Originally posted by tofurious
Market forces should be able to balance out the number of physicians practicing in these "tight" markets and other less desirable markets if there are a set number of physicians in the total work force. If there is a continuous influx of labor, the laws of supply and demand will never reach an equilibrium.
Of course, your high school econ analysis is probably better than my high school econ analysis. I should shut up before I get banned.
I agree with you in theory. Don't you think that LA, SF, and NY are so competitive that even US grads will have trouble finding a job because of other US grads from California? Most FMGs who train in NY don't seem to stay there, although I am overgeneralizing.
From a purely economic standpoint I agree with you, however the
AAMC has deemed that there will be 25,000+ residencies with only around 18,000 US students released.(These are rough numbers.) This means that the system relies on the FMGs. Theoretically this hurts US doctors, except for the fact that the rate of physician retirement is fairly high and some specialties cannot even keep up. A great example of this is urology and anesthesia. They need to suck up whoever they can to meet the growing demand for services with a shrinking supply of new doctors. When they run out of US grads, they'll take whoever is willing to sign on for residency. Urology doesn't tap into the pool but IM, peds, and anesthesia certainly do.
If the AAMC were to unwisely flood the system with doctors, then the FMG thing would be irresponsible, as US doctors would lose jobs. However I don't think we are there yet. Health care is still growing rapidly and the AAMC still severly controls the number of US grads released per year. They want a shortage as it is better for business and for matching. This could change if the demand for health care were to drastically decrease(i.e. if we became a more healthy, prevention conscious society) but the way things are going with increasing cancer, increasing obesity, etc. this probably won't happen.
One area where are think your predictions are true is CT surgery. There is a huge training infrastructure, which is starting to take FMGs, as fellowships are not filling. Their case volume is drastically decreasing due to interventional cardiology advances, and there will soon be an oversupply. In 2-3 years the CABG may become obsolete( trials are pending). They really should think about cutting back on their total fellowship slots or there will be alot of out of work CT surgeons.