TheNationalResidency MatchingProgram

The National Residency Matching Program (NRMP) & Other Matches: 

The National Residency Matching Program (NRMP) & Other Matches Isaac K. Wood, M.D. Associate Dean of Student Activities Virginia Commonwealth University School of Medicine

What is the Match?: 

What is the Match? The Match is a system by which students are paired with residency training programs. Prior to 1951, appalling abuses of the system occurred: Weak programs would pressure students to sign contracts. Although there was a uniform announcement date of pairings, it was unworkable.

Who Oversees the NRMP?: 

Who Oversees the NRMP? Association of American Medical Colleges American Hospital Association American Medical Association American Board of Medical Specialties American Medical Student Association AAMC Organization of Student Representatives AMA Medical Student Section Consortium of Medical Student Organizations

The NRMP Algorithm: 

The NRMP Algorithm The algorithm favors students. All applicants (U.S. M.D. Students, D.O. students, physicians, IMGs) are treated equally. Using the algorithm, the computer matches students in six minutes.

The NRMP Algorithm: 

The NRMP Algorithm The Match handles each applicant in sequence. An attempt is made to place an applicant into his or her most preferred program. If this is unsuccessful, an attempt is then made to place the applicant into the second, third, etc. ranked program. This process continues until there is a (tentative) match or until the applicant’s listed programs have been exhausted.

The NRMP Algorithm: 

The NRMP Algorithm When subsequent applicants go through the process, an attempt is first made to place them into their most preferred program. If a program they ranked highly has ranked them higher than applicants already tentatively matched, the new applicants get the spot and the previously matched applicants go back through the algorithm.

The NRMP Algorithm: 

The NRMP Algorithm When applicants are “bumped” from a spot and go back through the Match, the process again begins with their first-choice program. The Match is complete when all applicants have either been matched with one of their choices or all the programs listed by the applicants have filled their positions.

Participating Specialties: 

Participating Specialties Most PGY-1 positions are offered through the NRMP Match using the Electronic Residency Application Service (ERAS). Ophthalmology, Otolaryngology, Neurology, Neurological Surgery, some Plastic Surgery Programs and Urology either use the San Francisco Matching Program or their own Matching Program. Most PGY-2 positions are NOT offered through the Match.

Intern Positions: 

Intern Positions There are three types of PGY-1 positions offered: Categorical Preliminary Transitional

Categorical Positions: 

Categorical Positions Are designed for broad specialties. Do not require preliminary training. Are for individuals who want to remain in the same program throughout their residency. Found in Family Medicine, Internal Medicine, Pediatrics, Emergency Medicine, Obstetrics and Gynecology, General Surgery and Pathology.

Preliminary Positions: 

Preliminary Positions Are designed for students seeking one or two years of clinical experience prior to another specialty. Available in Internal Medicine and General Surgery. If applying to an advanced program, you must apply separately for a preliminary program.

Transitional Positions: 

Transitional Positions Generally designed for students who cannot decide on a medical specialty. Year closely resembles the M3 clerkship assignments. May also serve as a substitute for a preliminary year.

Advanced Positions: 

Advanced Positions Are those positions above the PGY-1 level that are available to senior students. Presume the student will complete a preliminary year. Offer positions at the PGY-2 or higher level.

Advanced Programs: 

Advanced Programs Examples of programs that may require a preliminary year are: Anesthesiology Dermatology Neurology Ophthalmology Physical Med & Rehab Diagnostic Radiology Radiation Oncology THE STUDENT MUST CHECK WITH EACH PROGRAM TO DETERMINE ITS REQUIREMENTS!

Rank-Order Lists: 

Rank-Order Lists The order in which a student lists programs is the Rank-Order List (ROL). The programs complete a similar list of candidates. The ROL is submitted to the NRMP electronically. The ROL may be modified as often as desired until mid-February at which point the student MUST CERTIFY a final ROL.

Optimizing the ROL: 

Optimizing the ROL Two key elements: List your first-choice programs first. Consider how many programs you should list.

Optimizing the ROL: 

Optimizing the ROL Applicants consistently do better if they list their top choice first. Thereafter, rank programs in the order of their acceptance to you—not in the order in which you think you are acceptable to the programs. For highly competitive specialties, a long ROL increases the odds a student will match. For programs that are easier to match with, the student may want a relatively short list.

Optimizing the ROL: 

Optimizing the ROL The key to success is to consider, for each program you list, whether you would rather go to that program or whether you would prefer to be unmatched and take your changes in the scramble. The most common reason that applicants don’t match is that they do not list enough programs.

Confidentiality: 

Confidentiality Match rules do not allow programs or applicants to ask each other how they will be ranked. ROL’s from both parties are confidential. Applicants must report any program to the NRMP that offers a contract outside of the Match for punitive actions.

Match Results: 

Match Results Match Day is in Mid-March Three days prior to Match Day at 12 noon EST, students may check the NRMP website to see if (but NOT WHERE) they matched. On that same day, the Dean of Student Activities gets a list of all students who did not match and those applicants are notified.

Match Results: 

Match Results Two days prior to Match Day at 11:30 a.m. EST, program directors learn if their programs filled. At 12 noon, the NRMP website makes available to the Dean of Student Activities a list programs with openings. At this time, unmatched students and programs can begin scrambling to fill the open positions.

Match Results: 

Match Results One day prior to Match Day, at 2:00 p.m. EST, the Dean of Student Activities is sent a confidential list where each student matched. On Match Day, at 12 noon EST, there is a party where students are given notification of where they matched, or the student may check the NRMP website at 1:00 p.m. EST.

Special Situations: 

Special Situations Couples Match Military Match Early Match

Couples Match: 

Couples Match May be used by married students, engaged students or close friends. The couple enrolls in the Match, but indicates they want to be in the Match as part of a couple. Couples apply to and interview at programs separately, but within the same geographic region. Each person completes a ROL, trying to rank programs equally. The couples are treated as a single entity, unless they cannot be matched together. Then the NRMP runs an independent Match.

Military Match: 

Military Match Who’s obligated? Students in the School of Medicine of the Uniform Services University of the Health Sciences are obligated to do a military residency (military medical school in Bethesda, Maryland). Students enrolled in the Health Professions Scholarship Program owe the military one year for each year of funding with a two-year minimum obligation. A student may do this as part of the residency, or after completing a civilian residency, if allowed to defer. Anyone may apply for a military residency.

Military Match: 

Military Match The U.S. Army residency programs (all specialties) go through ERAS. The process is similar to NRMP in terms of ROL’s. Representatives of the teaching hospitals make the selections rather than a computer. Match results are distributed early in the senior year. Students still owe the military time sponsored as a resident (receives officer’s pay, some benefits, and a salary bonus) upon completion of the residency.

Military Match--Pitfalls: 

Military Match--Pitfalls There are generally many more applicants for military residency positions than available slots. So military students will want to apply for both military and civilian Matches. Civilian residencies may be unwilling to take a student from the military unless there is a written commitment that the student will not be pulled for active duty.

Early Match: 

Early Match The early match programs use the San Francisco Matching service. The website for this is www.sfmatch.org The Urology programs conduct their own match. The San Francisco Match does not set the deadline dates, the programs do.

Early Match--Neurosurgery: 

Early Match--Neurosurgery May: Accept requests for registration. May-June: Program directory available on line and students contact programs for deadline dates. Summer: Gather all application materials and mail to the SFM. Target date is August 26. November 1: Medical Student Performance Evaluation is released. December: Programs and applicants submit ROL’s January 19: All ROL’s must be in by 12 noon PST. January 27: Programs and Dean of Student Activities faxed Match results. January 28: Applicants who do not know the results may call. February 2: Release of vacancies.

Early Match--Neurology: 

Early Match--Neurology May: Accept requests for registration. May-June: Program directory available on line and students contact programs for deadline dates. Summer: Gather all application materials and mail to the SFM. Target date is September 2. November 1: Medical Student Performance Evaluation is released. December: Programs and applicants submit ROL’s January 18: All ROL’s must be in by 12 noon PST. January 27: Programs and Dean of Student Activities faxed Match results. January 28: Applicants who do not know the results may call. February 2: Release of vacancies.

Early Match--Ophthalmology: 

Early Match--Ophthalmology May: Accept requests for registration. May-June: Program directory available on line and students contact programs for deadline dates. Summer: Gather all application materials and mail to the SFM. Target date is September 9. November 1: Medical Student Performance Evaluation is released. December: Programs and applicants submit ROL’s January 12: All ROL’s must be in by 12 noon PST. January 20: Programs and Dean of Student Activities faxed Match results. January 21: Applicants who do not know the results may call. January 26: Release of vacancies.

Early Match--Otolaryngology: 

Early Match--Otolaryngology May: Accept requests for registration. May-June: Program directory available on line and students contact programs for deadline dates. Summer: Gather all application materials and mail to the SFM. Target date is August 19. November 1: Medical Student Performance Evaluation is released. December: Programs and applicants submit ROL’s January 5: All ROL’s must be in by 12 noon PST. January 13: Programs and Dean of Student Activities faxed Match results. January 14: Applicants who do not know the results may call. January 19: Release of vacancies.

Early Match--Urology: 

Early Match--Urology Spring 2005-January 7, 2006: Information available on line and registration is accepted through December 28. Application via ERAS. Fall-January 2006: Interview with programs. December-January 7: Applicants and programs submit preference lists. January 7: Deadline for preference lists. January 7-24: Matching process performed. January 24: Results faxed to Dean of Student Affairs

Important Dates in the NRMP Application Process: 

Important Dates in the NRMP Application Process March-November: Students obtain information from residency programs. Mid-July: Applicants will receive a token so they can register with ERAS and begin working on application materials. The NRMP Directory of Programs is posted on the NRMP website. Mid-August: Applicants can begin registering for the NRMP’s Main Match--$65 fee. September 1: Students may begin sending applications to training programs. November 1: The Medical Student Performance Evaluation (Dean’s letter) is submitted to ERAS. December 1: This is the initial NRMP deadline. After this date there is an additional $50 charge to register with the NRMP. Early January to Mid-February: Applicants and programs enter their Rank-Order Lists using the R3 System on the NRMP website. January 31: Programs must submit their final program information on the number of positions available. Mid-February: The R3 System closes. March: Scramble and Match results.