A blog post entitled "How a Nobel Economist Ruined the Residency Matching System for Newly Minted MDs" appeared on the Forbes website. In it, Amy Ho, the medical student author, lists all the things she considers wrong with the National Resident Matching Program (the "Match").
I would have commented about this on the site itself except that I have a lot to say, and in order to post a comment, I would have had to agree to allow Forbes to post tweets in my name. No, thanks.
The title of the post is misleading. As the author noted, the Match as been around since 1952. It was established to make the process of finding a residency position fair for all graduating medical students. Alvin Roth, the economist who shared a Nobel Prize based in part on his work with the Match algorithm, simply refined the process in the 1980s and 1990s to make it even more fair. Roth didn't ruin the Match; he made it better.
She also says the system is wasteful because millions of dollars are spent on travel for interviews each year. I suppose applicants could be interviewed on Skype or FaceTime, but how would they meet residents, see the facilities, and assess the programs? I think most job applicants would prefer to take a look at the place they might be employed at for 3 to 7 years.
In a real stretch, Ms. Ho complains that the Match hampers dual degree applicants such as those with MD/JD, MD/MBA and MD/MPH degrees from negotiating higher salaries from hospitals. It's fine if a student wants to earn a combined MD/JD degree, but as a former program director, I question whether such a degree really provides more value for a residency program. She argues that mean earnings for 25-34-year-olds with doctorates or professional degrees are $25,000-$35,000 more than first-year resident salaries. Maybe not just dual degree graduates but all first-year residents should be given higher salaries since an MD degree is in fact a doctorate. And by the way, MBAs and MPHs are not doctorates.
She writes: "For hundreds of students a year, the Match means a change in career, as students who do not match in their preferred specialty are often forced into an alternate career specialty if they would like to practice as a physician. It also means a change in life circumstance, notably, for those with preferred location given family situations or with spouses unable to find a new job in the short two-three months between Match day and residency start dates in June."
How would that change if the Match disappeared? Everyone can't be a dermatologist, and everyone can't be a resident in San Francisco. There are only so many programs.
She concludes "it's about time to trash the Match," but doesn't say how she would replace it. Would she like to return to 1951 when an applicant had to decide whether to commit to the first offer he got or take a chance and interview at a few more hospitals? I don't think so.