This is such a charged and loaded issue. Astonishing really the sentiment out there. There was another thread exactly like this about a month ago in this same forum.
I've stated many times that the clinical hospitals of most of the caribbean schools that i've rotated at (Every hospital in the Saint Barnabus network, which includes St. Barn, Newark BI, Clara Maass, as well as St. Micheal's are pretty weak. St. Joe's is halfway decent, but that is mainly because the UMDNJ residents go through that for IM [I believe... if I am wrong, then I am sorry]). I am also suspect of the standardization as well as the 5th semester apparently all the carib schools except SGU have. So, I think the bias PD/PC have against US-IMG and FMG's, and so the more difficult time they have getting interviews and residencies is warrented. I also think the prematch is BS. That all said, I have no misplaced sense of entitlement, and for how much of a socialist I have been called on these forums (see Topics in Healthcare if you want more proof), I think these programs should have freedom to pick whoever they want. Tons of people go to undergrad with no gaurentte of a job. There are unemployed or underemployed (or in a different field) from Law school, Business school. As long as doctors are private employees and the job is not a civil service job, as long as people getting the job have valid credentials (which could be the argument... not accepting any foreign credentials or not accepting any carib credentials, but the ECGME or whatever the letters are in control of that, and since they accept credentials, hospitals can too and these people can enter residency), PD/PC should have the right to pick whomever they want for, essentially whatever reason they want as related to their ability to do the work (not picking someone they think can do the job besides the fact they are a female, minority, homosexual and for no other reason is slightly different... not being able to communicate properly in the language does effect your job performance, going home and bumping uglies with another dude does not).
I have shared some horror stories of overqualified people almost not getting a job, and some horribly unqualified people getting a job... it doesn't just happen in medicine, but in every other business. And almost all of you arguing here to entitle medical students residency also decry the idea of any health reform that brings doctors close to being government employees. But even then, in nationalized countries like england and the NHS, they import doctors from India as well... we can't have it both ways... if Medicine is a private corporation industry of goods and services, even if Medicare pays for the residency spots, we have no obligation of service to medicare/the government after the residency spot, and there is no obligation for US AMGs to get those spots.