Articling Mentorship Program Mentee Enrolment Form. The Articling Mentorship Program provides candidates registered in the. Please provide other information that may be helpful in matching you with a mentor. Bid to force articling positions shot down. Understanding the Current Study of the Match. A copy- edited version of this paper appeared as Roth, Alvin E. Roth, Department of Economics, Harvard University, and Harvard Business School. March 1, 1. 99. 6 The purpose of this article is to discuss what the NRMP does, why what it does is important, and what are the issues which will be the focus of the study of the NRMP I have been asked to direct. Although medical students are unaccustomed to thinking of the NRMP as a market, as an economist I am struck by its similarities to other entry- level professional labor markets I have studied. What makes the NRMP unusual- -although far from unique- -is that the matching of residents to hospitals is organized via a computer algorithm. What makes it familiar are the problems the market experienced which led the NRMP to be organized this way. These problems mostly had to do with timing. Articling Program; Contact.
Let me begin with a capsule history of the market, extracted from Roth (1. Then I'll discuss some other markets which presently have timing problems, and other markets which have employed matching algorithms, and why these sometimes fail. This will set the stage for a discussion both of why there is a great deal of common interest among students and hospitals in preserving an orderly market, and why there is also potentially room for disagreement between students and hospitals about what kind of matching algorithm should be employed. The study of the NRMP I have been asked to direct is intended to shed some light on this latter issue. A capsule history: Internships, the predecessors to today's residency positions, were introduced around 1. One form which the competition among hospitals for interns took was that hospitals attempted to hire interns a little earlier than their principal competitors. Consequently, the date by which most internships had been finalized began to creep forward from the end of the senior year of medical school. Dates of appointment unravelled from one year to the next, first slowly then faster, so that by 1. This meant that students had to apply for positions long before they were far enough along in their education to know their tastes and talents, and hospitals had to hire future staff with little information about how they would develop in their two remaining years of medical school. So there was considerable reason for dissatisfaction on all sides. In 1. 94. 5 the medical schools embargoed letters of reference, and the date of appointment was successfully moved to one year before employment would begin. In subsequent years the dates at which letters were released, and appointments made, were moved back into the senior year. But the problems in this market did not end when the appointment date was controlled. There followed a period in which students were called upon to make increasingly prompt decisions whether to accept offers. In 1. 94. 5 offers were supposed to remain open for 1. Each subsequent year that interval was shortened, until by 1. What had happened was that hospitals found that, if an offer was rejected very near the deadline, it was often too late for them to reach their next most preferred candidates before they had accepted other offers. Even when there was a long deadline, much of this action was compressed into the last moments, because a student who had been offered a position at, say, his third choice hospital, would be inclined to wait as long as possible before accepting, in the hope of eventually being offered a preferable position. So the period before the deadline was frenzied, with students seeking to improve on the positions they had been offered by contacting the hospitals they preferred, and with hospitals sometimes pressuring students into early decisions in order not to have to contact students on their waiting lists after the deadline had expired. Some other markets with timing problems: Table 1, from Roth and Xing (1. Table 1 concentrates primarily on professional labor markets. Some of these organizations, like the NRMP, were created for this purpose. Many of them have considerable compulsory power. But in many cases a solution to the timing problem has proved elusive. The difficulties encountered by these other markets may therefore illuminate some potential pitfalls we need to keep in mind when thinking about changes in the NRMP. To make it easy to describe the common phenomena found in a diverse set of markets, Table 1 loosely categorizes each market as most recently being in one of four . Stage 1 markets are in the process of unraveling. Stage 2 markets have regulations specifying the time before which offers and sometimes other contacts cannot be made, and sometimes how long offers must remain open. But stage 2 markets are still decentralized, with employers contacting potential employees directly. Stage 3 markets have procedures which not only determine the timing of transactions, but also organize the transactions (e. The most common form of stage 3 organization, like the NRMP, has employers and employees contacting each other (via applications, interviews, etc.) in a decentralized way, after which each employer submits a rank ordering of applicants to a central clearinghouse, and each applicant submits a rank ordering of positions. The clearinghouse uses these preference lists to produce a match according to some prespecified algorithm, and employers and employees are informed of the match. Stage 4 markets also use such centralized mechanisms, but have begun to unravel prior to the centralized market, for reasons and in ways similar to stage 1 unraveling. The various markets for new law graduates in Table 1 show contemporary examples of both unraveling and centralized clearinghouses. The Table shows the same variety in contemporary regional medical markets in the National Health Service of the U. K. In Roth (1. 99. Roth 1. 99. 0) it was shown that all of those which failed produced matches which were unstable, in the sense that there could be a student and hospital program who would both prefer to be matched to each other than to accept the matching produced by the algorithm. The algorithms failed in response to the stratagems such students and hospitals undertook to become matched to one another. In contrast, it was shown in Roth (1. Roth (1. 99. 1) that (except for some problems with married couples) the NRMP, as it was then, and the two largest of the successful British algorithms, produced stable matchings, at which no such mutually unhappy students and hospitals exist. In general, there is considerable evidence that to successfully organize a market like the NRMP, the matching algorithm must produce a stable matching. Since the failures (and continued unraveling) in these markets are costly to all concerned, stable matchings are in everyone's interest. But there can be more than one stable matching, and in general students and hospitals have room to disagree about which stable matching is the best for them. To get a quick idea of why this is so, consider a simple algorithm whose basic idea has been independently discovered in a number of markets (including the NRMP), but which was first mathematically understood, in an abstract setting, by Gale and Shapley (1. In one version of this algorithm, the one on which the current NRMP algorithm is largely based, hospitals make offers to their highest ranked students, who tentatively hold the best of the offers they have so far received and reject the rest. Hospitals which are rejected at any stage make additional offers, to their next highest ranked students, and so forth, until no more offers or rejections remain to be made, at which point each student is matched to the position (if any) whose offer he or she is holding. Ignoring for a moment some of the complexities of the actual resident market (such as the fact that married couples and students who match to 2nd year positions require two positions), the matching produced in this way is stable. However, a different stable matching in the simple market can be obtained by having the students make offers to the hospitals. To get an idea of why the hospital- offering algorithm is better for the hospitals and worse for the students than the student- offering algorithm, consider the special case in which the hospital- offering algorithm happens to end after the first round, i. In this special case, each hospital would get its first choices, while each student would get the hospital which ranked him first, which of course might not be his first choice. In the reverse situation, with students making offers, if no hospitals issued any rejections then each student would get his first choice, and each hospital would get those students who ranked it first. Of course the algorithms won't typically end after one round of proposals, but in the market with no couples or other complexities there remains a systematic advantage to the side which proposes. The kind of mathematics used to analyze algorithms in this way is called game theory, and it not only speaks to questions of stability, but also of strategy. For example, we can ask if it is possible to design a stable matching algorithm with the property that, when it is used, no student or hospital can ever do better than to submit as his Rank Order List his full true preferences. This turns out to be impossible (Roth 1. Sonmez 1. 99. 6), although in a simple market without the complexities of the NRMP, the student- offering algorithm would at least have this property for the students. And no procedure for producing stable matchings is guaranteed to remove all strategic considerations for either side of the market. However there is good reason to believe that the properties found in simpler markets should carry over to the NRMP, at least to a large extent, at least most of the time. The study of the NRMP which is presently underway will allow us to make this last statement more precise. Much of the recent debate (Williams; Peranson and Randlett 1. AMSA/Public Citizen 1. Parties, activities, sports. Patrick's Day. The start of summer. In a relaxed atmosphere, all the members of our firm are invited to our famous BBQ lunch. In the fall. All our professionals, their partners and our students and articling students get together at the biannual BCF retreat. In a relaxed setting, members of the executive committee present the strategic plans for the years to come. Every year. Our Montreal and Quebec City offices compete in a sporting event reminiscent of the good old Canadiens. Members of our team are great competitors in softball, soccer and hockey.
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