The National Resident Matching Program and Antitrust Law

Abstract

In May 2002, a group of physicians filed a class action lawsuit alleging that the National Resident Matching Program (NRMP) violates antitrust laws. The plaintiffs contend that NRMP practices have stabilized lower-than-competitive wages and imposed exhausting working conditions on residents. They also maintain that NRMP procedures virtually force applicants for house officer positions to forfeit their right to negotiate for better wages and conditions. The plaintiffs also allege that the defendants have collectively fostered anticompetitive accreditation standards through the Accreditation Council for Graduate Medical Education. Jung v Association of American Medical Colleges could present antitrust law with some difficult challenges. Although the matching program on its face appears to limit competition in a manner that previous cases have found illegal, it operates in the context of important professional activities (medical education and quality improvement) that may generate some judicial deference. At this early stage, no confident prediction can be made about the outcome of the case if it goes to trial; however, the plaintiffs appear to have a plausible case under existing antitrust doctrine, and lengthy litigation is possible. Given the important questions that the litigation will not address, such as the potential costs of a finding of illegality to the government and other payers, and the impact of such a finding on the health care system as a whole, a legislative solution seems highly desirable.

The gastroenterology fellowship Match: How it failed and why it could succeed once again

“…27 The suit seeks to represent the class of all former residents against several medical organizations, including the NRMP, and against the class of all hospitals that employ residents. The legal theory of the complaint is discussed by Miller and Greaney 28 and Chae. 29 The underlying economic claim is that the NRMP restrains competition for residents, and suppresses their wages.…”

Challenging the Medical Residency Matching System through Antitrust Litigation

“…The parties. In 2002, a group of three physicians led by Paul Jung, MD, a research fellow at the Johns Hopkins University, brought a class action suit on behalf of all current and former medical residents against a group of defendants that oversaw and participated in the match process and employed medical residents [2]. The size of the group of residents being represented by the suit was considerable, including all persons who had been employed as resident physicians since 1998 in programs that were accredited by the ACGME, as well as physicians in ACGME-accredited fellowships [1].…”

Out-of-Match Residency Offers: The Possible Extent and Implications of Prematching in Graduate Medical Education

“…The NRMP has considered proposals to limit outside-the-match offers 15 and to conduct a second match for unmatched candidates. 16 Neither has been adopted, in part because of concerns expressed by program directors ''dependent'' on international medical graduates, who might have difficulty getting visas in time for their July start dates.…”