The formula used to match medical students with teaching hospitals puts too much weight on the hospitals' preferences, consumer and student groups complained last week.
They asked the Association of American Medical Colleges, which helps run the match, to rejigger the formula to give the edge to the future interns' choices.
The hospital bias in the current formula may keep thousands of future doctors each year from getting to work in hospitals they prefer, charged Lydia J. Vaias, M.D., president of the American Medical Student Association, and Sidney Wolfe, M.D., director of Public Citizen's Health Research Group.
The bias in the formula was scrutinized in several articles recently in the journal Academic Medicine.
Each spring, the National Resident Matching Program helps teaching hospitals fill their internships from the ranks of graduating medical students.
More than 15,000 graduating U.S. medical students and several thousand others enter the match each year. Both the students and the hospitals list their choices in rank order.
Before the match, hospitals interview students but cannot make individual offers of jobs.
The match was instituted in the early 1950s "chiefly to curb aggressive recruitment efforts by hospitals seeking house staff, who were then in short supply," according to an article by Kevin Jon Williams, M.D., of Thomas Jefferson University in Philadelphia that raised the issue of bias.
When a student's and hospital's top choice coincide, there is no problem because that student will get the position. No student or hospital is matched with a partner they did not choose.
But the critics say the problems can occur in matches that involve reaching further down the list.
Williams estimated as many as 2,500 students each year are affected by the bias toward hospitals.
The edge should go to the students because they have more at stake than the hospital residency program, Vaias and Wolfe argued. Also signing their complaint was a Georgetown medical student, Randy Sasich, who wrote a paper on the problem.
The match is sponsored by the medical colleges, the American Medical Association, the American Hospital Association and two medical specialty boards.