The Process Of Matching Hospitals And Residents

1988 Words8 Pages
Problem
Initial Solution
The process of matching hospitals and residents was chaotic and confusing before the NRMP began to be used in 1952. The main way hospitals chose medical students was to extend an offer to the student as early as they could. The demand of the hospitals was greater than the number of students looking for residencies, prompting “considerable competition among hospitals for interns.”1 This competition lead to hospitals presenting students offers earlier than others could. With offers so early, hospitals could not know the final class standings or grades of the students by the time they finished school.1 In the most extreme cases, hospitals would send offers to students two years preceding the internship.1 In 1926, the
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The small adjustments began in 1945; the first of which would help students by resolving “that hospitals should allow students 10 days after an offer had been made to consider whether to accept or reject it.”1 In the year 1946, another change was made and students were given up to eight days to respond.1 In 1949, the AAMC proposed “that appointments should be made by telegram at 12:01 A.M., November 15, with applicants not required to accept or reject them until 12:00 noon the same day. Even this 12-hour waiting period was rejected by the American Hospital Association (AHA) as too long”1. They agreed on the “Appointment of Interns” which contained that “no specified waiting period after 12:01 A.M. is obligatory”3. Even after these changes were made, it was clear that there were still problems in the matching process. “In order to avoid these problems and the costs they imposed, it was proposed, and ultimately agreed, that a more centralized matching procedure should be tried”1.
Second Iteration of the Solution

Ultimately, the students were unhappy with modified original system. Their decisions had to be made quickly and without the ability to consider other offers. The hospitals had to select students before the students had developed any notable skills or even knew their specialty. Named as a form of “congestion” and “market failure” by Roth in 2008, it was evident that changes in the residency matching program needed to be made. Thus,
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