In pursuit of folly

Despite the agreement of most of the professional organizations that are concerned with medical education and health manpower that there is an increasing physician surplus, little has been done to address this problem. The number of entering first-year residency positions has remained relatively stable during the past several years, with the number of applicants consistently in excess of the number of positions. Nonetheless, national or state incentives to decrease the number of residency positions have been criticized frequently. The reasons for the physician surplus, the resistance to adjusting the size of residency training efforts, and the feasibility of existing solutions to balance physician supply with demand are critically reviewed.