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Comment & Response
June 9, 2020

An Early Result Acceptance Program for Residency Application—Reply

Author Affiliations
  • 1University of Michigan Medical School, Ann Arbor
  • 2American Medical Association, Chicago, Illinois
JAMA. 2020;323(22):2345. doi:10.1001/jama.2020.6516

In Reply We agree with Dr Adler that it is important to think critically about any proposed changes to the current residency selection process, such as an ERAP discussed in our Viewpoint.1

As Adler notes, the National Resident Matching Program uses a computerized mathematical algorithm to align the preferences of applicants with the preferences of programs to produce the best possible outcome for filling training positions available at US teaching hospitals. The match algorithm is similar to Gale and Shapley’s solution to the college admission problem,2 in which they defined an unstable match as one in which 2 applicants, 1 and 2, are assigned to colleges A and B, respectively, although 2 preferred A and 1 preferred B. Our proposal was not intended to restrict where students apply or whom programs may interview. Rather, we suggested that students have the option to apply initially to a limited number of programs based on their preferences in an ERAP and match using the Roth-Peranson algorithm that is used currently by the National Resident Matching Program. This initial restriction in applications would not be expected to destabilize the algorithm but to facilitate improved preference signaling between applicants and programs, and may improve the efficiency of the market.