Congestion (and lawsuits) in applications for medical residency

  The figure below is a slide from a lecture I once gave about the transition from medical school to medical residencies in the U.S.  The lower row (in brown) represents the Match, which arose in the 1950's to deal with congestion in processing offers and acceptances. (Since 1998 it's been doing that successfully using the Roth-Peranson algorithm).  However the advent of electronic application systems has led to congestion in the application and interviewing process (top row, in blue).  And now that has led to lawsuits.

 

 Here's the story of one lawsuit:

 Residency Software Developer Sues Doctor Who Helped Launch a Competing Product
— AAMC-partnered Thalamus goes after key players in ResidencyCAS   by Rachael Robertson, MedPage Today, September 10, 2026 •

"The graduate medical education (GME) software company Thalamus filed a lawsuit against its competitor Liaison International and ob/gyn leader Maya Hammoud, MD, MBA, over alleged anticompetitive conduct.

"Thalamus brought the suit in July, claiming that the defendants "engaged in a coordinated effort to unfairly compete in the residency application market through anticompetitive means." Specifically, it alleges that Hammoud violated a non-disclosure agreement signed when she was evaluating its technology for a different project -- before she helped launch a competing product. 

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 And here's the story of another:

Doctor Sues Over Residency Application System— Arizona wound care physician calls ERAS a monopoly that's gouging applicants  by Kristina Fiore,  MedPage Today, September 1, 2026  

"A physician is bringing antitrust claims against the Association of American Medical Colleges (AAMC) for what she alleges is a monopoly over the residency application process that's gouging doctors. 

...

"Hilgers PLLC, the Dallas law firm representing Buhrke, filed a similar suit against AAMC last year, alleging its medical school application service, AMCAS, was overcharging students. It made similar allegations against the law school application process.

...

"The current complaint alleges that AAMC makes a substantial part of its income from ERAS fees -- about $120 million annually, from about 64,000 applicants.

"Applicants often apply to dozens of programs in order to have a better shot at ensuring a residency position, at an average cost of about $1,800 per person. Buhrke submitted 81 applications through ERAS, paying $1,691 in total, according to the complaint.

"The vast majority of physicians use ERAS to apply, as it has only two competitors: ResidencyCAS for ob/gyn and emergency medicine, and SF Match for ophthalmology and plastic surgery.


"AAMC also took an equity stake in competitor Thalamus so that it wouldn't be a threat to its monopoly, the complaint alleged. "