I have a major problem with continued residency expansion.
but I gotta be honest, I have never understood the anger surrounding these fellowships. The majority are taken up by FMGs who come here for 1-2 years, and then go back. A small minority of them end up going for the ABR backwards path certification and end up thus impacting the job market, but this is seriously a minority.
I have met and trained with a number of these people. Some are super smart and genuinely want to learn here and go back home and take stuff back. I have even met some that paid a lot of money out of their own pocket just to come observe for 1-2 months before going back, so in comparison a 1 year fellowship where you actually get PAID is a sweet deal for some. (one guy told me he was literally doing it for the money - 60k US salary for a year is a ton in South Asian terms). Some are not so smart or well trained and need the extra year of education before going back. and yes, some are exceptional, are motivated to stay in the US, and get sponsored by the department to enter the 5 year ABR Pathway for certification.
Yes, it's 'cheap labor' for departments that is cheaper than hiring an NP. But it ultimately did not bother me one bit during residency, and I learned a lot from some of the fellows earlier in my training.
I would much rather a department open a 1 year fellowship than try to expand resident slots.