University based residency programs?

Would you mind restating that question? I couldn't understand what you are asking.

 

I haven't drank enough tonight to understand that.

 

If I am understanding the question correctly:

That is a broad generalization that is not true. Sure, some University-based residencies are not competitive, and most spots are filled by IMGs, but others are impossible to get into without having done research, getting high Step I scores (and maybe AOA), getting multiple Honors-designations on third year clerkships, and receiving great letters of recommendation (even for primary-care spots).