Optimizing Medical Student Clerkship Schedules Using a Novel Application of the Hungarian Algorithm

Matthew T MacLean; Jerzy R Lysikowski; Robert V Rege; Dorothy M Sendelbach; Angela P Mihalic

doi:10.1097/ACM.0000000000003676

Optimizing Medical Student Clerkship Schedules Using a Novel Application of the Hungarian Algorithm

Acad Med. 2021 Jun 1;96(6):864-868. doi: 10.1097/ACM.0000000000003676.

Authors

Matthew T MacLean¹, Jerzy R Lysikowski², Robert V Rege³, Dorothy M Sendelbach⁴, Angela P Mihalic⁵

Affiliations

¹ M.T. MacLean is currently a preliminary resident in internal medicine, Cone Health, Greensboro, North Carolina. At the time of writing, he was a fourth-year medical student, University of Texas Southwestern Medical Center, Dallas, Texas; ORCID: https://orcid.org/0000-0002-0514-7218 .
² J.R. Lysikowski is director of academic evaluation, quality education, and simulation analytics, Office of Medical Education, University of Texas Southwestern Medical Center, Dallas, Texas; ORCID: https://orcid.org/0000-0003-0577-6214 .
³ R.V. Rege is associate dean for undergraduate medical education and professor of surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas; ORCID: https://orcid.org/0000-0002-6864-713X .
⁴ D.M. Sendelbach is assistant dean for undergraduate medical education and professor of pediatrics, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas; ORCID: https://orcid.org/0000-0002-7195-6195 .
⁵ A.P. Mihalic is dean of medical students, associate dean for student affairs, and professor of pediatrics, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas; ORCID: https://orcid.org/0000-0002-7578-0254 .

PMID: 32826419
DOI: 10.1097/ACM.0000000000003676

Abstract

Problem: Medical students often have preferences regarding the order of their clinical rotations, but assigning rotations fairly and efficiently can be challenging. To achieve a solution that optimizes assignments (i.e., maximizes student satisfaction), the authors present a novel application of the Hungarian algorithm, designed at the University of Texas Southwestern Medical Center (UTSW), to assign student schedules.

Approach: Possible schedules were divided into distinct pathway options with k total number of seats. Each of n students submitted a ranked list of their top 5 pathway choices. An n × k matrix was formed, where the location (i, j) represented the cost associated with student i being placed in seat j. Progressively higher costs were assigned to students receiving less desired pathways. The Hungarian algorithm was then used to find the assignments that minimize total cost. The authors compared the performance of the Hungarian algorithm against 2 alternative algorithms (i.e., the rank and lottery algorithms). To evaluate the 3 algorithms, 4 simulations were conducted with different popularity weights for different pathways and were run across 1,000 trials. The algorithms were also compared using 3 years of UTSW student preference data for the classes of 2019, 2020, and 2021.

Outcomes: In all 4 computer simulations, the Hungarian algorithm resulted in more students receiving 1 of their top 3 choices and fewer students receiving none of their preferences. Similarly, for UTSW student preference data, the Hungarian algorithm resulted in more students receiving 1 of their top 3 preferences and fewer students receiving none of their ranked preferences.

Next steps: This approach may be broadly applied to scheduling challenges in undergraduate and graduate medical education. Furthermore, by manipulating cost values, additional constraints can be enforced (e.g., requiring certain seats to be filled, attempting to avoid schedules that begin with a student's desired specialty).

MeSH terms

Algorithms*
Choice Behavior*
Clinical Clerkship / standards*
Female
Humans
Male
Texas
Young Adult