The authors respond to a proposal in this issue of Academic Medicine by Ray, Bishop, and Dow, who recommend adopting a free-market approach to the Match in which applicants and programs negotiate directly with each other to find and fill residency positions year-round. This Invited Commentary examines and responds to the reasons Ray and colleagues give for changing the Match and explores their proposal's implications and likelihood of success.The authors question Ray and colleagues' argument that assumptions underlying the National Resident Matching Program algorithm have been violated. The authors suggest there is insufficient evidence for the "July effect" and that the possibility for improvement in physician supply due to the year-round entry of graduates into the workforce ultimately faces the rate-limiting step of caps on residency positions allocated to programs. Most important, competency-based medical education, on which the free-market proposal depends, is not yet sufficiently developed.Nonetheless, the imbalanced ratio of applicants to positions in the Match is contributing to a rise in the numbers of student applications and program interviews. Although the proposed free-market approach might, as Ray and colleagues envision, curtail applications as well as reduce time and financial resources currently expended on the process, it would require significant changes on the part of applicants, residency programs, medical schools, and other stakeholders.Because the proposed free-market approach could reduce some negative effects of the imbalance of applicants and positions, it merits ongoing discussion along with other more immediate practical solutions to issues with the Match.

译文

作者回应了Ray,Bishop和Dow在本期《学术医学》中的一项建议,他们建议采用自由市场的方法进行匹配,在该方法中,申请人和计划直接彼此进行谈判以找到并填补居住职位全年。这篇邀请的评论研究并回应了Ray和同事提出的改变比赛的原因,并探讨了他们的建议的含义和成功的可能性。作者质疑Ray和同事的论点,即违反了国家居民匹配计划算法的假设。作者认为,没有足够的证据证明 “7月效应”,并且由于毕业生全年进入劳动力市场而改善医生供应的可能性最终面临分配给住院医师职位上限的限速步骤程序。自由市场提案所依赖的最重要的基于能力的医学教育尚未得到充分发展。尽管如此,比赛中申请人与职位的不平衡比例正在导致学生申请和计划面试的数量增加。尽管如Ray及其同事所设想的那样,拟议的自由市场方法可能会减少申请并减少目前在该过程中花费的时间和财务资源,但这将需要申请人,居住计划,医学院,和其他利益相关者。由于提议的自由市场方法可以减少申请人和职位不平衡的一些负面影响,因此值得持续讨论以及其他更直接的实际解决方案来解决匹配问题。

+1
+2
100研值 100研值 ¥99课程
检索文献一次
下载文献一次

去下载>

成功解锁2个技能,为你点赞

《SCI写作十大必备语法》
解决你的SCI语法难题!

技能熟练度+1

视频课《玩转文献检索》
让你成为检索达人!

恭喜完成新手挑战

手机微信扫一扫,添加好友领取

免费领《Endnote文献管理工具+教程》

微信扫码, 免费领取

手机登录

获取验证码
登录