In a yearly ritual, an algorithm pairs medical students with U.S. residency programs. An anthropologist explains how this technology of destiny is all too human.
There’s talent, oh yes. And a thirst to prove yourself. But where to put you?” This week, students in their final year of medical school will gather across the United States in the Zoom equivalent of banquet halls, anxiously awaiting an envelope that will determine the next three to seven years of their lives. Held every year on the third Friday of March, Match Day is a rite of passage in the most classic anthropological sense.
In other words, how does the matching algorithm answer, for tens of thousands of aspiring doctors, the Sorting Hat’s rather agonizing question: “But where to put you?”Here’s how it works: After applying and interviewing at programs in their desired specialty , students rank each program according to what economists such as Alvin Roth—who won the 2012 Nobel Prize in economics for developing the matching algorithm—call “true preferences.
Where economists view the matching algorithm as an efficient and rational system, for students anxiously counting down the days, minutes, and even seconds until they open their envelopes, the Match symbolizes something both more mysterious and intimate: fate. This perception of algorithm-as-destiny is further cemented by the rules of the Match: If you renege on your assignment, you cannot reenter the market in the future.
Roth credited this decline in participation to demographic changes in medical schools: As more women entered the field, there were more medical school couples, and these couples often preferred to live in the same place. In a 1980 letter to the editors of The New England Journal of Medicine, one pair of medical school spouses called on the NRMP to recognize the “unnecessary agony” of their predicament, concluding that “human agency is preferable to the machine here.
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