March 18, 2004 is a seriously huge day for almost all 4th-year medical students. It's Match Day.
At 1:00 pm (1300 hours) Eastern Standard time, most every senior medical student in the country will open an envelope, and in that envelope will be the name of a residency program. The students opening these envelopes won't know until then which program they've been matched with. A program on the East Coast? West Coast? Unknown.* The only thing the students do know is that they've already committed themselves, contractually, to whichever program in in their envelopes. When the students sent in their rank order lists, they agreed to begin their residencies at whichever program they were matched with.
No wonder most of them are nervous, anxious, and excited.
No wonder that this system is the target of a lawsuit.
The suit alleges that the Match process is an illegal anticompetitive scheme that allows hospitals to keep wages for resident physicians well below market rates. Supporters of the Match claim that it benefits both hospitals and medical students by eliminating the chaos that occurred before the adoption of the Match.
My opinion? It's probably both.
Wages for residents across the country are essentially uniform across geographic regions and specialties. And they are much, much lower than the wages a resident can command while "moonlighting," or performing work outside of the residency. When you figure in the hours residents work, their wages can sometimes be as low as $10 an hour, making them the cheapest source of medical labor in the entire hospital.
There are generally more residency positions than there are medical school graduates to fill them. If the hospitals weren't conspiring to keep wages low, this undersupply of graduates of American medical schools would cause hospitals to bid up wages and sweeten their working conditions to attract scarce applicants. But wages aren't in danger of going up anytime soon. Working conditions may or may not have improved with the passage of new work-hour restrictions, but the plain fact is that hospitals are not competing for residents on the basis of wages.
On the other hand, there are undoubtedly some benefits which residents receive under the Match. Exploding offers? Nonexistent. Third-years inking employment contracts with the choice residencies? Doesn't happen. People familiar with the market for judicial clerks, which until recently was chaotic in just these kinds of ways, will certainly appreciate the benefits of the Match system.
Like AMSA, I haven't taken a position on the lawsuit yet. I'm sympathetic to the argument that resident wages are too low, and I don't buy the hospitals' line that residencies are "training" and not employment (they are both training and employment, much like the early years at a big firm for a law school graduate). But I also remember how few of my classmates in medical school really resented the Match process, and how smooth and trouble-free that process seemed to be.
So at this point, I'll just wish everyone a HAPPY MATCH DAY!!!
* Not completely unknown. If you didn't put a program on your rank order list, it won't be in your envelope on Match Day.Posted by Carey at March 17, 2004 09:24 PM