Investigating the fairness of the National Resident Matching Program

The National Resident Matching Program (NRMP) was established in the early 1950s to bring order and fairness to a previously chaotic application process for internship and residency positions. Over the years many reservations were raised about the fairness of the process, specifically, that hospital programs are doing better than students are (i.e., programs obtain preferred residents more often than students receive preferred programs). This paper presents an analysis of the results of the 1986 Match. The findings do not support the claim that the results of the Match are biased in a way that favors programs. Overall, the students' success was greater (i.e., receiving on average higher-ranked choices) than was the hospital programs' success. In fact, in 20 of 22 specialty programs, the students' degree of success was greater than or equal to the success of the programs. This finding raises the question of fairness toward programs rather than students. The authors analyze factors that affected both the hospitals' and the students' degrees of success in the 1986 Match and suggest strategies for improving the Match results.