To the Editor Although the residency match system has become increasingly complicated and has a number of problems, the implementation of an early result acceptance program (ERAP), as suggested by Dr Hammoud and colleagues, raises a number of concerns.1
First, the match was originally instituted to bring more stability to the process of obtaining a residency position. The algorithm currently used is similar to Gale and Shapley’s solution to the college admission problem and stable marriage problem, which later led to Shapley winning the Nobel Prize in Economics in 2012.2 The goal of their approach was to prevent instability, which is defined as the presence of an outcome in which the result is mutually better for an applicant-institution pair than the actual outcome.3 To achieve stability, all involved parties must be unrestricted. The creation of a 2-tiered matching system will increase instability and suboptimal applicant-institution pairings, thus defeating the purpose of the match.
Adler C. An Early Result Acceptance Program for Residency Application. JAMA. 2020;323(22):2344–2345. doi:10.1001/jama.2020.6513
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