he Gastroenterology Fellowship Match : How It Failed and Why t Could Succeed Once

c P he market for gastroenterology (GI) fellows adopted a entralized Match in 1986, and abandoned it in the late 990s. We discuss why the Match initially was adopted, ow and why it broke down, what differences this has ade in the market for fellows, and what would be eeded to restart the Match successfully. We assess the ffects of the Match by comparing the GI fellows market ow with when the Match was operating, and with the ellowship markets for internal medicine subspecialties hat continue to use a Match. The breakdown of a ell-functioning Match is rare, but may be caused by nusual shifts in market conditions, such as those exerienced by gastroenterology in the late 1990s. The roblems the gastroenterology Match originally was deigned to solve re-emerged with the demise of the atch. The market has become more local and less ational, than when there was a Match in place, and rogram recruitment of fellows occurs earlier and is ore dispersed in time than internal medicine subspeialties that continue to use a Match. There is no evience that the demise of the Match has had any effect n wages. The evidence strongly suggests that the atch could be reintroduced successfully, which would ncrease the mobility of potential GI fellows, allow poential fellows to compete for the widest range of prorams, and allow programs to compete for the widest ange of fellows.