The Market Structure of Residency Training

To the Editor: Whitcomb and Caswell, in their articulate Sounding Board article (March 13 issue), 1 have clearly pointed out the fallacy of relying on free-market forces to modify the current overabundance of specialty residency programs and the ultimate maldistribution of physicians in practice. Prestigious teaching hospitals, spurred by the fear of losing their competitive edge, have increased their house staff and the number of their specialty and subspecialty programs without heed to the medical needs of the population they serve, without attention to the costs of duplicative tertiary care services within a limited geographic area, and without recognition of their . . .