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November 12, 2003

Effect of a Match on Salaries for Medical Fellows—ReplyEffect of a Match on Salaries for Medical Fellows—Reply

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;290(18):2408. doi:10.1001/jama.290.18.2408-a

In Reply: Dr Schlegel is dissatisfied that we compared different subspecialties with one another. To test the hypothesis that a match results in lower wages, we looked for a set of comparable markets, only some of which use a centralized match. We compared all internal medicine subspecialties, and found no systematic difference in wages between subspecialties that use a match and those that do not.

Schlegel proposes that the appropriate comparison would be between the wages paid to fellows in the same fellowship program, some of whom are recruited within the subspecialty match and some of whom are recruited outside it. He suspects this test would also fail to detect any wage differences. Without data we cannot tell. But even if wage differences were found, they would be difficult to interpret. If 2 fellows in the same program were hired by different means, there would likely be some difference between these individuals. This, rather than the difference in how they were hired, might account for their different wages. More important, such a test would not be informative about whether the presence of a match systematically raises or lowers wages across the subspecialty as a whole (eg, average wages), which is the question we addressed.

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