Inefficiencies in Residency Matching Associated with Gale–Shapley Algorithms

Abstract Objective This study aimed to investigate emerging trends and increasing costs in the National Residency Matching Program (NRMP) and San Francisco Residency and Fellowship Match Services (SF Match) associated with the current applicant/program Gale–Shapley-type matching algorithms. Design A longitudinal observational study of behavioral trends in national residency matching systems with modeling of match results with alternative parameters. Patients and Methods We analyzed publicly available data from the SF Match and NRMP websites from 1985 to 2020 for trends in the total number of applicants and available positions, as well the average number of applications and interviews per applicant for multiple specialties. To understand these trends and the algorithms' effect on the residency programs and applicants, we analyzed anonymized rank list and match data for ophthalmology from the SF Match between 2011 and 2019. Match results using current match parameters, as well as under conditions in which applicant and/or program rank lists were truncated with finalized rank lists, were analyzed. Results Both the number of applications and length of programs' rank lists have increased steadily throughout residency programs, particularly those with competitive specialties. Capping student rank lists at seven programs, or less than 80% of the average 8.9 programs currently ranked, results in a 0.71% decrease in the total number of positions filled. Similarly, capping program rank lists at seven applicants per spot, or less than 60% of the average 11.5 applicants ranked per spot, results in a 5% decrease in the total number of positions filled. Conclusion While the number of ophthalmology positions in the United States has increased only modestly, the number of applications under consideration has increased substantially over the past two decades. The current study suggests that both programs and applicants rank more choices than are required for a nearly complete and stable match, creating excess cost and work for both applicants and programs. “Stable-marriage” type algorithms induce applicants and programs to rank as many counterparties as possible to maximize individual chances of optimizing the match.

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COVID-19 and the Ophthalmology Residency Match: Data from Applicants' Perspectives

Journal of Academic Ophthalmology ◽

10.1055/s-0041-1728759 ◽

2021 ◽

Vol 13 (01) ◽

pp. e73-e77

Author(s):

Benjamin Steren ◽

Ankur Parikh ◽

Bilal Ahmed ◽

Benjamin Young ◽

Jayanth Sridhar ◽

...

Keyword(s):

Interest Groups ◽

The United States ◽

Application Process ◽

Substantial Impact ◽

Clinical Exposure ◽

Residency Programs ◽

Informed Decisions ◽

Rank List ◽

Perceived Impacts ◽

Residency Application

Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has had a profound impact on medical education, particularly for those applying to residency programs in 2020 to 2021. This study describes the challenges for potential ophthalmology residency applicants so that residency leadership can make informed decisions about changes to the process. Methods A survey was distributed electronically via social media and medical school ophthalmology interest groups from June 18, 2020 to July 2, 2020 to individuals interested in applying to ophthalmology residency in the United States. Survey questions included demographics and perceived impacts of COVID-19 on ability, confidence, intention to apply, and perceptions toward changes in the application process for the 2020 to 2021 ophthalmology residency application cycle. Results One-hundred sixteen total responses were received. Eighty-six responses (74%) were from individuals intending to apply in the 2020 to 2021 application cycle. Most respondents (86%) felt that their application would be affected by COVID-19 with 51% feeling less confident. Only four (5%) felt that they could adequately compile a rank list following a video interview, and over half (51%) anticipated applying to more programs than they originally intended. Academic plans of seven (8%) respondents were significantly altered via deferral of application or cancellation of a research year. Thirty-nine (45%) students reported delayed ophthalmology electives, with less than half (41%) feeling that they had adequate clinical exposure to be prepared for residency. Conclusion The COVID-19 pandemic has had a substantial impact on the 2020 to 2021 ophthalmology residency application cycle. As stakeholders begin to approach this cycle, these findings will help them make effective and informed decisions to create the best overall experience for all involved.

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Conspiracy Rises Again

Qui Parle ◽

10.1215/10418385-7861837 ◽

2019 ◽

Vol 28 (2) ◽

pp. 307-333

Author(s):

Poulomi Saha

Keyword(s):

San Francisco ◽

Central Valley ◽

The United States ◽

University Of California ◽

British India ◽

Philosophical Concept ◽

The Past ◽

Revolutionary Violence ◽

The University ◽

Indian Students

Abstract This essay takes up conspiracy as a discursive, political, and philosophical concept. By tracing the ideological and textual kinship between anticolonialism in India and Ireland and radicalism in the United States, it illuminates transcolonial circuits of a curiously shared revolutionary project. Rather than simply offer a historical account of those interconnections, it theorizes a practice of reading revolutionary violence as perpetual, repetitive haunting, a politics of the undead. It argues for a historiographical live burial by which violences of the past reappear to disrupt the imperial promise of futurity and continuity. From the 1916 “Hindu-German Conspiracy Trial” in San Francisco, during which members of the Ghadr Party—consisting of diasporic Indian students at the University of California, Berkeley, and Punjabi farmers in the Central Valley—were accused of conspiring with German diplomats to arm anticolonial revolt in British India, this essay tracks forms of radical sympathy that emerge, flourish, and stutter in an era of ethnonationalist constriction.

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Japan's Foreign Aid after the San Francisco Peace Treaty

Journal of American-East Asian Relations ◽

10.1163/187656100793645886 ◽

2000 ◽

Vol 9 (3-4) ◽

pp. 197-220 ◽

Cited By ~ 1

Author(s):

Saori N. Katada

Keyword(s):

Foreign Aid ◽

San Francisco ◽

Foreign Relations ◽

The United States ◽

Peace Treaty ◽

Critical Importance ◽

The Past ◽

The World ◽

The Relationship ◽

The U.S

AbstractThe year 2001 marks the fifty-year anniversary of the San Francisco Peace Conference that concluded the U.S. occupation of Japan, and defined the future course of Japan's foreign relations with the rest of the world, particularly with Asia. During these fifty years, Japan transformed itself from a war-devastated nation of poverty and instability to the second richest economy of the world after the United States. Japan's foreign relations with Asia remains of critical importance, and Japan's foreign aid, the largest of the world in the past decade, contributed significantly in shaping the relationship.

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Die Entwicklung der Homöopathie in den Vereinigten Staaten

Gesnerus ◽

10.1163/22977953-0510102007 ◽

1994 ◽

Vol 51 (1-2) ◽

pp. 84-100

Author(s):

Josef M. Schmidt

Keyword(s):

United States ◽

Cultural History ◽

20Th Century ◽

19Th Century ◽

San Francisco ◽

United States Of America ◽

The United States ◽

The Past ◽

History Of ◽

The 19Th Century

After an enormous spread in the United States of America during the 19th century homeopathy had almost completely vanished from the scene by the beginning of the 20th century. For the past two decades, however, it seems once again to experience a kind of renaissance. Major aspects of this development—in terms of medical and cultural history, sociology, politics, and economics—are illustrated on the basis of a general history of homeopathy in the United States. Using original sources, a first attempt is made to reconstruct the history of homeopathy in San Francisco which has some institutional peculiarities that make it unique within the whole country.

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Recent Outbreaks of Shigellosis in California Caused by Two Distinct Populations of Shigella sonnei with either Increased Virulence or Fluoroquinolone Resistance

mSphere ◽

10.1128/msphere.00344-16 ◽

2016 ◽

Vol 1 (6) ◽

Cited By ~ 26

Author(s):

Varvara K. Kozyreva ◽

Guillaume Jospin ◽

Alexander L. Greninger ◽

James P. Watt ◽

Jonathan A. Eisen ◽

...

Keyword(s):

South Asia ◽

San Francisco ◽

Shiga Toxin ◽

Diarrheal Disease ◽

Severe Disease ◽

The United States ◽

Whole Genome ◽

Pathogenic Potential ◽

Content Type ◽

Emerging Trends

ABSTRACTShigellosis is an acute diarrheal disease causing nearly half a million infections, 6,000 hospitalizations, and 70 deaths annually in the United States.S. sonneicaused two unusually large outbreaks in 2014 and 2015 in California. We used whole-genome sequencing to understand the pathogenic potential of bacteria involved in these outbreaks. Our results suggest the persistence of a localS. sonneiSDi/SJo clone in California since at least 2008. Recently, a derivative of the original clone acquired the ability to produce Shiga toxin (STX) via exchanges of bacteriophages with other bacteria. STX production is connected with more severe disease, including bloody diarrhea. A second population ofS. sonneithat caused an outbreak in the San Francisco area was resistant to fluoroquinolones and showed evidence of connection to a fluoroquinolone-resistant lineage from South Asia. These emerging trends inS. sonneipopulations in California must be monitored for future risks of the spread of increasingly virulent and resistant clones.Shigella sonneihas caused unusually large outbreaks of shigellosis in California in 2014 and 2015. Preliminary data indicated the involvement of two distinct bacterial populations, one from San Diego and San Joaquin (SDi/SJo) and one from the San Francisco (SFr) Bay area. Whole-genome analysis and antibiotic susceptibility testing of 68 outbreak and archival isolates ofS. sonneiwere performed to investigate the microbiological factors related to these outbreaks. Both SDi/SJo and SFr populations, as well as almost all of the archivalS. sonneiisolates belonged to sequence type 152 (ST152). Genome-wide single nucleotide polymorphism (SNP) analysis clustered the majority of California (CA) isolates to an earlier described lineage III. Isolates in the SDi/SJo population had a novel lambdoid bacteriophage carrying genes encoding Shiga toxin (STX) that were most closely related to that found inEscherichia coliO104:H4. However, the STX genes (stx1Aandstx1B) from this novel phage had sequences most similar to the phages fromShigella flexneriandS. dysenteriae. The isolates in the SFr population were resistant to ciprofloxacin due to point mutations ingyrAandparCgenes and were related to the fluoroquinolone-resistantS. sonneiclade within lineage III that originated in South Asia. The emergence of a highly virulentS. sonneistrain and introduction of a fluoroquinolone-resistant strain reflect the changing traits of this pathogen in California. An enhanced monitoring is advocated for early detection of future outbreaks caused by such strains.IMPORTANCEShigellosis is an acute diarrheal disease causing nearly half a million infections, 6,000 hospitalizations, and 70 deaths annually in the United States.S. sonneicaused two unusually large outbreaks in 2014 and 2015 in California. We used whole-genome sequencing to understand the pathogenic potential of bacteria involved in these outbreaks. Our results suggest the persistence of a localS. sonneiSDi/SJo clone in California since at least 2008. Recently, a derivative of the original clone acquired the ability to produce Shiga toxin (STX) via exchanges of bacteriophages with other bacteria. STX production is connected with more severe disease, including bloody diarrhea. A second population ofS. sonneithat caused an outbreak in the San Francisco area was resistant to fluoroquinolones and showed evidence of connection to a fluoroquinolone-resistant lineage from South Asia. These emerging trends inS. sonneipopulations in California must be monitored for future risks of the spread of increasingly virulent and resistant clones.

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Looking Back at US Pharmacy’s Past to Help Discern Its Future

Annals of Pharmacotherapy ◽

10.1177/1060028020911085 ◽

2020 ◽

Vol 54 (9) ◽

pp. 907-920

Author(s):

Natalia Shcherbakova ◽

Shane Desselle

Keyword(s):

Patient Care ◽

Current Knowledge ◽

Digital Health ◽

Data Extraction ◽

Improve Patient Care ◽

The United States ◽

Original Research ◽

The Past ◽

Emerging Trends ◽

The Future

Objective: To review specific literature that aimed to predict the future of US pharmacy, beginning in the late 1980s. Data Sources: Articles were identified from searching MEDLINE, CINAHL, Google Scholar, and references of relevant articles. The following combinations of search terms were used: future, pharmacy, prediction, and forecast. Study Selection and Data Extraction: The following inclusion criteria were applied: (1) full-text commentary, review, or original research and (2) focused predominantly on the pharmacy in the United States. Data on predictions for the future of pharmacy were extracted. Data Synthesis: We selected 3 articles published between 1988 and 2006, with each aiming to project the future for the following decade. We examined each prediction in light of the current knowledge. Relevance to Patient Care and Clinical Practice: Educators, practitioners, and other stakeholders should consider reflecting on the changes in pharmacy for the past 3 decades and applying both historical and emerging trends to improve patient care and sustain practice in the third decade of the 21st century and beyond. Conclusion: Most of the predictions for the future of pharmacy from the past 3 decades materialized, with some still in progress (reimbursement for pharmacy services), whereas others manifested in unexpected ways (transition from shortage to excess of pharmacists). Current forces shaping pharmacy include, but are not limited to, growing spending and use of specialty drugs, automation of pharmacy operations, growth of pharmacy in the digital health enterprise, and growing consumer interest in the use of analytical pharmacy that tests drugs before dispensing.

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Pop-Up Potential

10.37419/jpl.v6.i4.3 ◽

2020 ◽

Vol 6 (4) ◽

Author(s):

Alexandra Lizano

Keyword(s):

New York ◽

San Francisco ◽

The United States ◽

Sharing Economy ◽

Large Cities ◽

The Past ◽

Potential Benefits ◽

New Type ◽

Municipal Level ◽

Regulatory Models

Pop-up restaurants have risen in popularity over the past decade in the United States. As used in this Comment, a pop-up restaurant is when an existing restaurant space temporarily loans that space to another chef or restaurant for a limited period of time. This Comment seeks to explore the potential benefits and exploit the drawbacks of pop-up restaurants as property solutions in large cities. Pop-up restaurants thrive in the landscape of the sharing economy, and as such, legal scholars pose that it is imperative to understand this new type of economic scheme to efficiently regulate the entities within it. The beneficial services that pop-ups offer must be weighed against the drawbacks in order to determine if they are worthy of creating adaptive permitting regimes in particular cities. Should a city choose to regulate pop-ups, this Comment poses that such regulation would be most effective at the municipal level. Furthermore, this Comment examines two successful regulatory models—those of San Francisco and New York—and suggests that they can serve as a guide to cities that do not currently regulate pop-up restaurants.

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the inadvertent modification of the atmosphere by air pollution

Bulletin of the American Meteorological Society ◽

10.1175/1520-0477-50.4.199 ◽

1969 ◽

Vol 50 (4) ◽

pp. 199-207 ◽

Cited By ~ 22

Author(s):

Vincent J. Schaefer

Keyword(s):

New York ◽

Air Pollution ◽

Los Angeles ◽

San Francisco ◽

Kansas City ◽

The United States ◽

Front Range ◽

Noticeable Increase ◽

The Past ◽

Dense Concentration

There has been a very noticeable increase in air pollution during the past ten years over and downwind of the several large metropolitan areas of the United States such as the Northwest—Vancouver-Seattle-Tacoma-Portland; the West Coast from San Francisco-Sacramento-Fresno-Los Angeles; the Front Range of the Rockies from Boulder-Denver-Colorado Springs-Pueblo; the Midwest—Omaha-Kansas City-St. Louis-Memphis; the Great Lakes area of Chicago-Detroit-Cleveland-Buffalo; and the Northeast—Washington-Philadelphia-New York-Boston. The worst accumulation of particulate matter occurs at the top of the inversion which commonly intensifies at night at levels ranging from 1000 to 4000 ft or so above the ground. This dense concentration of air-suspended particles is most apparent to air travelers. Thus, it has not as yet disturbed the general public except during periods of stagnant weather systems when the concentration of heavily polluted air extends downward and engulfs them on the highways, at their homes and in their working areas.

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International Research and Variation in Views of Ethnicity

Perspectives on Global Issues in Communication Sciences and Related Disorders ◽

10.1044/gics2.2.66 ◽

2012 ◽

Vol 2 (2) ◽

pp. 66-72

Author(s):

Ella Inglebret ◽

Amy Skinder-Meredith ◽

Shana Bailey ◽

Carla Jones ◽

Ashley France

Keyword(s):

United States ◽

Classification System ◽

International Research ◽

The United States ◽

Research Articles ◽

Journal Articles ◽

Research Participants ◽

The Past ◽

International Scale ◽

Publication Patterns

The authors in this article first identify the extent to which research articles published in three American Speech-Language-Hearing Association (ASHA) journals included participants, age birth to 18 years, from international backgrounds (i.e., residence outside of the United States), and go on to describe associated publication patterns over the past 12 years. These patterns then provide a context for examining variation in the conceptualization of ethnicity on an international scale. Further, the authors examine terminology and categories used by 11 countries where research participants resided. Each country uses a unique classification system. Thus, it can be expected that descriptions of the ethnic characteristics of international participants involved in research published in ASHA journal articles will widely vary.

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Proportion of Individuals With Past-Year Suicidal Ideation Who Attempted Suicide Over the Past 10 Years in the United States, and the Influence of Age and Sex

Crisis ◽

10.1027/0227-5910/a000690 ◽

2020 ◽

pp. 1-5

Author(s):

Shannon Lange ◽

Courtney Bagge ◽

Charlotte Probst ◽

Jürgen Rehm

Keyword(s):

United States ◽

Suicidal Ideation ◽

Random Effects ◽

Attempted Suicide ◽

Suicide Attempts ◽

The United States ◽

Individual Level ◽

The Past ◽

Meta Analyses ◽

Age Category

Abstract. Background: In recent years, the rate of death by suicide has been increasing disproportionately among females and young adults in the United States. Presumably this trend has been mirrored by the proportion of individuals with suicidal ideation who attempted suicide. Aim: We aimed to investigate whether the proportion of individuals in the United States with suicidal ideation who attempted suicide differed by age and/or sex, and whether this proportion has increased over time. Method: Individual-level data from the National Survey on Drug Use and Health (NSDUH), 2008–2017, were used to estimate the year-, age category-, and sex-specific proportion of individuals with past-year suicidal ideation who attempted suicide. We then determined whether this proportion differed by age category, sex, and across years using random-effects meta-regression. Overall, age category- and sex-specific proportions across survey years were estimated using random-effects meta-analyses. Results: Although the proportion was found to be significantly higher among females and those aged 18–25 years, it had not significantly increased over the past 10 years. Limitations: Data were self-reported and restricted to past-year suicidal ideation and suicide attempts. Conclusion: The increase in the death by suicide rate in the United States over the past 10 years was not mirrored by the proportion of individuals with past-year suicidal ideation who attempted suicide during this period.

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