In any powerful group where admission to the group is desirable and competitive, there is nepotism. And as the more prestige, power, and money the group has, the level of nepotism grows. It is really unfortunate though because Orthodontists used to be the cream of the crop but with nepotism, many unqualified students have been admitted. And with more unqualified students, the standard of orthodontic care has decreased.
Don't even get me started with some of the orthodontic residencies with 10-15 residents that are out to make money. They are teaching residents to be orthodontic assistants rather than an orthodontist.
With the direction our field is going, an Orthodontist's work will no longer be distinguishable from a GP who took a weekend course in the future. I feel sad for our profession and more importantly future orthodontic patients.