I agree that the AMA is an organization opposed to the individual goals of its members. I don't think that this is an active effort to keep doctors' pay high. It's a provocative headline and I guess it got me, so here comes some word vomit:

From what I see, there are 3 main bottlenecks; acceptance into college, acceptance into medical school, and acceptance into a residency program. This article appears to suggest that we combine the first two hurdles, college and medical school, into a single six-year program probably added on to the offerings of an undergraduate institution. I have no idea how this would look in terms of testing, attrition rates, or overall learning experience, but it does sound pretty similar to some pre-pharmacy and pre-physical therapy programs I've heard of. The LCME, although controlled by the AMA and lambasted by the author, is instrumental in determining which institutions are meeting important criteria and would still need to be retained under this model. The decrease in investment time would be considerable to the future doctors, however, and that could be good.

My main bone to pick is that the doctor positions that we really need in the coming decades are "primary care" roles - doctors that have a clinic and help patients avoid having to go to the hospital if possible. The type of doctor one becomes is decided by the third hurdle; acceptance into a residency program. Graduating medical students compete against their peers both domestic and international for a limited number of training spots which are required to progress to board certification. The most highly contested spots are generally for surgical or radiological specialties, meaning that primary care is implicitly de-emphasized. Of course, that wouldn't be a problem if there were more residency spots, but that part is actually not controlled by the AMA. Residency programs are funded by the federal government through Medicare [(Wikipedia, I'm lazy)](https://en.wikipedia.org/wiki/Residency_%28medicine%29#Financing_residency_programs) and this funding has been FROZEN FOR 10 YEARS, against the stated desire of the AMA. Add to that the fact that hospital systems use residents as underpaid, overworked, powerless versions of doctors that are "only" required to work 80 hours per week on the books, and you can see the abuse potential here.

There's a whole bushel of problems surrounding medical education, and this article touches on a few facets of it but I feel that it points fingers the wrong way, for the wrong reasons, and offers a nonstarter as a solution. Expanding the number of residency slots is absolutely essential to help weather the demographic shift that we are undergoing now, but without careful oversight an expansion will just expand the number of burned-out physicians making life-threatening mistakes after their 20th hour on call. The need for a 4-year college degree is debatable and I could be persuaded on that point, but the 4-year medical school track is the best model we've got right now, and the residency programs are also an essential phase of the training.