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MEDICAL SCHOOL
EVALUATION & GRADUATION

Selecting a Residency Program in 2020

By Joshua T. Hanson, MD, MPH

A rite of passage occurs every March. of couples (i.e., two senior medical students Still, when March began, there was much
Every year, senior medical students across wishing to link their preferences) to be in- concern over what The Match would hold.
the nation find out where they will be com- troduced into the algorithm. For their work, It remained a resounding success. The total
pleting their residency training. Physicians Shapley and Roth were awarded the 2012 number of positions offered was 38,106: the
and medical schools refer to it as Match Nobel Prize in Economic Sciences. It had highest on record. This represented a
Day. It is a day of celebration for been a time-tested process. growth of 2.7% from the previous year. De-
students, their loved ones, As in all aspects of life, the spite this, the percent of all positions filled
their educators and their COVID-19 pandemic also increased to 94.9% from the previous
future program direc- tested the Match Pro- year. After the algorithm was run, 1,927 po-
tors. The opening of gram and intro- sitions remained unfilled, which was a de-
the letter deter- duced uncertainty. cline of 3.6% compared to 2020.
mines their spe- In a usual year, It was no different at the Long School of
cialty and their students would Medicine. First and foremost, the overall
training hospital; travel around the match rate was consistent with that of allo-
for many, it is the country to inter- pathic senior medical students, indicating
major milestone in view at programs the school’s senior class was very competi-
their professional during the late fall tive in the national job market. It is also
development and is and early winter. clear that LSOM students love the city and
more meaningful than This would give them a the state. For the class of 2021, 23% have
commencement. sense of the program. Pro- chosen to train in San Antonio and 58%
The transition from medical grams would be able to host will remain in Texas. Primary care remains
school to residency was not always so applicants in order to understand how very popular for the school’s senior class,
organized. Residency programs, the pro- they would fit into the program. Unsurpris- with 43% going into a primary care spe-
grams that train physicians into their partic- ingly, that was not to be in 2020. cialty. By matching to these training pro-
ular specialty after medical school, were Early in the application cycle, the Coali- grams in these ways, LSOM physicians will
developed in the 1920s. In that era, offers tion for Physician Accountability, an um- continue to provide excellent care to the
were made to students as early as the second brella membership organization for many people of Bexar County and Texas for years
year of medical school. It was not until the national medical organizations, issued rec- to come.
1950s that the National Resident Matching ommendations that all interviews be con- Despite the numerous challenges 2020
Program was organized to “provide an or- ducted online in recognition of the dangers presented, the medical education commu-
derly and fair mechanism for matching the inherent in traveling. Schools, programs and nity proved resilient and adapted to the
preferences of applicants…with the prefer- students recognized the value in these rec- challenges. While the obstacles were sub-
ences of residency program directors.” ommendations and complied. This meant stantial, the established processes with novel
The initial algorithm that was put into new support systems would need to be im- adjustments created an environment where
place has been remarkably stable and very plemented along with the development of students could proceed with training, pro-
successful, with only minor modifications new skills. At the Long School of Medicine grams could be filled with capable and pre-
in nearly seven decades. In the 1960s, econ- (LSOM), support programs were created; ferred applicants and, most importantly,
omists David Gale and Lloyd Shapley de- these programs included sessions on increas- patients could receive excellent health care.
scribed an algorithm that would solve the ing online presence, management of acces-
so-called stable marriage problem: a way to sible interview rooms and an ability to Joshua T. Hanson, MD, MPH is
match two sets together while taking into borrow hardware, such as webcams and ring Associate Dean for Student Affairs
account each element’s preferences. This lights to improve their experience. Addi- at the University of Texas Health
was applied with great success. Economist tionally, LSOM residency programs greatly San Antonio Joe R. and Teresa Lozano Long
Alvin Roth, known for his work in organ increased their online presence to present School of Medicine. He is a member of the
donation, contributed with a redesign in the themselves to applicants that would other- Bexar County Medical Society.
late 1990s. This permitted the introduction wise not be able to visit.

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