Rank List Game Theory

Let’s play a game.

Assume you are about to enter a 3 to 7 year apprenticeship that will redefine your character, scramble your personal life, pay you ~$8/hr,  greatly increase your risk of suicide compared to the average population, help you fulfill a life-long dream, and provide you with the privilege and responsibility to comfort and heal. Assume it is both wonderful and a little daunting.

You guessed it: We’re playing a game called “Becoming a Resident Physician.” It is one of the stranger games I have ever played, one that requires a peculiar, very personal calculus. Over the past few months, I have had many conversations with friends who are going through the same process and have been surprised by the diversity of approaches to the game. Anecdotally, it seems to me that the strongest forces within the game are family situation (which increases desire for a good location) and youth (which increases the desire for prestige). All this has made me very curious about how different people think about such situations. That’s why I’m interested what your approach might be. So, play with me?

Here is a very simple scenario:

1)      Assume you must list, in order, your top three choices: Prestigious Hospital (PH), Unique Training Hospital (UTH), Good Location Hospital (GLH).

2)      Assume that each hospital is excellent in its namesake quality and is satisfactory in the other two qualities. For example Good Location Hospital puts you in the city you most want to live in and close to your friends, family, loved ones; however, GLH has only satisfactory prestige and opportunities for unique training.

3)      Caveats:

It cannot be known what effect the prestige of the hospital will have on your career; however, it is not likely to be deleterious.
Optimizing unique training is likely to provide you with a significantly more lucrative career and/or greater academic success overall; however, current and future healthcare reforms are likely to reduce the lucrativeness and/or research funding by an unknown amount.
Good Location provides easier access to places of interest, friends, family, loved ones; however, you will have very little time to enjoy these things.
Assume that all other things are equal (though they never really are).

So, that’s it: PH vs. UTH vs. GLH. What’s your rank list and why?

As you might guess, I’m in the process of finalizing my rank list, which will be finalized February 20th. Then a computer somewhere in Baltimore, or so I am told, will take all the lists of applying medical students and all the lists of students desired by hospitals and create the “Match,” assigning one student to one hospital. The commitment is binding. One must, the following  July, report to the hospital at which one matched or one will not become a physician.  On Match Day, March 15th (beware the Ides of March!) every medical student in the US and Canada will be given an envelope, and at the exact same hour, all across the continent, we will open our letters and discover where we will become physicians.