22, their second two from 22 – 24, and a three-year residency afterwards, leaving them with less debt (because they'd pay undergrad tuition) and with a faster path to an actual career.
This sort of thing is hugely important to me because I wrote an essay called "Why you should become a nurse or physicians assistant instead of a doctor: the underrated perils of medical school" (http://jseliger.wordpress.com/2012/10/20/why-you-should-beco...) which explains what numerous med students, residents, and doctors say they wish someone had told them.
Part of the essay includes this:
Once I realized how nasty the residency match process is and how fundamentally unfair the labor market for residents is, I was shocked: residency programs have formed a cartel designed to control cost and reduce employee autonomy, and hence salaries. I only went to law school for a year, by accident, but even I know enough law and history to recognize a very clear situation of the sort that anti-trust laws are supposed to address in order to protect workers. When my friend entered the match process like a mouse into a snake’s mouth, I became curious, because the system’s cruelty, exploitation, and unfairness to residents is an obvious example of employers banding together to harm employees. Lawyers often get a bad rap in our society, and sometimes for good reasons, but a case like this looked ripe to me.
It turns out that I’m not a legal genius and that lawyers have noticed this anti-trust violation. So an anti-trust lawsuit was filed. You can read about it in the NYTimes, including a grimly hilarious line about how “The defendants say the Match is intended to help students and performs a valuable service.” Ha! A valuable service to employers, since employees effectively can’t quit or negotiate with individual employers. Yes, indeed, curtailing employee power by distorting markets is a valuable service. The article also noted this bit of regulatory capture: