In reply to: Would something like the medical school residency matching posted by Tex Francisco
Residency is a match, not medical school.
Saying is that the residency program and the medical student have come to an agreement before the match. Very few go into the match without already knowing where they are going. At least that was the way it was in 1985.
Not for my wife who came from Nigeria for undergrad and med school. It was very much a process of building relationship and agreeing (silently) to a match during auditions.
You usually know what specialty, and you generally have it narrowed down to a couple places, but unless a place ranked you as one of their top spots and you ranked them number one, there are no guarantees.
For example, if a place has 8 residency spots, if the people that program ranked 1-8 all put it down as their #1 choice, then they should all match.
But tie breakers goes to the applicant, so an applicant who ranked the program first, but the program ranked 9th, would "bump" someone who ranked the program second, but the program ranked in their top 8.
Again, most people know within 3 schools where they'll be going, but there are definitely plenty of surprises on match day
To be fair, last I went through this was 20 years ago so it may have changed.
I'm under the impression that it's an iterative process. In that case the person ranked higher by the residency gets the spot unless their first choice takes them also.
It actually works really well. As for surprises, that depends on specialty and applicant.
If a program A ranks applicant 1 first and applicant 2 second
And program B ranks applicant 2 first and applicant 1 second
And if applicant 1 ranks program B first, and applicant 2 ranks program A first
Then, applicant 1 will match to program B and applicant 2 will match to program A assuming there are no others where the applicant ranked the program number one and the program ranked the applicant number one
But that's a different case. Each applicant gets their highest rated residency that is available to them, but that doesn't mean an applicant can jump someone by having the residency listed first and sometime else using it listed at 5th.
In short, there's no penalty to listing "reach" residencies. It's hard to explain this, but effectively they run an iterative process so the residency gets the highest listed residents who have that residency as their highest listed available residency.