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Updated: Jun 11, 2025

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
The Neuromuscular Portal and Match: Working Toward a More Fair, Equitable, and Transparent Process
Ruple S Laughlin1, Shirlyn Adkins1, Michael Baer1
1From the Mayo Clinic (R.S.L.); AANEM (S.A., J.S.), Rochester, MN; University of Pennsylvania (M.B., R.S.P.); Thomas Jefferson University (S.D., E.S.W.), Philadelphia, PA; Duke University (K.G.), Durham, NC; University of Missouri (R.G.), St. Louis; Department of Neurology (A.C.G.), Harvard Medical School/Massachusetts General Hospital, Boston, MA; Virginia Commonwealth University (K.G.G.), Richmond; University of Vermont (M.K.H.), Burlington; University of Connecticut (M.I.), Storrs; Department of Neurological Sciences (S.S.), Stanford University, Stanford, CA; Keck USC College of Medicine (N.T.), Los Angeles, CA; and University of Michigan (Z.L.), Ann Arbor.
Abstract:
Prior to 2021, the neuromuscular medicine fellowship application process suffered from non-standardized timelines and substantial variability. To rectify this, the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM) established a standardized application timeline and an online application portal in 2020-2021, followed by the introduction of a partial match process. In 2021-2022, AANEM launched a traditional, binding, two-way match system for fellowship positions allocation based on the Gale-Shapley stable matching algorithm. Surveys assessing perceptions of fairness in the application portal and match process were dispatched to applicants and program directors following the 2021 and 2022 recruitment cycles. In the 2020-21 cycle, 90% of program directors and 95% of applicants affirmed the standardized timeline benefited applicants. However, 57% of applicants deemed the process as unfair. All programs and most applicants (58%) favored a transition to a two-way match. The implementation of the two-way match in 2021-22 attracted participation from 97% of programs, with 80% of applicants and 95% of programs viewing the process as fair to applicants. A significant majority of both applicants (86%) and programs (94%) supported maintaining the standardized timeline and two-way match. We advocate for the universal adoption of the AANEM Match for neuromuscular fellowship recruitment and a standardized fellowship application timeline across all neurologic specialties to promote transparency, fairness, and equity for applicants.
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