We are helping a task force of the American Gastroenterology Association to evaluate the current state of the (decentralized) market for gastroenterology fellows, and to assess the prospects of reorganizing it via a suitably designed centralized clearinghouse, a "match." This market used a match from 1986 until the late 1990s. Starting in 1996, participation in the match declined precipitously, and it was formally abandoned after 1999. Consequently, the experience of this market when the match was in place, in comparison to the periods before and since, allows an assessment of the effects of the match. An analysis of how the match failed in the 1990s yields insights into the prospects for success of a new match. These events offer economists a rare window on how decentralized labor markets clear, and on how market clearinghouses succeed and fail.