They spend 12 years completely sleep deprived (no reason to put med students on 72 hour shifts), and told the ama is unfallible, has teams of researchers investigating causes and effects , and to not trust any outside sources due to snake oil salesmen and harmful cures. They get out owing 500K , and the only way to pay it off is to be a part of the ama. They were brain washed into following the ama , and financially incentivized that is the correct answer.