The meme about AMA artificially limiting the supply of new residency slots turned out to be much more complex the more I read about it (and IMO mostly incorrect, at least as described by the just-so stories on the internet where I first learned about it).

The actual limiting factor is federally funded residency positions which are funded by CMMS, and were artificially capped by the Balanced Budget Act of 1997 during a widespread climate of financial austerity after Gingrich had led Republicans to retake the House in 1994 for the first time in decades.

At the time, AMA apparently did release a report that included support for reducing the number of residency slots, so that detail is correct. But the decision wasn't made by them, and federal healthcare spending was already on the chopping block (and was a politically attractive area to make cuts given the Clinton's administration failed healthcare reform proposal).

As early as 2006 [4], the AMA started releasing policy position statements requesting caps on federal funding to be increased, but it wasn't until the CARES ACT in 2020 that Congress funded 1000 new CMMS funded slots were funded (but limited to small gradual increases each year) and started to be implemented in 2021-2022. And they continue to advocate for increases that so far haven't been adopted.

So while there's a kernel of inarguable truth that the AMA and other medical professional groups did support certain caps back in 1997, it has always been, then and now, a policy decision by Congress. With the motivation to set limits driven by concern over federal healthcare spending inflating budget expenditures.

But it makes for a simpler, emotionally resonant narrative of a shadowy self-interested group pulling the strings at the expense of the public (that also conveniently redirects outrage away from the people actually empowered to fix the problem, or that federal spending is a crucial lever to fix the problem).

[1] https://www.ama-assn.org/press-center/ama-press-releases/ama...

[2] https://washingtonian.com/2020/04/13/were-short-on-healthcar...

[3] https://www.openhealthpolicy.com/p/medical-residency-slots-c...

[4] https://pmc.ncbi.nlm.nih.gov/articles/PMC1785175/

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