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November 12, 2003

Effect 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

To the Editor: In their Research Letter, Drs Niederle and Roth1 reported that fellowship markets without a match offered similar salaries as those that do. Although the authors acknowledged that "the market for fellowships is not the same as the market for residencies," they nonetheless concluded that "eliminating the resident match would not necessarily increase residents' wages." Their underlying comparison between fellowship and residency, however, is misleading: an applicant for nephrology fellowship, for instance, in which there is no match, is not in the same market as an applicant for pulmonary/critical care, in which there is. The correct comparison from which one could draw conclusions about the effect of a match on fellowship salary would be between the salaries paid to fellows who obtain positions through the match and the salaries paid to fellows who are offered positions in the same fellowship program outside the match. I suspect that the salaries would be found to be identical in this circumstance. The very existence of a residency match allows all programs to pay lower salaries because the participating programs can operate as a cartel.

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