The Urology Residency Match

Yesterday was Match Day for urologists, a medical specialty that runs its own residency match, in advance of the NRMP.

They write: "This year's Match once again proved urology is a competitive specialty for aspiring young physicians. More than 430 applicants registered for the 2019 SAU/AUA Urology Residency Match. Of those who registered, 90 percent submitted preference lists, competing for a record 339 available positions across the country. When the matching algorithm was processed, 85 percent matched to a vacancy within 136 registered and accredited U.S. training programs, leaving only nine vacancies unmatched."

Here are the statistics from the AUA's web page:

Urology Residency Match Statistics

There are 137 non-military accredited urology residency programs in the United States. (Military programs cannot participate due to government regulations regarding eligibility.) For 2019, 135 non-military accredited urology residency programs in the United States listed 339 positions with 330 vacancies being matched. 389 applicants submitted preference lists netting 59 unmatched applicants. Of the senior medical students in the U.S. applying, 91% percent were matched.

View additional 2019 Urology Residency Match Statistics [pdf]

	Jan 2019	Jan 2018	Jan 2017	Jan 2016	Jan 2015	Jan 2014	Jan 2013
Programs
Positions Offered	339	325	319	295	296	285	279
Positions Filled	330	314	317	294	295	285	279
Positions Open	9	11	2	1	1	0	0
Applicants
Registrations	434	436	477	468	493	534	537
Lists Submitted	389	402	422	417	433	446	434
Ranked by Programs	368	369	385	373	388	420	400
Matched	330	314	317	294	295	285	279
Not Matched	59	88	105	123	138	161	155
Averages and Match Results
Average Applications	71.0	70.0	68.0	65.0	63.0	59.0	53.0
Average Interviews	37.0	11.0	11.0	10.0	10.0	10.0	9.0
Average Offers	14.85	13.78	11.77	11.35	12.23	9.35	8.87
US Seniors Matched	91%	86%	82%	77%	77%	68%	69%
US Graduates Matched	78%	43%	47%	47%	43%	15%	33%
Int'l Graduates Matched	58%	24%	33%	17%	31%	24%	23%
Women Matched	83%	75%	75%	68%	68%	65%	68%

******************
And here's some process data from the pdf:

HT: Mike Rees

Fifty years of "brain death"

There was a time when death came in threes: neurological, respiratory, and circulatory processes all shut down more or less together, because when a body lost one of these the others inevitably followed very quickly.  But what makes most deceased organ transplantation possible is that respiration and circulation can be maintained on a ventilator after the end of neurological activity, so that organs can remain oxygenated after the brain has died.

The Uniform Determination of Death Act (UDDA) states that an individual who has sustained either:
"an irreversible cessation of circulatory and respiratory functions, or
an irreversible cessation of all functions of the entire brain, including the brain stem, is dead."


A recent Hastings Center Report discusses brain death on the 50th anniversary of its 'birth'.


Brain Death at Fifty: Exploring Consensus, Controversy, and Contexts
Robert D. Truog  Nancy Berlinger  Rachel L. Zacharias  Mildred Z. Solomon

Abstract: This special report is published in commemoration of the fiftieth anniversary of the “Report of the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death,” a landmark document that proposed a new way to define death, with implications that advanced the field of organ transplantation. This remarkable success notwithstanding, the concept has raised lasting questions about what it means to be dead. Is death defined in terms of the biological failure of the organism to maintain integrated functioning? Can death be declared on the basis of severe neurological injury even when biological functions remain intact? Is death essentially a social construct that can be defined in different ways, based on human judgment? These issues, and more, are discussed and debated in this report by leading experts in the field, many of whom have been engaged with this topic for decades.
***********

And here's an article about the report in Forbes (it seems to be in their section on "retirement":-)
What Does "Dead" Mean? The Debate Continues Some 50 Years After Harvard Defined Death.  Robin Seaton Jefferson

“Capron, one of the architects of the UDDA, summarized the situation well in 2001 when he described efforts to determine when death has occurred as both ‘well settled, yet still unresolved.’
**********

The article suggests that we won't have to worry about precise definitions of death once we don't need deceased donors for transplantation any more, but I'm not so sure.  Ventilators help keep people alive while their bodies are struggling, and some will recover.  But if not, there is still often a decision to be made about when to disconnect the ventilator, and make it available for someone who still has a chance of recovery.

Carbon tax with revenue returned through equal lump-sum rebates: open letter

An open letter from many economists, published today as an op-ed in the Wall Street Journal, proposes a carbon tax with the revenue to be returned to taxpayers, as a way to put incentives in place to deal with climate change.
 Here it is in the WSJ: 
Economists’ Statement on Carbon Dividends--Bipartisan agreement on how to combat climate change.

And you can click through to the oped (ungated) and related articles at https://www.clcouncil.org/?mod=article_inline

ECONOMISTS’ STATEMENT ON CARBON DIVIDENDS

27 Nobel laureates, all 4 former Fed Chairs, and 15 former Chairs of the Council of Economic Advisers unite behind carbon dividends as the bipartisan climate solution.

• Wall Street Journal op-ed
• Washington Post
• Axios
• Wall Street Journal article

Organ donation in Germany

Spiegel.de has the story:
Nach langem Abwärtstrend, Zahl der Organspender deutlich gestiegen
(GT: After a long downward trend, the number of organ donors has increased significantly)

"Last year, 955 people left organs for other critically ill patients after their death, as the German Foundation for Organ Transplantation (DSO) announced. That was an increase of nearly 20 percent compared to 2017 with 797 donors and the first major increase since 2010.
...
"a discussion on new organ donation rules has started in parliament across parliamentary boundaries. So far, withdrawals are only allowed with expressly agreed consent, but many postpone the occupation with this topic again and again.

"Spahn is therefore campaigning for a "double contradiction solution" ["doppelte Widerspruchslösung"]. Accordingly, everyone is automatically considered a donor. One should be able to say no to this, otherwise - as a double barrier - relatives would have to be asked. In an open debate in the Bundestag at the end of November broad reservations against such a new regulation became clear.

"Instead, a group led by Greens leader Annalena Baerbock and left-leaning boss Katja Kipping suggests a mandatory recurring query, such as collecting new passports or identity cards - with the option of not yet deciding."
**********

HT: Rosemarie Nagel

Repugnance watch: what to do with a mass-murderer's gun collection?

The NY Times has the story:
A ‘Moral Dilemma’ After Las Vegas Massacre: Sell the Gunman’s Weapons, or Destroy Them

"When the gunman in the Las Vegas mass shooting died, he left behind a hoard of guns and firearm accessories in his two Nevada homes and the hotel suite he used as a perch for his attack.
...
"Now, the main lawyer involved in passing on Mr. Paddock’s nearly $1.4 million estate to the families of the 58 people he slaughtered at an outdoor country music festival is facing a quandary. Should the firearms be sold to raise as much money as possible for the bereaved, or would it be more appropriate to destroy the guns in an emblematic rejection of the kind of violence that Mr. Paddock carried out?
...
"Mr. Paddock died without a will. Lawyers for the victims encouraged Mr. Paddock’s mother — who, under Nevada law, became the heir by default — to give his assets to the estates of the 58 people killed by her son. The mother, Irene Hudson, transferred her right to inherit the estate in March of last year.

"In addition to those killed, hundreds of others were injured in the shooting. However, lawyers say the compensation should go to the loved ones of the dead rather than the injured, saying the money would have greater impact on their lives than if the large number of people hurt in the rampage were also beneficiaries.

Legal and illegal markets for marijuana in Canada

The Canadian newly legal market for marijuana is having trouble competing with the illegal market. It may be a question of design:

Canada legalized pot in October. But its black market is still going strong

"When the government launched Canada’s official recreational-pot market on Oct. 17, it was banking on the idea that many users would prefer to buy legally and that the black market would quickly begin to fade. It says things seem on track, with “early reports of a 65 percent reduction for illegally sourced products,” according to a spokeswoman for the minister in charge of the cannabis file.

But there are also signs things aren’t going as expected.

In a national poll Ipsos conducted for Global News a month after legalization, more than a third of Canadian cannabis users said they were still buying from their regular dealers and hadn’t even tried the legal system.  

...

"The government’s most jolting decision, illegal dealers here said, was to structure the new industry in a way that tended to bar them from it. In 2015, when the government first committed to legalization, many of them planned to apply to open private shops.

“All of us thought, ‘Okay . . . I’m going to be able to come out of the shadows and I’m going to be able to pay taxes,’ ” David said. “As time went on, it became clear that’s not what they were after.”

"In Quebec and several other Canadian provinces, all cannabis stores are government-run, leaving no path to legality for people like David, who has worked in the underground industry for more than a decade, operating his business full time for several years."

College admissions: early decision stats for this season

The Washington Post looks in on early decision (and early action) college admissions:
Early applications surge at prestigious colleges. So does early heartache.

"Early applications have been expanding for years, but last month some big-name schools reported record-setting spikes. Totals were up 9 percent at Dartmouth College, 19 percent at Duke University, 21 percent at Brown University.
"Some counselors worry the trend is widening the divide between haves and have-nots because early application programs often require those admitted to enroll. That proviso, known as “early decision,” tends to help the affluent.
Many students need to compare financial aid offers and weigh whether to take out loans.
...
"Still, highly selective colleges and universities often fill a third to half of their first-year classes through early rounds — which makes the regular round even more competitive. To address equity concerns, schools typically pledge to give students in need the same financial aid they would have received if they had been admitted in the regular cycle."

Non-transplant tissue banks

The Brown Political Review (a student publication at Brown University) takes a look at the lightly regulated market for cadavers and body parts for uses other than transplants:

Merchants of Death: The Thriving, Unregulated Body Brokerage Industry
BY JONATHAN HUANGNOVEMBER 27, 2018

"Cadavers are irreplaceable in both the training of new medical students and medical research. Companies that make medical products also rely heavily on human tissue. Many medical schools operate their own donation programs, which provide the majority of cadavers needed for their education and research. However, many other bodies are obtained from body brokers. These body brokers, also known as non-transplant tissue banks, serve as middlemen between the recently deceased and the market for cadavers. They solicit donations from patients or their families, dismember or otherwise process the bodies as required, and sell what remains to the highest bidders. Each part has a price: a foot may sell for $250, a head might fetch $1,000. For these businesses, bodies are raw materials to be harvested and sold to other institutions for further use."

Econometricians as engineers: Susan Athey on machine learning

At the recent ASSA/AEA meetings in Atlanta,Susan Athey presented the
AEA/AFA Joint Luncheon - The Impact of Machine Learning on Econometrics and Economics 
Susan Athey, Stanford University, introduced by Ben Bernanke, Brookings Institution

You can see the video of her talk here (and videos of other talks here).

She spoke about the complementarities between econometrics and machine learning. Much of the talk was about how economists interact with computer scientists and other kinds of data scientists in the role of tech-company engineers and market designers.  Here is a photo of her final slide.

  
(maybe easier to read below, taken from the video...)

Repugnance watch: Illegal migration crisis? It's hard to see in the numbers

Listening to President Trump Tuesday night, there's no doubt that he thinks many Americans can be rallied around the idea of an illegal immigration crisis.

I'm no expert, but evidence for that crisis is hard to see, and not just in the border state I live in.  Here's a report through 2016 by the Center for Migration Studies.

The US Undocumented Population Fell Sharply During the Obama Era: Estimates for 2016
Robert Warren, Center for Migration Studies

"Introduction
In the myriad discussions of undocumented immigration over the past two years, two of the most significant and underreported facts are that: (1) after 2000, arrivals from Mexico dropped sharply, falling to their lowest levels since the 1970s; and (2) the total population, as well as the population of most of the states and countries of origin, are lower now than they were in 2010. This report provides evidence that the historic shift from growth to decline continued in 2016."

More commentary on the shortage of transplantable kidneys, and compensation for donors

The recent editorial by McCormick, Held and Chertow continues to attract comments.  Here are three more.

From the Washington Post:
What if we paid people to donate their kidneys to strangers? by Megan McArdle.

"What if a simple policy could save tens of thousands of people every year from a deeply unpleasant treatment followed by early death? A policy that would disproportionately help the most disadvantaged? While actually saving taxpayer money?

"That’s a pretty rare combination; presumably you’d be pretty excited. But what if the policy involved paying people to donate one of their kidneys to a stranger?

"Possibly you are now less excited. Possibly you are now picturing a sci-fi dystopia where the poor serve as organ farms for the wealthy. Which is what such people as Gabriel Danovitch worry about.
...
“It’s about health and welfare,” says Danovitch of his transplant work. “We’re not talking about a financial interaction.”

"But . . . aren’t we? Transplant surgeons make hundreds of thousands of dollars a year for their work. In fact, everyone in the operating room except the donor is getting handsomely rewarded.

"And indeed, payments to health-care providers can distort patient care, sometimes harming patients. Yet no one suggests moving to an all-volunteer health-care system, because the distortions introduced by paying providers are infinitely preferable to what would happen if we refused to pay them."
***********

From Vox:
Study: the kidney shortage kills more than 40,000 people a year. You can help.
By Dylan Matthews
"If there were enough kidneys for everyone in the US who needed one, we could save 43,000 lives every single year.

"That’s the conclusion of researchers Frank McCormick, Philip Held, and Glenn Chertow, in an editorial published in the Journal of the American Society of Nephrologists.
**********

From the Volokh Conspiracy:
Laws Banning Organ Markets Kill Even More People than Previously Thought
New analysis finds that thousands more die every year because the law forbids purchase of the kidneys they need to survive.
Ilya Somin

"The injustice of status quo policy is more than just a matter of failing to help people in need. It is the equivalent of actively killing them. Consider a situation where Bob needs to buy food in order to keep from starving. Producers are willing to sell him what he needs at market prices, but the federal government passes a law saying that it is illegal to sell food for a profit. Bob is only allowed to acquire such food as producers are willing to give him for free. If Bob starves as a result, the government is actively culpable for his death. It cannot claim that it was merely an innocent bystander who refused to help him in his time of need. The same point applies if the government (or anyone else) uses coercion to prevent people from selling organs that ESRD patients need to live."
##

I'm reminded of earlier posts by these conspirators:

Saturday, July 18, 2009

Eugene Volokh on kidney transplantation and the law

and this 2007 essay in the Harvard Law Review:
Medical Self-Defense, Prohibited Experimental Therapies, and Payment for Organs
Essay by Eugene Volokh

Harm reduction: quality assurance for illegal drugs in Australia

The WaPo has the story, from Australia

Music festivals are offering to test the safety of people’s drugs and police are increasingly liking the idea

"MELBOURNE, Australia — When young visitors from around the world headed to Australia’s Groovin the Moo music festival in Canberra last summer, public health policy researchers were watching carefully. In a rare decision, local officials there had allowed the installation of a pill testing facility, allowing festival goers to have illegal substances examined for unusual and potentially even more dangerous additives, without having to fear arrest.

"For a long time, authorities at festivals in Australia and elsewhere almost entirely focused on preventing people from taking drugs in the first place. That approach has done little to drive down the number of drug-related deaths, however, and a mounting body of research suggests that pill testing facilities might be a more promising strategy.
...
"While the idea has recently gained more support, drug tests aren’t new and have also been tried out in some parts of the United States. Installing such facilities at music festivals has de-facto been the norm in some European countries, including the Netherlands and Austria, for more than a decade. But amid more detailed research and increases in drug-related hospital admissions, supporters of drug tests are now also gaining momentum in Australia and New Zealand, where authorities have so far only allowed limited trials.
...
"Critics argue that the approach could encourage young people to take more drugs and that it sends the wrong message. On-site tests have also been singled out for being inaccurate, given the sometimes limited availability of equipment.

But supporters of the tests maintain that their approach is far more effective than focusing on arrests. Pill testing “has been shown to change the black market” for the better and may even decrease overall drug consumption, as “negative results would deter a majority of people from consuming drugs and spur them to warn their friends,” according to a summary of arguments in favor of tests by Australia’s parliamentary library. Research by the Global Drug Survey came to a similar conclusion last year."

Israel adopts the 'Nordic model' of criminalizing the hiring of prostitutes

The Jerusalem Post has the story:

ISRAEL BECOMES 10TH COUNTRY TO CRIMINALIZE HIRING PROSTITUTES
When the law goes into effect, a first-time offender will be fined NIS 2,000 for hiring or attempting to hire a prostitute and NIS 4,000 for further offenses.

"The Knesset on Monday passed a landmark law against prostitution making hiring sex workers a crime, rather than the work itself.

The law makes Israel the 10th country to institute what is called the “Nordic Model” of combating human trafficking and prostitution. 
*********
Here's Haaretz, which speaks about the eradication of prostitution (which seems unlikely to this observer of black markets...):

Israel Passes Law Banning the Buying of Sex

"According to the law, which passed in a 34-0 vote, anyone buying or attempting to buy sex would be fined 2,000 shekels ($534), which doubles for a second offense. For any further violations the offender could be prosecuted and the fine could reach 75,300 shekels.

"The law goes into effect in a year and a half, to give the state a chance to create rehabilitation services for prostitutes. An interministerial committee on reducing prostitution recommended that the government allocate tens of millions of shekels for this purpose.
...
"Justice Minister Ayelet Shaked, who did not come to the Knesset but turned the bills into a government-sponsored proposal, said that the “consumption of prostitution is a moral failing that seriously harms the status of women. A woman’s body is not an object to be sold to the highest bidder.”

MK Shelly Yacimovich (Zionist Union), who actively promoted the bill, said that “the war on the clients of prostitutes is similar to the war on slavery and the freeing of slaves, no less. In the beginning, the call to make the johns the offenders was considered radical and revolutionary, but in the end we arrived at this law, which is definitely a significant and historic step.”

"Attorney Nitzan Kahana, codirector of the Task Force on Human Trafficking and Prostitution, said the passage of the law ended 2018 with good news for all Israeli women.

“The Knesset is fulfilling its obligation to work with all its might to eradicate the cycle of prostitution,” she said. “We promised to end exploitation for prostitution, which is a social disgrace for us all and initiates many young women into a world of exploitation and violence. Today we took a historic step.”

Market design on Sunday

8am at the ASSA conference would be incomplete without a final session on matching markets:

Matching Markets - Behavioral Issues and New Theoretical Approaches

Paper Session

 Sunday, Jan. 6, 2019   8:00 AM - 10:00 AM

 Atlanta Marriott Marquis, L507

Hosted By: ECONOMETRIC SOCIETY

• Chair: Jacob Leshno, Columbia University

Strategic ‘Mistakes’: Implications for Market Design Research

Georgy Artemov

, 

University of Melbourne

Yeon-Koo Che

, 

Columbia University

Yinghua He

, 

Rice University

•  View Abstract
 
•  Download Preview (PDF, 1.39 MB)

The Cutoff Structure of Top Trading Cycles in School Choice

Jacob Leshno

, 

Columbia University

Irene Lo

, 

Columbia University

•  View Abstract
 
•  Download Preview (PDF, 1.67 MB)

Complementary Inputs and Stability in Large Trading Networks

Ravi Jagadeesan

, 

Harvard University

•  View Abstract

Obvious Dominance and Random Priority

Marek Pycia

, 

University of California-Los Angeles

Peter Troyan

, 

University of Virginia

•  View Abstract

Discussant(s)

Allan Hernandez Chanto

, 

Queensland University

Ran Shorrer

, 

Pennsylvania State University

Alexandru Nichifor

, 

University of Melbourne

Shengwu Li

, 

Harvard University