{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T06:31:37Z","timestamp":1788676297385,"version":"build-2803163510"},"reference-count":11,"publisher":"American Medical Association (AMA)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>In the US, tens of thousands of medical student applicants and residency programs rank each other annually. The matching algorithm, Gale-Shapley, has been relatively unchanged for over 50 years, and although it results in a stable solution for the match, where no applicant and program would prefer to be matched together than to their assigned match, it does not optimize the overall match result.<\/jats:p><\/jats:sec>Objective<\/jats:title>To compare the performance of a mixed-integer linear optimization-based approach, the residency optimizer, for matching and against the currently used Gale-Shapley algorithm.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This quality improvement study used anonymized rank lists and match data for ophthalmology residency matches conducted between 2011 to 2021. The Gale-Shapley algorithm and the residency optimizer were compared for overall performance for both applicants and programs, under both unlimited choice rank lists and capitated lists. The algorithms were also compared for couple matching. Final data analyses were performed in April 2025.<\/jats:p><\/jats:sec>Exposure<\/jats:title>Matching with an ophthalmology residency and fellowship.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Algorithm performance was compared in terms of mean matched rank of applicants and programs, as well as the percentage of applicants matching their top 3 ranked programs. For the capped rank list experiments, the percentage of positions filled and the percentage of applicants matching their top choices were measured. For couple matching, the percentage of couples matched was computed.<\/jats:p><\/jats:sec>Results<\/jats:title>For a total of 6990 applicants (635.5 applicants per year) and a mean of 114.6 programs per year from 2011 to 2021, applicants matched 0.45 rank positions better (2.40 using the optimized algorithm vs 2.85 using Gale-Shapley), and the program matched applicants 0.32 rank positions better (2.65 for the optimized algorithm vs 2.97 for Gale-Shapley) per position under residency optimizer match than under Gale-Shapley. In total, 78.4% of applicants (4079 of 5200 applicants) matched to 1 of their top 3 choices with the residency optimizer match compared with 70.9% (3668 of 5174 applicants) with the Gale-Shapley algorithm. The residency optimizer eliminated unfilled residency positions and resulted in a mean of 2.4 fewer programs with unfilled slots annually. The residency optimizer outperformed the Gale-Shapley algorithm with truncated match lists and outperformed Gale-Shapley in successfully matching couples.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>These findings suggest that alternate match algorithms optimizing global utility may generally improve residency and fellowship match outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.17077","type":"journal-article","created":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T15:31:11Z","timestamp":1750692671000},"page":"e2517077","source":"Crossref","is-referenced-by-count":1,"title":["Improving Residency Matching Through Computational Optimization"],"prefix":"10.1001","volume":"8","author":[{"given":"Yue","family":"Wu","sequence":"first","affiliation":[{"name":"Karalis-Johnson Retina Center, Department of Ophthalmology, University of Washington, Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia S.","family":"Lee","sequence":"additional","affiliation":[{"name":"Karalis-Johnson Retina Center, Department of Ophthalmology, University of Washington, Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron Y.","family":"Lee","sequence":"additional","affiliation":[{"name":"Karalis-Johnson Retina Center, Department of Ophthalmology, University of Washington, Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russell N.","family":"Van Gelder","sequence":"additional","affiliation":[{"name":"Karalis-Johnson Retina Center, Department of Ophthalmology, University of Washington, Seattle"},{"name":"Department of Laboratory Medicine & Pathology, University of Washington, Seattle"},{"name":"Department of Neurobiology & Biophysics, University of Washington, Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2025,6,23]]},"reference":[{"issue":"3 1","key":"zoi250536r1","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1097\/00001888-195205000-00008","article-title":"The matching plan for internship placement.","volume":"27","author":"Mullin","year":"1952","journal-title":"J Med Educ"},{"issue":"5","key":"zoi250536r5","doi-asserted-by":"publisher","first-page":"460","DOI":"10.1001\/jamaophthalmol.2020.0252","article-title":"Current applicant perceptions of the ophthalmology residency match.","volume":"138","author":"Venincasa","year":"2020","journal-title":"JAMA Ophthalmol"},{"issue":"2","key":"zoi250536r7","doi-asserted-by":"publisher","first-page":"e105","DOI":"10.1016\/j.jemermed.2019.11.025","article-title":"What if I do not match? scrambling for a spot and going outside the match.","volume":"58","author":"Ritchey","year":"2020","journal-title":"J Emerg Med"},{"issue":"4","key":"zoi250536r8","doi-asserted-by":"publisher","first-page":"748","DOI":"10.1257\/aer.89.4.748","article-title":"The redesign of the matching market for American physicians: some engineering aspects of economic design.","volume":"89","author":"Roth","year":"1999","journal-title":"Am Econ Rev"},{"key":"zoi250536r2","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1007\/978-0-387-30162-4_393","volume-title":"Encyclopedia of Algorithms","author":"Irving","year":"2008"},{"key":"zoi250536r3","unstructured":"National Resident Marching Program. Main residency match data and reports: the match. Accessed October 28, 2020. https:\/\/www.nrmp.org\/main-residency-match-data\/"},{"key":"zoi250536r4","unstructured":"Association of University Professors of Ophthalmology. Ophthalmology residency match report. Accessed May 16, 2025. https:\/\/aupo.org\/sites\/default\/files\/2021-04\/Ophthalmology%20Residency%20Match%20Summary%20Report%202021.pdf"},{"key":"zoi250536r6","unstructured":"Wu? Y. Game theoretic consequences of resident matching.? arXiv. Preprint posted online March 12, 2020. doi:10.48550\/arXiv.2003.07205"},{"key":"zoi250536r9","doi-asserted-by":"crossref","unstructured":"Benjamin? DJ, Heffetz? O, Kimball? MS, Rees-Jones? A. Can marginal rates of substitution be inferred from happiness data? evidence from residency choices. NBER working paper 18927. 2013. Accessed May 16, 2025. https:\/\/www.nber.org\/system\/files\/working_papers\/w18927\/w18927.pdf","DOI":"10.3386\/w18927"},{"key":"zoi250536r10","unstructured":"National Resident Matching Program. Results of the 2019 NRMP applicant survey. July 1, 2019. Accessed May 16, 2025. https:\/\/www.nrmp.org\/match-data\/2019\/07\/results-of-the-2019-nrmp-applicant-survey\/"},{"key":"zoi250536r11","unstructured":"National Resident Matching Program. Report archives. Accessed February 14, 2020. https:\/\/www.nrmp.org\/report-archives\/"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2835467\/wu_2025_oi_250536_1749744075.80359.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T15:31:13Z","timestamp":1750692673000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2835467"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,23]]},"references-count":11,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,6,2]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2025.17077","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,23]]}}}