An article by Dr. Joseph Bernstein in
Clinical Orthopaedics and Related Research (December 2017, Volume 475, Issue 12, pp 2845–2849 ) argues that a signaling mechanism might help deal with congestion in the Orthopaedic Surgery match.
"
Not the Last Word: Want to Match in an Orthopaedic Surgery Residency? Send a Rose to the Program Director," (gated)
I was invited to write the comment, below, which appeared along with two other (less favorable) comments from surgeons. (All of the comments appear, without titles, in the same Not the Last Word column at the link...)
Roth,
Alvin E. “Congestion and signaling in residency matching,” Clinical
Orthopaedics and Related Research,
December 2017, 475: 2847, 2849
Now that applying to many residency programs is easy, programs
receive so many applications that they have trouble deciding whom to interview,
particularly because receiving an application is no longer as strong a signal
of interest as it was when applying was harder [1]. The same could be said for
how residents applied to colleges when they were younger, and how they will
apply to fellowships when they are older. The internet and common application
tools make sending applications easier, and evaluating them harder. (This is the
common problem of congestion: e.g. it’s
harder to use email when we get too many emails, etc.…)
In congested markets, in which not every interesting
applicant can be interviewed, signals are important. An application itself is a
signal about an applicant’s accomplishments. Like a peacock’s tail, it shows
how desirable a candidate is, i.e. why the program should be interested in the
applicant. When a program receives too many applications it becomes more costly
to read them all, but each one continues to convey the applicant’s
accomplishments.
What is lost when applications are easy to send is how interested the applicant is in the
program. And, in a congested market, it helps to be able to signal not only how
interesting you are, but also how interested, because programs that can’t
interview every attractive applicant need to devote much of their interviewing
to applicants who might ultimately be interested.
In Economics, the AEA’s signaling system allows each
candidate to send no more than two signals of particular interest in being interviewed, for free [2]. Why [only] two? Because while it can be shown
how one signal can unambiguously improve the process of selecting candidates
for interviews [3], too many signals could harm the process. Suppose we allowed 50 signals: then the absence of a signal would start to be a
signal itself (“this candidate must not be interested in us at all if he didn’t
even send us one of his 50 signals…”)
Signals get much of their value by being scarce. So when you can send
only two, a program which receives one knows that you targeted them as one of
only two recipients.
To which programs should a candidate signal? We advise
candidates not to send either of their signals to the very top programs in
their field. Those programs can simply interview the candidates they like best,
since they have good reason to believe that every application signals genuine
interest. Signals will do the most good if sent to programs that should be
interested in the candidate, but to whom it might not be obvious that he or she
is interested in them.
The resident match removes congestion from the process of
making offers and accepting or rejecting them, since each participant can
submit a long rank order list that is processed centrally [4]. But interviewing
remains congested, because interviews take time. It is worthwhile considering how
changes in the market design [5] could smooth the process. Organizing a signaling system—and then
monitoring how it works--seems like a promising step.
[1] Bernstein, Joseph, “Want to Match in an Orthopaedic
Surgery Residency? Send a Rose to the Program Director,” this journal, this
issue [?]
[2] Coles, Peter, John H. Cawley, Phillip B. Levine, Muriel
Niederle, Alvin E. Roth, and John J. Siegfried, “The Job Market for New
Economists: A Market Design Perspective,” Journal
of Economic Perspectives, 24,4, Fall 2010, 187-206.
[4] Roth, Alvin E.
“The origins, history, and design of the resident match,” JAMA. Journal of the American Medical
Association, vol. 289, No. 7, February 19, 2003, 909-912.
[5] Roth, Alvin E.
Who
Gets What—and Why: The New Economics of Matchmaking and Market Design, An
Eamon Dolan Book, Houghton Mifflin Harcourt, Boston, New York,
2015.
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