sure thats fine but what happens when Kansas actually meets these requirements and so does Moffit? Because the assumption is that some of these places will not meet and not all of them have low patient volume
Then they both get to keep their spots. Ideally, the lines are moved so as to get us back to 120-150 a year. I do not care where those cuts are made.
First things first let's talk about basic things that aren't based on case volume. These are my opinions of what should happen at minimum. Feel free to copy and paste them to twitter.
1. There HAS to be a 1:1 Attending to Resident ratio at absolute minimum. 6 attendings with 8 residents is absolutely unacceptable and grounds for immediate contraction. The concept of 'well 2 residents are on research' is an absolute affront to our field.
2. Minimum of 6 attendings to be eligible for a residency program (Willing to compromise on this). I think going through 4 years of residency learning from 4 attendings (the minimum) is not acceptable. For programs with significant numbers of lab-based attendings (say 80/20 research) this has to be 6 full-time equivalents (FTEs), meaning that if you have 2 80% researchers, you need 8 attendings.
3. To piggy back on 1 and 2, 1 FTE Attending: 1 Resident minimum ratio. 5 attendings that are 80% research = 1 Resident. 5 attendings that are 80% clinical = 4 residents.
4. All academic attendings are required to have at least 2 to 3 months every academic year without having resident coverage. If there are not enough attendings to accomodate all the residents (even with the ones that are on research), then contract the residency.
5. Maximum number of hospitals that a resident rotates at during their residency is 3, not including true electives that are resident driven (and not semi-mandatory such as a pediatrics rotation).
I imagine that policies such as these would eliminate at least 10-15 spots a year without even getting into massively increased graduation requirements.