When it comes to highly competitive specialties...

[Chadleez1]

Like ortho and derm, where spots are few and incredibly competitive, are those spots kept small with the purpose of limiting the number of people who can get in? I've always wondered this.

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[navs]

Actually I would say the purposes is to limit those that graduate!!

That way the make sure they will always be in strong demand out in the private sector.

Great idea, don't u think?? Maybe other fields should do that to prevent their classical cycles.

 

[Chadleez1]

I think that is what I was trying to ultimately get out...but thanks for your answer. It would make sense, in some cases, to try and do that with other specialties.

 

[neutropeniaboy]

•••quote:•••Originally posted by Chadleez1:
•Like ortho and derm, where spots are few and incredibly competitive, are those spots kept small with the purpose of limiting the number of people who can get in? I've always wondered this.•••••That is the thought of the American Board of Otolaryngology and the "Academy" as well. The residency review process is very rigorous. Limiting the number of residencies ensures that otolaryngologists will always been in demand. More importantly, it also ensures that the education residents receive won't be substandard.

 

[Chadleez1]

So does pay reflect these "thougher" specialties?

 

[nyskindr]

There are many reasons for the limitation in size of programs.Training in a highly specialized fields such as ENT,Ortho,Urology etc requires a resident to complete a large number of complex cases to become truly qualified. Few hospitals are in a position to offer the number of supervised cases necessary,and those that are need to be sure that the number of trainees is appropriate to the surgical volume of the hospital.In addition full time faculty required to teach is often difficult to come by as salaries in academic medicine is often much lower than in private practice.Federal funding and reimbursment to hospitals for many specialties have been reduced in favor of primary care residencies.This is a large factor in limiting the number of residency slots.Specialists are costly to train and run up large bills hence the drive to limit them.

 

[wernicke]

I wouldn't put it past these specialties to limit the number of graduates entering and leaving. It definitely ensures a constant demand of these people.

I know that in the field of dentistry, orthodontics and endodontics do limit their graduates on purpose. This ensures the huge amounts of money that they receive after they graduate ($200-$300+). A friend of mine (dentist) told me that several procedures performed by endodontist can actually be performed by the general practitioner. But, dental schools do not teach all of the techniques. This ensures that only the specialists have jobs.

 

[Chadleez1]

Thanks everyone for your insight...it makes it more clear to me as to why some specialties are more limited than others, which I guess I'd always attributed to popularity, money, etc., which is why I figured they wanted to limit them.

 

[mcwmark]

Yes- we were told by a well-known chairman of a department (keeping him anonymous) that the reasoning (beyond any political bs) is really just to ensure job security, procedures, and high compensation for the field. Very simple-supply and demand.

Example: there is a shortage of opthalmologists in the country, but there isn't a large stampede to open more residency slots for those LASIK and cataract procedures.

 

[Chadleez1]

You know, I can't really say I disagree with this practice. I'm sure there are more fundemental issues than those on the surface, though.

 

[Jay Shoaps]

This discussion is rendered more interesting, of course, by the fact that we as med students/docs benefit enormously from the limitation of slots for med school, e.g. compared to other countries where anyone can get in--so I guess it isn't so bad. At least we know that we can get jobs when we graduate, unlike say, lawyers or college professors.