Assigning doctors to mandatory service hospitals: a strategy-proof approach

I analyze the mechanism used to assign medical doctors to mandatory service positions in Türkiye. To address staffing gaps in underserved areas, the government requires newly graduated, specialized, or subspecialized doctors to work in designated hospitals. Doctors submit ranked preferences, and the current mechanism is equivalent to the Boston mechanism followed by a general lottery step, but without any priority structure on the hospital side. This lack of hospital preferences turns the assignment into a one-sided matching problem, where only doctors have preferences. Despite high satisfaction reports by the Ministry of Health – claiming most doctors are assigned to one of their top choices – the mechanism has significant drawbacks. Most importantly, the mechanism is not strategy-proof: doctors may benefit from misrepresenting their preferences. For example, some may list less-demanded but acceptable hospitals as top choices to avoid assignment to more undesirable locations. Such strategic behavior distorts the allocation and undermines transparency. Doctors also share strategies in online forums, introducing further inefficiencies. To address these issues, I propose replacing the current mechanism with random serial dictatorship (RSD). RSD is strategy-proof, eliminating incentives for manipulation, and offers a simpler, more transparent process for mandatory service assignments.