New Report Exposes How Medical Residency Hiring Monopoly Harms Patients and Doctors

WASHINGTON, D.C. - Today, the House Judiciary Committee released an interim staff report titled "Medical Mis-Match: How a Residency Hiring Monopoly Harms Patients, Doctors, and the American Public." The report details evidence produced to the Committee showing the "Match," a placement system for resident physicians, operates as a monopoly in the medical residency hiring market. The Match's monopolistic practices harm resident physicians, impede patients' access to care, and constrain the growth of America's physician workforce. The Match's anticompetitive conduct is currently shielded from scrutiny by a special-interest antitrust exemption that allows it to harm the public while avoiding judicial oversight.

Transcribed interviews, non-public documents and communications produced to the Committee show that:

• Medical institutions created the Match to eliminate competition in the residency hiring market. The Match achieved its monopolistic power over the residency market by instituting an "All In" policy that requires Match-participating residency programs to register and fill all positions through the Match or another national matching plan, and then merging with its largest competitor;
  
• The Match strips applicants of their ability to negotiate the terms of their employment and aggressively restricts traditional hiring practices. As a result, residents are forced to accept low salaries and endure long hours and poor working conditions without a meaningful opportunity to obtain new employment;
  
• The Match's anticompetitive conduct contributes to the existing physician shortage, and leads to worse patient care and more residents pushing to unionize. At the same time, residents suffer from widespread discrimination and abuse as well as alarmingly high rates of suicide and depression.

Though the Match is currently protected by an antitrust exemption, Congress has the power to repeal it and help restore competition in America's medical residency market. The Committee will continue to conduct its oversight to inform potential legislative reforms that could help restore competition in the medical residency market and relieve the bottleneck that contributes to America's growing physician shortage.

Read the full interim staff report here.

Read the full appendix here.