according to the media reports, he lowered his colleagues evals so that he would "rank" better in comparison. So, he didn't need to jack his evals excessively high if he also lowered his ~competitions evals somewhat.
In some senses, yes, there is some rivalry. However, I was never in a program in which there was a ~electronic/computerized transcript during residency. There was no way to really change "rankings". Also, after graduating, nobody in my program was "ranked" like ~first in class or val dictorian or etc... So, the story and sugested system is interesting and unfamiliar to me.
The pyramidal system as you describe is no longer allowed. Accredited programs admit only the number of categorical interns as they are allowed to graduate categorical chiefs. You may have some turn over and changes in the "classes" as they progress. Some individuals may drop out, change residencies, not be continued and some may fall a class or two behind because of some years of research during residency. But, no programs are not allowed to run a pyramid system.
It means they have 24 prelim/transitional spots and 6 categorical. Though, 24 seems alot, there is a ratio of categorical to prelim spots that are allowed. It is not a 1:1 ratio. I actually think it is a 2-4:1 ratio of prelim to categorical allowed.
My favorite line in the article is:
Yep, the licensing board needs to have a reasonable expectation that someone given license will behave in a predictable and reliable fashion. Someone that just has impulses to engage in insanity, is not diagnosed, and does not seem to have a predictable "disease" that can be reasonably under treatment can not be trusted. Licensing boards provide licenses to bipolar, addicts, and other mental disorded physicians as long as they can show evidence of appropriate ~disease control.
i hope not ob/gyn or pediatrics then....
