Better than an algorithm

The Standard March 18, 2020 [Since this column was submitted it was decided that students would learn of their matches via email.]

Friday, all across the United States, approximately 38,000 fourth-year medical school students will gather with fellow classmates from their respective institutions to find out where they will be spending the next three years or more in residency programs. Without the looming threat of the coronavirus, that day would include family members and significant others joining the soon-to-be graduates for the simultaneous revealing of their matches at ceremonies occurring around the country at noon Eastern Time. At most Match Day events each student, after having opened up their envelope, steps up to a microphone to read where they will be doing their residency and then marks that spot on a large map.

So, what has been the process leading up to the match? Each of these seniors has chosen a specialty, applied to an average of 36 different residency programs and gone to interview where they were invited. The applicants placed each of those programs on a list of preferences from first to last. The residency programs also ranked their interviewees from first to last. These rankings are submitted and basically fed into a computer. Thanks to a mathematical algorithm which helped economists Lloyd Shapley and Alvin Roth win the 2012 Nobel Prize in economics, most students end up with what is considered their best overall outcome. The National Resident Matching Program hired Roth to work with Elliott Peranson to improve the algorithm they already used which was based on principles similar to those encoded by the Gale-Shapley algorithm.  They designed it so that the applicant should rank their schools in exact order of preference to have the best chance to get their top selection. The algorithm leans more in the favor of the students’ choices as opposed to those of the programs.

On Match Day each student finds out only where they will go. They never know how they stacked up with any other programs. The programs do not know how the interviewees ranked them. Some people dislike this methodology, finding it too clinical or impersonal. While approximately 75% of the students are matched with one of their top three choices, many others are left utterly disappointed. Some do not match at all. 2018 set a record as the most successful year up until that point with 96.2 percent of medical school graduates matched with a residency program. That left over 1,400 students with no match by virtue of the fact that there were fewer spots available than applicants.

As wonderful as mathematics and innovation can be, they can’t solve all of our problems. God is infinitely better than an algorithm. Even when our plans go the way we want, sometimes what we believe is best does not end up being so. We often can’t see the bigger picture. When making life decisions it is a welcome reminder that God cares deeply and will lead us as we seek help. The path won’t always be straight, but God has an end point in mind. Jesus promised to leave us The Holy Spirit as a guide and counselor. God will direct our path.

“To humans belong the plans of the heart, but from the Lord comes the proper answer of the tongue. All a person’s ways seem pure to them, but motives are weighed by the Lord. Commit to the Lord whatever you do, and he will establish your plans.” (Proverbs 16:1-3) “In their hearts humans plan their course, but the Lord establishes their steps.” (Proverbs 16:9) Part of the letter that the Lord Almighty, the God of Israel had the prophet Jeremiah take to those exiled from Jerusalem to Babylon said, “’For I know the plans I have for you,’ declares the Lord, ‘plans to prosper you and not to harm you, plans to give you hope and a future. Then you will call on me and come and pray to me, and I will listen to you. You will seek me and find me when you seek me with all your heart.’”  (Jeremiah 29:11-13)

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