Econ Papers Daily / 期刊论文
土耳其住院医师重新安置中保留既得权利
Preserving acquired rights in the re-placement of medical residents in Türkiye
摘要
We analyze the re-placement mechanism implemented in Türkiye for reassigning doctors to residency programs after scoring errors were realized. By law, initial placements based on faulty scores are acquired rights, prohibiting re-placement to less favorable programs. This setup requires balancing fairness for doctors with improved rankings, preserving acquired rights, and adhering to program capacities. Our analysis focuses on the two-step serial dictatorship mechanism implemented by the Center for Assessment, Selection, and Placement (CASP) to address this problem. We show that the CASP mechanism violates fairness, such that higher-scoring doctors may justifiably envy the assignments of lower-scoring peers. Yet, when doctors adopt a weakly dominant strategy and truncate preferences below their initial placements, a more lenient notion of q-fairness is satisfied. Additionally, we show how manipulation incentives under the CASP mechanism lead to excessive deviations from target capacities. We propose the Acquired Rights Adjusted Serial Dictatorship (AR-SD) mechanism to prevent strategic manipulation and minimize deviations. Furthermore, we describe simple modifications to the CASP mechanism that render it equivalent to AR-SD. Finally, simulations using total deviations as a metric show that AR-SD consistently achieves fewer deviations than the CASP mechanism.
中文摘要
我们分析了土耳其在发现评分错误后，为重新分配医生至住院医师项目而实施的重新安置机制。根据法律，基于错误评分的初次安置被视为既得权利，禁止将医生重新安置至较不理想的方案。这一设定要求在改善排名的医生公平性、维护既得权利以及遵守项目容量之间寻求平衡。我们的分析聚焦于评估、选拔与安置中心（CASP）为解决此问题而实施的两步序列独裁机制。我们证明，CASP机制违反了公平性，使得得分较高的医生可能合理地对得分较低同行的分配产生嫉妒。然而，当医生采取弱主导策略并将其偏好截断至初次安置之下时，一种更为宽松的q-公平性概念得以满足。此外，我们展示了CASP机制下的操纵激励如何导致对目标容量的过度偏离。我们提出了既得权利调整序列独裁（AR-SD）机制，以防止策略性操纵并最小化偏离。进一步，我们描述了将CASP机制简单修改后使其等同于AR-SD的方法。最后，使用总偏离度作为指标的模拟显示，AR-SD始终比CASP机制实现更少的偏离。