of course can be criticized, but when FMGs are the predominant takers of all of these fellowships, discussion of the ethics of fellowships that are non-accredited should be divorced from the job market discussion to a certain extent. not a popular opinion, but seems to be clear to me.
My impression of jd's point is that a fellowship exploiting foreign grads isn't necessarily germane to the job market discussion, unless of course, they're staying after. The ethics of doing this is a separate topic.
I agree, FMGs (and the exploitation thereof) are more the "target" of these unaccredited fellowships, which is distinct from the US MD/DO job market.
However, I personally view this as a "slippery slope" area. There appear to be two concurrent processes, at least as best available data suggests:
1) A proliferation of unaccredited Radiation Oncology fellowship positions (usually filled by FMG/IMG docs)
2) A yearly surplus production of American-trained Radiation Oncologists (roughly 200 new attendings produced per year, roughly 100 attendings retiring or leaving clinical practice per year)
As the (ultra robust) ARRO survey demonstrates, there is currently enough elasticity in the job market to keep new grad unemployment under 5% (as far as we know, and I'll refrain from commenting on the quality of the jobs taken by new grads).
Given current practice, reimbursement, and retirement trends - is it reasonable to assume consistent expansion is sustainable, indefinitely? I don't think it is, but I don't know when the tipping point will happen.
If/when this juggernaut of supply finally goes too far, what is the obvious escape valve for the pressure? Fellowships. All these institutions are effectively preparing for an even bigger army of cheap labor by building out a web of unaccredited fellowships.
So yeah, right now, fellowships and the job market can be separated into two conversations, but the two are far and away NOT divorced.