What is it?
“The Match” is the system in the United States by which applicants are placed into residency and fellowship programs. It allows applicants and residency programs to participate in the conventional process of interviewing but diverges from the traditional system in that no positions are offered or accepted following the interview season. Instead, each applicant is given the opportunity to submit a list to the National Resident Match Program (NRMP) ranking the programs at which he/she interviewed in order of most to least desirable. Likewise, residency programs will also submit a list to the NRMP ranking the applicants they interviewed. Notably, not all programs or applicants need be ranked. After both applicants and residency programs have submitted their rank order lists (ROL’s), a complex Nobel prize-winning algorithm is used to produce an optimal match for all participants. More information on how the algorithm works is available in an NRMP produced video here. For more information on the overall process for IMG’s, the NRMP has created an overview video.
Example scenario: After submitting applications through the electronic residency application system (ERAS) to approximately 40 programs, the applicant is invited to interview at 15 programs, of which the applicant elects to attend 13 of them. After attending the interviews, the applicant decides he would rather not attend 2 of the programs at which he interviewed and leaves them of his ROL ranking the remaining 11 with number 1 being his most desirable and 11 being his least desirable. The programs then rank him among all the other applicants they interviewed and the ROL’s are submitted to the NRMP and on Match Day, the applicant receives an email notifying him into which program he has been placed.
Why is it used?
“The Match” is governed and conducted by the NRMP which is an organization initially established by medical students in the 1950’s as a response to unfair and chaotic residency recruiting practices. The goal was to produce a system which standardized and equalized opportunities for applicants and residency programs to optimize “matching” these two parties.
Eligibility is variable based on the applicant type, and for international medical graduates (IMG) consists of being certified by the Educational Commission for Foreign Medical Graduates (ECFMG). This means that the following requirements must be met by the time the ROL is submitted (although realistically, no program will interview an IMG without all these available):
- Passing scores on Step 1, Step 2 Clinical Knowledge (CK), and Step 2 Clinical Skills (CS) of the United States Medic al Licensing Exam (USMLE), and
- Primary source verification of the IMG’s medical school transcript.
More information on eligibility requirements for IMG’s can be found here.
As the goal for the NRMP is to standardize and equalize opportunities for all applicants and programs, certain regulations are in place to this end. An applicant must first agree to the “Match Participation Agreement for Applicants and Programs”, which is an exhaustive description of the regulations governing the match process (2018 Match Participation Agreement for Applicants and Programs). Click this link to access an NRMP list of most important things an applicant should know - below are some of the most notable:
- Applicants are free to keep confidential their ranking preferences and the names, specialties, geographic locations, or other identifying information about programs to which they have or may apply.
- Applicants are responsible for providing complete, timely, and accurate information to programs during the application, interview, and matching processes. Information that is false, misleading, incomplete, or plagiarized from another source is grounds for a violation investigation.
- The binding match commitment shall be deemed honored if the applicant remains in the training program through the first 45 days after the start date specified in the appointment contract. An applicant who gives notice of resignation, resigns, or vacates a position within 45 days of the start date specified in the contract shall be presumed to have breached the Agreement unless a waiver has been granted by the NRMP.
- Applicants with confirmed violations of NRMP policy may be barred for one year from accepting a position, regardless of start date, in any program sponsored by a Match-participating institution, and/or starting a new position or new training year in any program sponsored by a Match-participating institution if training would within one year from the date of issuance of the Final Report. Applicants who violate Match Week Supplemental Offer and Acceptance Program (SOAP) communications policies may be barred for one year from participating in SOAP.
- Failure to comply with all terms of the Match Participation Agreement, whether intentionally or not, may result in an investigation and the imposition of sanctions, including but not limited to being barred from accepting or starting a position in any program at a Match-participating institution, being barred from future NRMP Matches, and being identified as a Match violator in the R3 system.
How do I do it?
The NRMP has resources available to assist in the process for each of the 3 steps involved in the Matching process accessible below:
Should the applicant be informed that he was not placed into a residency program, he is eligible to enter the supplemental offer and acceptance program (SOAP®). More information is available regarding the SOAP for international medical graduates in this video.