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The encyclopedia · People & Management · People decision · 2006–2008

Gastroenterology brought back a national match and ended the fellowship offer wars

After its 1999 match collapse, gastroenterology interviews drifted to 20 months early; Roth and Niederle helped restart the match in 2006.

American Gastroenterological Association

the move

Gastroenterology fellowships ran a centralized match from 1986 until the late 1990s, with more than 300 positions advertised annually and fill rates of 88% or higher. In 1996 an anticipated cut in positions met an unexpected drop in applicants, programs lost confidence in the match and began making early offers; by 1999 only 14 positions were left in it.

Without the match the market unraveled: interviews moved two months earlier for 2003 positions and three months earlier for 2005 — about 20 months before employment began — and fellows increasingly stayed at their own hospital, city and state. Economists Muriel Niederle and Alvin Roth documented the collapse and argued that a redesigned match could succeed again.

In June 2006 the specialty restarted a centralized match, backed by resolutions from the four main gastroenterology societies, and a 2008 report in Gastroenterology documented the first two years. The economists also found matched specialties' wages were no lower than unmatched ones, so the match restored order without suppressing pay.

why it works

  • Deferred acceptance makes truthful rankings a safe strategy, so candidates stop gaming the list.
  • A stable match means no pair would rather be matched elsewhere, ending the early-offer arms race.
  • A single match date thickened the market, concentrating interviews into one season.
  • Evidence showed the match did not depress wages, removing the antitrust worry.
the payoffA central match ended offer wars and restored mobilityclever

what transfers

When offers explode, the market unravels earlier each year and nobody can plan; a match that makes truthful rankings safe can re-thicken a market even after it has failed once.

what came after

The reintroduced match held, and the gastroenterology episode became a standard lesson in how clearinghouses fail and can be rebuilt; the same deferred-acceptance machinery now underpins residency matches and school-choice systems worldwide.

references

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