The Match

The National Resident Matching Program (NRMP), otherwise known as "The Match," is a process in which medical students engage in order to get into residency programs. The NRMP provides a uniform system by which residency candidates simultaneously "match" to first- and second-year postgraduate training positions accredited by the Accreditation Council for Graduate Medical Education (ACGME)(www.acgme.org).

What is the Match?

The National Resident Matching Program (www.nrmp.org)(NRMP) contains information about registration, deadlines, etc. The NRMP describes, in brief, the basic process through which the Match is conducted.

The NRMP provides a uniform system by which residency candidates simultaneously "match" to first- and second-year postgraduate training positions accredited by the ACGME.

It is uniform in that all the steps of the process are done in the same fashion and at the same time by all applicants and participating institutions. All students should enroll in the Match and are bound to abide by the terms of it. However, if a student is offered a position by an institution not in the Match, such as an osteopathic position or an unaccredited position, his or her dean of student affairs can withdraw the student before the Match deadline for changes. Keep in mind that if at least one of the institution’s residency programs participates in the Match, all programs in that institution must offer positions to U.S. allopathic medical school seniors only through the NRMP or another national matching program.

It is a violation of NRMP rules for either an applicant or a program to solicit information about how the other will rank them. If that information is solicited from you, you are under no obligation to, nor should you, provide it. It is not a violation for an applicant or a program to volunteer information about how one plans to rank the other. Any verbal indication of ranking is not binding, however, and the rank order list takes precedence. Students are advised not to rely on such verbal remarks when creating their rank order lists.

An applicant who certifies a rank order list enters into a binding commitment to accept the position if a match occurs. Failure to honor that commitment is a violation of the Match Participation Agreement signed during registration and triggers an investigation by the NRMP. If the violation is confirmed, the applicant may be barred from future matches for up to three years and the NRMP will notify the applicant’s medical school, the American Board of Medical Specialties, and all programs on the rank order list.

The Match is “nearly” all-inclusive because it lists almost all first-year positions in ACGME accredited training programs. Candidates for residency positions in Ophthalmology, Neurology, Neurological Surgery, and some Plastic Surgery programs will participate in the San Francisco Match, although programs will participate in both matches. These candidates must, however, participate in the NRMP in order to secure a preliminary position for each of these specialties. Furthermore, programs sponsored by some branches of the Uniformed Services do not participate in the NRMP.

The entire NRMP Match process is conducted via the Web using the Registration, Ranking, and Results System (R3). Users can access R3 through the NRMP Web site(www.nrmp.org). Applicants will pay their registration fee online with a credit card or telecheck, enter their rank order list, and receive Match results via the Web.

The following section includes a detailed example from the NRMP, which illustrates how the Match works. In reading through this example, you will see how the Match accomplishes, in one day, what once took weeks of negotiation between residency applicants and hospitals when no NRMP existed. It is possible not to get the position you preferred; you may not match at all, but there are some simple guidelines that can help to ensure the best possible match for you.

• Do not overestimate yourself. Although you may think you will match at your top choice, you increase your chance of not matching by listing only one program.
• Do not underestimate yourself. Even if you do not think you have much of a chance and if you really want to go somewhere in particular, go ahead and rank it first. The program may not get its top ten choices, and you might be number eleven on its list. It will not negatively influence your chances of matching to less competitive programs lower on your list. Remember no one but you will know what rank you matched to.
• Do not list programs that you do not want. You may end up at a program that you really did not want. Decide whether it is better to be unmatched than to be matched to a program that you don't want.
• Remember that the order in which you rank programs is crucial to the Match process. Upon casual consideration, one or more programs may seem fairly equivalent to you, but if you take the time to consider carefully, you may discover reasons you would rank one program over another. The Match computer is fair, but it is also indifferent to anything other than the Rank Order List provided. If you rank one program above another, it will put you in the first program if it can without stopping to consider that, after all, maybe geographic location is more important to you than a higher faculty to resident ratio.
• Don't make your list too short. On an average, unmatched students' lists were shorter than matched students' lists. Students selecting highly competitive specialties are advised to make longer lists.

These are just some of the guidelines that will help you as you begin the process of entering the Match. More specific information, a schedule of dates, and registration materials from the NRMP are available on the NRMP Web site(www.nrmp.org) or through your Office of Student Affairs. Keep an eye out for notices regarding information from the NRMP. Not everyone will match to a position. Applicants can find out from the Web or their deans if they are unmatched before Match Day so that they will have the opportunity to contact hospitals that did not fill and hopefully secure a satisfactory position.

It is not true that only “bad” programs do not fill. A program may not fill if its rank list is at odds with the applicants who ranked it or is too short. There are likely to be several programs with unfilled positions after the Match that you would find desirable. In some cases, it may mean accepting a position in another specialty that you were considering as a second choice or were considering for the purpose of preparing you for the next year’s Match. Your dean’s office and the department chairman in your medical school, with information provided by the National Resident Matching Program, are prepared to help locate open positions for students who do not match.