This is an interesting debate. The NRMP was established to ensure that the matching program was fair and that hospitals could fill their positions while applicants can be assured that the process was "clean".
I think compensation for residents is fair considering we're all in a "training program" and that the US government pays for our training positions. Residents are paid well now compared to 30 years ago. In my opinion, without residency training, we're all useless; thus, we need the training as much as the hospitals need us.
The AMA has responded to this issue with the following answer, which I support:
Q--Would elimination of the NRMP "match" result in increased compensation for residents or better working conditions?
A?It is by no means clear that elimination of the "match" program would result in increased compensation or better conditions for residents. To the contrary, experience before the institution of the "match" program suggests that its elimination might well result in lower compensation or worse working conditions. In any event, given Medicare funding limitations, if compensation increases dramatically, it is quite possible that there would be a reduction in the number of residency slots. The only certain result would be chaos in the process by which students select their residency programs and by which residency programs find the best students. Anxiety, pressure of deadlines and reduced information as the basis for making decisions would likely result.
For the most highly competitive residency programs, there might even be a downward pressure on compensation.
There can be no certainty that Medicare funding of graduate medical education costs would be adequate?or even that present levels would continue undiminished. Similarly, some commentators have observed that residents might be asked to contribute to the cost of their "on the job" training through tuition possibly resulting in increased levels of indebtedness to pay for such tuition--to be offset by the higher compensation.
