Scotland matched 750 junior doctors a year to training posts with stable matching

Medical graduates in Scotland must complete a two-year foundation programme. Since the 1990s the Scottish Foundation Allocation Scheme has allocated them centrally instead of leaving placements to individual hospital negotiations.

The scheme ranks all applicants in one master list by academic performance and situational judgement tests, derives each programme's preferences from that list, then runs a stable-matching algorithm. Couples apply as linked pairs and are accommodated in the match.

Around 750 applicants fill posts in about 50 programmes each year; the algorithm typically matches roughly 93% in the first round, with a second round for the rest. The 2009 version added the master list and couple handling.

Use one ranked list, stable matching

One master list removes each hospital's incentive to hoard or trade candidates.

Stable matching means no applicant and programme would rather swap than stay put.

Couple handling solves a real constraint that simpler schemes ignore.

Repeated tie-breaking maximises the number of applicants matched.

One transparent priority list plus a stability-seeking algorithm converts a chaotic allocation into one nobody can profitably game.

The scheme ran for decades and its design was studied by computer scientists as a live instance of the hospitals-residents problem with couples. Allocation of foundation places has since been reorganised through the UK Foundation Programme Office, with Scotland still using linked, score-based matching.