Physician Shortage in the U.S.
The National Residency Matching Program (NRMP) was created in 1952 to help match medical school students with residency programs throughout the United States. Medical school students create a rank order list of residency programs based on their true preferences and NRMP uses a mathematical algorithm to match applicants to residency programs in a manner such that no single applicant can obtain a better outcome than the one produced by the algorithm. The algorithm is based on the works of mathematicians/economists Lloyd Shapley and David Gale who are known for their contributions to game theory. Since you cannot get a license to practice medicine in the United States without having completed a residency, the Match is a very risky and serious game.
As we’ve learned in the course, in order for a bipartite graph to even be considered for perfect matching, there needs to be an equal number of nodes on each side of the graph (in this particular case, the nodes on one side would represent medical school students and nodes on the other side would represent available residency positions). But various organizations and figures are beginning to warn that there won’t be enough residency positions for all the doctors graduating from US medical schools. That is, some medical school student will not be able to match to a residency program on his or her list, where the list consists of residency positions connected to a particular student by edges. With the millions of newly insured under the Affordable Care Act and expanded Medicaid, there is a growing demand for doctors. But the United States has fewer physicians per capita than many other high income and the U.S. physician supply has been growing slowly. And according to Atul Grover, who is the the chief public policy officer of the American Association of Medical Colleges (AAMC), the number of residencies is growing at a slower rate than the number of people enrolling in medical school.
In 2014, 5.6% of US allopathic (MD) medical school seniors did not match and another 22.3% of US osteopathic (DO) medical school seniors did not matching, which means in total 25% of applicants in the MRMP Match were not matched. Simplistically speaking, this translates into a 25% unemployment rate, which begs the question: how successful is “the Match?” The NRMP uses the same algorithmic system from 60 years ago despite the fact that times and needs of the population are changing. Today, many specialties have more US medical graduates than residency positions. And adding to the problem of not be able to achieve perfect matching, there are international medical graduates and physicians reapplying for residency who also compete in the Match. In an ideal world, there would be a residency position available for each graduating medical school student. As that does not seem to be the case in the United States today where there are students who are assigned a “phantom” node and not matched to any position on their list, many newly minted M.D.s have nowhere to go –consequences of a system that may be considered highly wasteful by some.
Sources:
http://www.nrmp.org/match-process/match-algorithm/