The idea of a second match has been around for at least 5-10 years, since I was in medical school. For whatever reasons, the NRMP insists that they cannot turn around the data quickly enough to do a second match in that time frame and the last proposal I saw (when I was in the AMA student section in 2005) was that it would extend the Match process by another 2 weeks.

Of course, that doesn’t mean the process couldn’t stand for some improvements.

There is no other profession I can think of that fills positions in this way. We don’t apply to college of medical school in this way, plenty of fellowship positions get filled by a ‘normal’ application process and the world goes on.

Consider the position of any senior medical student whose partner is not also a senior:
One partner is forced to enter the job market in a way where, one day in March you find out what city you’ll be in for the next 3-5 years and you then have until July to line up a job in that city.

The alternative is for the medical student to only apply to programs in one city.

Neither is desirable. All of these problems are supposed to help us avoid the evil of some well connected medical students securing positions through personal connections. Except that I’m not sure it does that very well. Where are people most likely to match? At their home program where the program knows them well. What can you do to get a leg up at an outside program? Away rotations are almost certainly over-rated, but loads of people have success by having one of their own professors make a call to an old friend/colleague. These are the same deals under another name.

We’d all be better off by getting rid of the black box and letting US Seniors apply for positions out in the open, with programs making offers on a rolling basis with a date in March as the deadline for accepting initial offers and programs working down waitlists to fill unfilled slots.

Students could weigh 3-4 offers and take one earlier in the year if they wanted, allowing spouses more time to find jobs and easing problems with relocation.