The Evolution of the Labor Market for Medical Interns and Residents: A Case Study in Game Theory

Abstract

The organization of the labor market for medical interns and residents underwent a number of changes before taking its present form in 1951. The record of these changes and the problems that prompted them provides an unusual opportunity to study the forces at work in markets of this kind. The present paper begins with a brief history and then presents a game-theoretic analysis to explain the orderly operation and longevity of the current market, in contrast to the turmoil that characterized various earlier short-lived attempts to organize the market. An analysis is also given of some contemporary problems facing the market. A subsidiary theme of the paper concerns the history of ideas: the problems encountered in the organization of this market, and some of the solutions arrived at, anticipated the discussion of such issues in the literature of economics and game theory.

The gastroenterology fellowship Match: How it failed and why it could succeed once again

“…9,10 A common reason for the failure of a Match is that it produces outcomes that are unstable in the sense that there can be firms and workers who are not matched to one another but who mutually would prefer to be. In contrast, Matches that produce stable outcomes, such as the NRMP, 11,12 generally are successful once they get underway. Table 1 lists some stable Matches (left column).…”

Modification of Shapley Value and its Implementation in Decision Making

“…A decision problem arising in the field of organization and evolution of labor market for medical interns and residents is successfully tacked by Roth (1984) in the framework of game theory.…”

Strategy-Proofness Makes the Difference: Deferred-Acceptance with Responsive Priorities

“…The American markets (Roth, 1984a) and the British markets in Edinburgh and Cardiff based the matching on a stable mechanism called hospital-proposing deferred-acceptance (DA-)mechanism (Gale and Shapley, 1962). Although the DA-mechanism is the predominant mechanism in the two-sided matching market literature (Roth, 2008), British markets have introduced and operated unstable mechanisms (Roth, 1991).…”