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The Match®: 10 things to know as the day draws nigh

Patrick Boyle , Staff Writer
March 18, 2020

Even as COVID-19 upends daily life, Match Day goes on — sending medical students on the next step in their careers and strengthening America’s health care system.

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Each March, tens of thousands of medical students across the nation simultaneously engage in one of the most exciting rites of their young careers: tearing open envelopes or clicking open emails to learn the hospital or clinic where they will train as residents. After four years of medical school, these graduates will spend several more years (typically, three to five) learning and practicing as residents in their desired specialties. Here are some facts behind The Match®.

A new CEO is in charge: In October, Donna L. Lamb, DHSc, MBA, BSN, became president and chief executive officer of the National Resident Matching Program®, which runs the Main Residency Match®.

“I feel excited and honored to usher so many individuals into their future,” Lamb told AAMCNews. “It’s my hope that applicants are confident in their preparation for their specialty of choice and are also confident that the Match® ensures fairness in the process of residency placement.”

It’s based on a Nobel-winning formula: The Match® is designed to provide a uniform way for graduating medical students to be matched with residencies rather than applying to residencies individually and at different times. The current algorithm, first used in 1998, is based on one developed in the 1960s by mathematicians Lloyd Shapley and David Gale, who sought to figure how to best match members of different groups seeking to be paired — such as students with schools or organ donors with patients awaiting transplants. The algorithm determined how matches can be accomplished as efficiently as possible.

In 2012, Shapley and academician Alvin Roth were awarded the Sveriges Riksbank Prize in Economic Sciences in Memory of Alfred Nobel for their research on the algorithm. See the Match® algorithm explained.

How the Match® matches: Residency applicants and residency programs each create a “rank order list”: for students, a list of residencies they’d like to fill, in order of preference; for programs, a list of students they’d like to accept, also in order of preference.

For a match to occur, the student and program must have included each other on their lists. The algorithm creates matches based on where the students and programs ranked each other. This five-minute video demonstrates how it works.

A two-stage reveal: On Monday, students learned if they have been matched to a residency via emails that were sent out at 11 a.m. ET. On Friday, they learn specifically where their residencies will be during the Match Day ceremonies (either in-person or online), which start at noon ET across the country, or by emails from the National Resident Matching Program® that go out at 1 p.m. ET. Students can also learn about both results through a mobile device.

Coronavirus impact: Many schools have made or are weighing changes to Match Day celebrations as the status of the virus outbreak changes in various regions of the country.

Matches are growing: Last year, a record-high 38,376 applicants submitted program choices for a record-high 35,185 positions. Most of those (32,194) were first-year positions.

Although figures for 2020 have not been released, Lamb said it will be “another banner year for the number of applicants with a certified rank order list participating in the Match®, and there is an increase in the number of positions.”

“It is appropriate for us to celebrate the majority of applicants who match into their training program,” Lamb said, “but we must also work to better understand the circumstances that cause some applicants to go unmatched and who face challenges about how to navigate their education and career.”

Ups and downs: Lamb noted that certain specialties showed significant increases in match rates last year for MD seniors: orthopedic surgery, neurological surgery, dermatology, plastic surgery, and radiation oncology. Specialties that saw declines included otolaryngology-head and neck surgery, obstetrics-gynecology, anesthesiology, and diagnostic radiology.

Alternative matches: The Main Residency Match® is by far the largest program, but other match services include the Urology Match (run by the American Urological Association and offering more than 300 residencies); San Francisco Residency and Fellowship Match Services (for ophthalmology, with 484 matches last year, and plastic surgery, with 58 matches last year); and matches for specific branches of the military through the Joint Service Graduate Medical Education Selection Board.

Second chances: Eligible students who don’t match to a residency program, as well as those who match for only part of their training, can participate in the Supplemental Offer and Acceptance Program® (SOAP®) to try to obtain a residency position that went unfilled through the Match®. SOAP® applications opened on March 16, and students will find out about residency placements on March 20.

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