They Passed Over American Doctors
— Chief_Engineer (@ChiefEngineerCE) December 24, 2025
The biggest misunderstanding in the U.S. healthcare debate is that America does not train enough doctors.
We do.
The real failure is what happens after medical school.
Each year, thousands of U.S. medical school graduates fail to match into a… pic.twitter.com/YMwkVON3Lt
They Passed Over American Doctors
The biggest misunderstanding in the U.S. healthcare debate is that America does not train enough doctors.
We do.
The real failure is what happens after medical school.
Each year, thousands of U.S. medical school graduates fail to match into a residency. In 2024, roughly 7 percent of U.S. MD seniors and a higher share of DO graduates went unmatched. These are not unqualified students. They completed medical school, passed required exams, and accumulated substantial debt, yet were denied the final step required to practice medicine.
At the same time, thousands of international medical graduates also matched into U.S. residency programs. This has led some to argue that foreign-trained doctors are simply “better.” That claim misses the point entirely.
Whether some foreign-trained physicians are excellent is not in dispute. Many are. But a rational healthcare system does not intentionally cap training slots in a way that locks out qualified domestic graduates, then declare a shortage and import replacements. Other major countries align medical school enrollment with residency or supervised training capacity so graduates can complete training and serve patients. They do not deliberately create artificial scarcity.
This is not about excluding international doctors.
It is about finishing the doctors we already train.Residency pay is standardized within programs, and duty hours are capped nationally. The issue is not compensation. The issue is scarcity and leverage.
You cannot practice medicine in the United States without completing residency. When residency slots are capped, programs fill every position they are allowed to fund. If qualified Americans go unmatched, the system does not pause or correct itself. It simply moves on to the next eligible applicants.The true choke point is not medical school. It is federally funded residency capacity.
Medicare funding for graduate medical education has been effectively capped since the late 1990s, while medical school enrollment has expanded significantly. Congress allowed the front end of the pipeline to grow without expanding the training capacity required to absorb it.
The result is a structural bottleneck.
Every unmatched American graduate represents years of education, public investment, and personal sacrifice that never translates into patient care. The country produces doctors it refuses to finish training.
The Resident Physician Shortage Reduction Act of 2025 would add 14,000 residency slots over seven years. That helps, but it does not come close to correcting decades of underinvestment.
Until residency slots are expanded at scale, the United States will continue graduating qualified doctors who never get to practice medicine. Hospitals will then cite physician shortages, not because doctors do not exist, but because the system failed to train enough of them.
It is not a shortage of talent.
It is a shortage of residency slots.
And that shortage is policy.Citations-
• American Medical Association, NRMP Match Data and Analysis, 2024–2025
• Association of American Medical Colleges, Medical School Enrollment vs GME Capacity
• National Resident Matching Program, Match Results by Applicant Type
• Educational Commission for Foreign Medical Graduates, IMG Match Statistics
• Norton Rose Fulbright, Congressional Inquiry into GME Funding and Accreditation
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