Monday, April 4, 2011

The gastro fellowship match after five years

A recent article takes stock of the Gastroenterology fellowship match, five years after it was reinstated with some new design rules (about exploding offers):
The Match: Five Years Later, by Deborah D. Proctor et al., Gastroenterology 2011;140:15–18

Proctor et al. report considerable progress, although they continue to monitor violations of market policy. There seems to be a particular issue with respect to research positions.

"...the NRMP/SMS was uniquely set up for our many diverse program offerings. Four tracks were created—Clinical, Clinical Investigator Research, Basic Science Research, and Research—and a reversion process was implemented for the 4 tracks, such that unfilled slots from 1 track could revert to open slots in another track. The GI Match successfully reopened in January 2006 with a match day in June 2006 for fellowship positions starting in July 2007."
"However, we must recognize that not all programs are eager or willing to participate in the Match process."

"The number of fellowship applicants genuinely committed to an academic research career has been
slowly declining. Simultaneously, competition has stiffened for the grant dollars that pay for these research training positions, and the criteria to renew grant support has become more demanding.
Needless to say, the competition for these increasingly scarce, well-qualified, research-track applicants has become fierce, and the authors are aware of several examples during the last application cycle of candidates interested in research being offered fellowship positions outside the Match.

"Although the statistics continue to demonstrate that Match participation is robust, healthy, and gradually increasing, there is also a growing desire to close the loopholes in Match rules that allow a small minority of programs to take unfair advantage of applicants and colleagues."

To summarize the overall encouraging statistics, in the (2006) Match for 2007 positions, 283 positions were offered and 585 applicants applied, of whom 276 were matched. In the Match for 2011 positions, 383 positions were offered to 642 applicants, of whom 362 were matched.

Here are some papers reporting various elements of the Gastroenterology market design.
The match offers programs the ability to have unfilled positions of one kind (e.g. research positions) revert to other kinds of positions via the Roth-Peranson algorithm (see
Roth, A. E. and Elliott Peranson, "The Redesign of the Matching Market for American Physicians: Some Engineering Aspects of Economic Design American Economic Review, 89, 4, September, 1999, 748-780.)

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