Abstract
IntroductionThe “stable marriage” algorithm underlying the National Residency Match Program (NRMP) has been shown to create optimal outcomes when students submit true preference lists. Previous research has shown students may allow external information to affect their rank lists. The objective of this study was to determine whether medical students consistently make rank lists that reflect their true preferences.MethodsA voluntary online survey was sent to third-year students at a single midwestern medical school. Students were given hypothetical scenarios that either should or should not affect their true residency preferences and rated the importance of six factors to their final rank list. The survey was edited by a group of education scholars and revised based on feedback from a pilot with current postgraduate year 1 residents.ResultsOf 175 students surveyed, 140 (80%) responded; 63% (88/140) reported that their “perceived competitiveness” would influence their rank list at least a “moderate amount. Of 135 students, 31 (23%) moved a program lower on their list if they learned they were ranked “low” by that program, while 6% (8/135) of respondents moved a program higher if they learned they were ranked “at the top of the list.” Participants responded similarly (κ = 0.71) when presented with scenarios asking what they would do vs what a classmate should do.ConclusionStudents’ hypothetical rank lists did not consistently match their true residency preferences. These results may stem from a misunderstanding of the Match algorithm. Medical schools should consider augmenting explicit education related to the NRMP Match algorithm to ensure optimal outcomes for students.
Highlights
The “stable marriage” algorithm underlying the National Residency Match Program (NRMP) has been shown to create optimal outcomes when students submit true preference lists
Medical schools should consider augmenting explicit education related to the NRMP Match algorithm to ensure optimal outcomes for students. [West J Emerg Med. 2020;21(1):4-7.]
When asked to advise a friend on scenarios that should influence a rank list, 96% (126/131) advised that they should move a program up their rank list to be closer to an ill parent and 77% (101/131) advised that they should move a program down their rank list if a global health director, who was the sole reason for their interest in the program, was leaving
Summary
The “stable marriage” algorithm underlying the National Residency Match Program (NRMP) has been shown to create optimal outcomes when students submit true preference lists. The National Residency Match Program (NMRP) algorithm has been shown to create optimal outcomes for students when students and programs submit true preference lists.[1] Despite this, previous research and anecdotal reports suggest that students may allow external information, such as perceived competitiveness, to influence their rank lists. This may be because historically it was possible to “game” the Match, as of the most recent revision in 1998, this is no longer true.[2] Multiple studies have shown that students alter their rank lists based on post-interview communication with programs.
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