Thursday, April 17, 2014

Did I ruin the medical labor market?

Students of economics are sometimes surprised that many of the things they know aren't known by everyone.

So a number of people have emailed me the blog post on the Forbes magazine web site that is headlined How A Nobel Economist Ruined The Residency Matching System For Newly Minted M.D.'s, and subtitled Match Magic: How One Economist Hurt Physicians and Patients.

In it, a graduating medical student who apparently just went through the Match a month ago argues that she would have done much better if there hadn't been a match, since then she could have picked a better job, in a nicer city, at a much higher wage. And she would have been spared the expense and inconvenience of interviewing. Because in a free market you are free to choose the job you want. That's the way economists get their jobs, she concludes.

A quick search of the web quickly reveals that other docs have a different view of the match and of markets more generally. Here's a post from a blog site called Skeptical Scalpel, which begins this way

"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.

"Ms. Ho blames the Match for the fact that 25% of those enrolled in 2014 failed to obtain a residency position. But even if the Match did not exist, there would still have been more than 34,000 people seeking some 26,000 positions, and 8000 doctors would not have found jobs..."

The NRMP data are here: 
94.4% of seniors at U.S. medical schools were matched in the main match. (Table 4).

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