Jung v. Association of American Medical Colleges was an antitrust class-action lawsuit that alleged collusion to prevent American trainee doctors from negotiating for better working conditions. The working conditions of medical residents often involved 80- to 100-hour workweeks. [1] The suit had some early success but failed when the US Congress enacted a statute exempting matching programs from federal antitrust laws.
Every year, American medical students and graduates participate along with foreign-trained physicians in a national matching plan to obtain a position in an accredited resident training program. Applicants and programs that participate in the matching plan submit rank-ordered preferences for training. A mathematical algorithm is used to place an applicant in a preferred program that also prefers the applicant.[ citation needed ]
The National Resident Matching Program, also referred to as "The Match," is the only comprehensive national matching plan in the United States.
The suit was launched by Paul Jung, MD on behalf of all current and former medical residents against defendants that oversaw and participated in the matching process as well as institutions that employed medical residents. [2]
The three physicians who launched the suit alleged that the NRMP Matching program was an anti-competitive practice, claiming that:
The defendants challenged the admissibility of the lawsuit with several arguments, including a lack of jurisdiction [4] and that the plaintiffs had not been injured. [5] The court dismissed the cases against two defendants for lack of jurisdiction, and three because the claims of conspiracy did not involve them. The federal district court did allow the case to proceed against 17 defendants, ruling:
... the Court finds that plaintiffs adequately have alleged a common agreement to displace competition in the recruitment, hiring, employment and compensation of resident physicians and to impose a scheme of restraints that has the purpose and effect of fixing, artificially depressing, standardizing and stabilizing resident physician compensation and other terms of employment among certain defendants. [4]
The lawsuit ended when Congress enacted legislation as a rider added to an unrelated bill (the Pension Funding Equity Act) that exempted participation in a matching program from federal antitrust laws.
The rider was called "Confirmation of antitrust status of graduate medical resident matching programs" (Section 207). Neither the rider nor the then-ongoing Jung v. AAMC case was debated. The rider was lobbied for by the AAMC and the American Hospital Association, and sponsored by Senator Judd Gregg of New Hampshire and Senator Edward Kennedy of Massachusetts. [2] Senators Kohl, Feingold, and Bingaman publicly criticized the way in which the rider was added. [3]
The rider praised the 50-year-old Matching Program, saying that "[a]ntitrust lawsuits challenging the matching process, regardless of their merit or lack thereof, have the potential to undermine this highly efficient, pro-competitive, and long standing process" and "would divert the scarce resources of our country's teaching hospitals and medical schools from their crucial missions of patient care, physician training, and medical research" [2]
The bill containing the rider was signed into law by President George W. Bush on April 8, 2004. [2]
The new law prohibited "using allegations related to the Match to support any antitrust claim", [2] retroactively. [3] The court ruled that the plaintiff's case was dependent on allegations related to the Match. [2] The case was dismissed under the authority of the new law. [6]
Urology, also known as genitourinary surgery, is the branch of medicine that focuses on surgical and medical diseases of the urinary-tract system and the reproductive organs. Organs under the domain of urology include the kidneys, adrenal glands, ureters, urinary bladder, urethra, and the male reproductive organs.
The Association of American Medical Colleges (AAMC) is a nonprofit organization based in Washington, D.C. that was established in 1876. It represents medical schools, teaching hospitals, and academic and scientific societies, while providing services to its member institutions that include data from medical, education, and health studies, as well as consulting. The AAMC administers the Medical College Admission Test and operates the American Medical College Application Service and the Electronic Residency Application Service. Along with the American Medical Association (AMA), the AAMC co-sponsors the Liaison Committee on Medical Education (LCME), the accrediting body for all U.S. MD-granting medical education programs.
Residency or postgraduate training is a stage of graduate medical education. It refers to a qualified physician, veterinarian, dentist or podiatrist (DPM) who practices medicine, veterinary medicine, dentistry, or podiatry, respectively, usually in a hospital or clinic, under the direct or indirect supervision of a senior medical clinician registered in that specialty such as an attending physician or consultant. In many jurisdictions, successful completion of such training is a requirement in order to obtain an unrestricted license to practice medicine, and in particular a license to practice a chosen specialty. In the meantime they practice "on" the license of their supervising physician. An individual engaged in such training may be referred to as a resident, registrar or trainee depending on the jurisdiction. Residency training may be followed by fellowship or sub-specialty training.
According to the US Department of Education, the Educational Commission for Foreign Medical Graduates is "the authorized credential evaluation and guidance agency for non-U.S. physicians and graduates of non-U.S. medical schools who seek to practice in the United States or apply for a U.S. medical residency program. It provides comprehensive information and resources on licensure, the U.S. Medical Licensure Examination (USMLE), residencies, and recognition."
Wilk v. American Medical Association, 895 F.2d 352, was a federal antitrust suit brought against the American Medical Association (AMA) and 10 co-defendants by chiropractor Chester A. Wilk, DC, and four co-plaintiffs. It resulted in a ruling against the AMA.
The American Osteopathic Association (AOA) is the representative member organization for the more than 176,000 osteopathic medical doctors (D.O.s) and osteopathic medical students in the United States. The AOA is headquartered in Chicago, Illinois, and is involved in post-graduate training for osteopathic physicians. Beginning in 2015, it began accrediting post-graduate education as a committee within the Accreditation Council for Graduate Medical Education, creating a unified accreditation system for all DOs and MDs in the United States. The organization promotes public health, encourages academic scientific research, serves as the primary certifying body for D.O.s overseeing 18 certifying boards, and is the accrediting agency for osteopathic medical schools through its Commission on Osteopathic College Accreditation. As of October 2015, the AOA no longer owns the Healthcare Facilities Accreditation Program (HFAP), which accredited hospitals and other health care facilities.
Rutgers Robert Wood Johnson Medical School is a medical school of Rutgers University. It is one of the two graduate medical schools of Rutgers Biomedical and Health Sciences, together with New Jersey Medical School, and is closely aligned with Robert Wood Johnson University Hospital, the medical school's principal affiliate.
Medical education in the United States includes educational activities involved in the education and training of physicians in the country, with the overall process going from entry-level training efforts through to the continuing education of qualified specialists in the context of American colleges and universities.
The Accreditation Council for Graduate Medical Education (ACGME) is the body responsible for accrediting all graduate medical training programs for physicians in the United States. It is a non-profit private council that evaluates and accredits medical residency and internship programs.
Medical resident work hours refers to the shifts worked by medical interns and residents during their medical residency.
The American Board of Otolaryngology, located in Houston, Texas, is a non-profit corporation that has set the mission of ensuring professional standards with certificates and memberships, and have offered training in the fields of head neck surgery to professionals since 1924.
The Liaison Committee on Medical Education (LCME) is an accrediting body for educational programs at schools of medicine in the United States and Canada. The LCME is sponsored by the Association of American Medical Colleges and the American Medical Association. It publishes many guides and standards, including the Directory of Accredited Medical Education Programs. The LCME currently accredits 155 U.S. schools, which includes 4 in Puerto Rico, as well as 17 others in Canada. The LCME accredits the schools that grant a Doctor of Medicine (M.D.) degree. Graduates of LCME-accredited schools are eligible for residency programs accredited by the Accreditation Council for Graduate Medical Education (ACGME).
An international medical graduate (IMG), earlier known as a foreign medical graduate (FMG), is a physician who has graduated from a medical school outside of the country where he or she intends to practice. The term non-local medical graduate may be similarly used in countries with distinct licensing regions within them. Generally, the medical school of graduation is one listed in the World Directory of Medical Schools (WDOM) as accredited by the Foundation for Advancement of International Medical Education and Research or the World Health Organization.
A fellowship is the period of medical training, in the United States and Canada, that a physician, dentist, or veterinarian may undertake after completing a specialty training program (residency). During this time, the physician is known as a fellow. Fellows are capable of acting as an attending physician or a consultant physician in the specialist field in which they were trained, such as internal medicine or pediatrics. After completing a fellowship in the relevant sub-specialty, the physician is permitted to practice without direct supervision by other physicians in that sub-specialty, such as cardiology or oncology.
Medical school in the United States is a graduate program with the purpose of educating physicians in the undifferentiated field of medicine. Such schools provide a major part of the medical education in the United States. Most medical schools in the US confer upon graduates a Doctor of Medicine (MD) degree, while some confer a Doctor of Osteopathic Medicine (DO) degree. Most schools follow a similar pattern of education, with two years of classroom and laboratory based education, followed by two years of clinical rotations in a teaching hospital where students see patients in a variety of specialties. After completion, graduates must complete a residency before becoming licensed to practice medicine.
Most physicians in the United States hold either the Doctor of Medicine degree (MD) or the Doctor of Osteopathic Medicine degree (DO). Institutions awarding the MD are accredited by the Liaison Committee on Medical Education (LCME). Institutions awarding the DO are accredited by the Commission on Osteopathic College Accreditation (COCA). The World Directory of Medical Schools lists both LCME accredited MD programs and COCA accredited DO programs as US medical schools. Foreign-trained osteopaths do not hold DO degrees and are not recognized as physicians in the United States or in other jurisdictions.
The American Medical Association (AMA) Physician Masterfile includes current and historical data on all physicians, including AMA members and nonmembers, and graduates of foreign medical schools who reside in the United States and who have met the educational and credentialing requirements necessary for recognition as physicians. A Masterfile record is created and ME number assigned when entering medical school or through the ECFMG. For medical students, there are two primary methods to create the initial record - the Student Outreach Program and the annual freshman matriculation file received from the Association of American Medical Colleges (AAMC).
The National Resident Matching Program (NRMP), also called The Match, is a United States-based private non-profit non-governmental organization created in 1952 to place U.S. medical school students into residency training programs located in United States teaching hospitals. Its mission has since expanded to include the placement of U.S. citizen and non-U.S. citizen international medical school students and graduates into residency and fellowship training programs. In addition to the annual Main Residency Match that in 2021 encompassed more than 48,000 applicants and 38,000 positions, the NRMP conducts Fellowship Matches for more than 60 subspecialties through its Specialties Matching Service (SMS). The NRMP is sponsored by a board of directors that includes medical school deans, teaching hospital executives, graduate medical education program directors, medical students and residents, and one public member.
The West Virginia University School of Medicine is the professional school for the study of medicine and other health professions at West Virginia University in Morgantown, West Virginia. The medical school was established in 1902 as the first such institution in the state of West Virginia, and remains one of only three medical schools in the state.
Match Day is a term used widely in the graduate medical education community to represent the day when the National Resident Matching Program or NRMP releases results to applicants seeking residency and fellowship training positions in the United States. Match Day for the NRMP Main Residency Match is on the third Friday of March each year, and Match Day ceremonies occur at many of the 155 medical schools in the United States where those results are announced. Match Days for the NRMP Fellowship Matches occur throughout the year because each Fellowship Match has its own schedule of dates. Other matching plans like the American Urological Association, and the San Francisco Match have dates on which they release their results. By participating in a national matching plan, applicants contractually agree to attend the residency, internship or fellowship programs to which they match. The same agreement applies to the programs; they are obligated to train the applicants who match to them. In 2017, Match Day hit a record-high as 35,969 U.S. and international medical school students and graduates vied for 31,757 residency positions.
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