The National Resident Matching Program NRMP Main Match provides an impartial venue for matching applicants' preferences for residency positions with program directors' preferences for applicants. Each year approximately 16,000 U.S. allopathic medical school seniors and 15,000 graduates of osteopathic, Canadian or foreign medical schools compete for approximately 23,000 residency positions.
There are four categories of programs participating in the Match:
* Categorical - programs that begin in the PGY-1 year and provide the training required for board certification in medical specialties.
* Advanced - programs that begin in the PGY-2 year after a year of prerequisite training.
* Preliminary - one-year programs beginning in the PGY-1 year that provide prerequisite training for advanced programs.
* Physician - programs that are reserved for physicians who have had prior graduate medical education. Physician programs are not available to senior U.S. medical students.
The NRMP is not an application service or a job placement service. Applicants must apply directly to residency programs in addition to registering for the Match. Most programs participate in the Electronic Residency Application Service (ERAS®), which transmits residency applications to program directors via the Internet. Applicants must register with both NRMP and ERAS® to participate in the services of each.
NRMP Matching Alogorithm
National Resident Matching Program
The National Resident Matching Program NRMP matching algorithm uses the preferences expressed in the rank order lists submitted by applicants and programs to place individuals into positions. The process begins with an attempt to place an applicant into the program indicated as most preferred on that applicant's list. If the applicant cannot be matched to this first choice program, an attempt is then made to place the applicant into the second choice program, and so on, until the applicant obtains a tentative match, or all the applicant's choices have been exhausted.
An applicant can be tentatively matched to a program in this process if the program also ranks the applicant on its rank order list, and either:
* the program has an unfilled position. In this case, there is room in the program to make a tentative match between the applicant and program.
* the program does not have an unfilled position, but the applicant is more attractive to the program than another applicant who is already tentatively matched to the program. In this case, the applicant who is the least preferred current match in the program is removed from the program, to make room for a tentative match with the more preferred applicant.
Matches are "tentative" because an applicant who is matched to a program at one point in the matching process may be removed from the program at some later point, to make room for an applicant more preferred by the program, as described in the second case above. When an applicant is removed from a previously made tentative match, an attempt is made to re-match that applicant, starting from the top of his/her list. This process is carried out for all applicants, until each applicant has either been tentatively matched to the most preferred choice possible, or all choices submitted by the applicant have been exhausted. When all applicants have been considered, the match is complete and all tentative matches become final.
Applicants' Rank Order Lists
Eight applicants are applying to four programs. After considering the relative desirability of each program, the applicants submit the following rank order lists to the NRMP.
Anderson
Brown
Chen
Davis
Eastman
Ford
Garcia
Hassan
1. City
1. City
1. City
1. Mercy
1. City
1. City
1. City
1. State
2. Mercy
2. Mercy
2. City
2. Mercy
2. General
2. Mercy
2. City
3. General
3. State
3. Mercy
3. State
3. Mercy
4. State
4. General
4. State
4. General
4. General
Applicant Anderson makes only a single choice, City, because he believes, based on remarks he heard from the program director, that he would be ranked very highly at City, and he in turn assured the director that he would rank City number one. It is acceptable for programs to express a high level of interest in applicants to recruit them into their program, and for applicants to say that they prefer one program over others. Such expressions, however, should not be considered as commitments.
Applicant Brown ranks only the two programs that were on every applicant's list -- Mercy and City. He is willing to go elsewhere but has ranked only those two programs because he believes he is very competitive. A member of Alpha Omega Alpha chosen in his junior year, he believes that he is a particularly desirable applicant. Applicants should consider ranking all programs they are willing to attend to reduce the likelihood of not matching at all.
Applicant Chen ranks City, which she prefers, and Mercy. Standing first in her class in her junior year, she knows that she is a desirable applicant, and she has been assured by the program director at Mercy that she will be ranked first. She thinks that Mercy will in fact rank her first, and so she reasons that there is no risk of her being left unmatched, even if she does not rank additional programs. Unmatched applicants have shorter lists on the average than matched applicants. Short lists increase the likelihood of being unmatched.
Applicant Ford would be very pleased to end up at State, where she had a very good clerkship, and believes they will rank her high on their list. Although, she does not think she has much of a chance she prefers City, General, or Mercy, so she ranks them higher and ranks State fourth. This applicant is using NRMP to maximum advantage.
Applicant Hassan is equally sure he will be able to obtain a position at State, but he too, would prefer the other programs. He ranks State first because he is afraid that State might fill its positions with others if he does not place it first on his list. Applicants should rank programs in actual order of preference. Their choices should not be influenced by speculation about whether a program will rank them high, low, or not at all. The position of a program on an applicant's rank order list will not affect that applicant's position on the program's rank order list, and therefore will not affect the program's preference for matching with that applicant as compared with any other applicants to the program. During the matching process, an applicant is placed in his/her most preferred program that ranks the applicant and does not fill all its positions with more preferred applicants. Therefore, rank number one should be the applicant's most preferred choice.
Applicants Davis, Eastman, and Garcia have interviewed at the same programs. Like the other applicants, they desire a position at City or Mercy and rank these programs either first or second, depending on preference. In addition to those desirable programs, those applicants also list State and General lower on their rank order lists. They are using NRMP well.
Programs' Rank Order Lists
Two positions are available at each program. The four programs, having determined their preferences for the eight applicants, also submit rank order lists to the NRMP.
Mercy
City
General
State
1. Chen
1. Garcia
1. Brown
1. Brown
2. Garcia
2. Hassan
2. Eastman
2. Eastman
3. Eastman
3. Hassan
3. Anderson
4. Anderson
4. Anderson
4. Chen
5. Brown
5. Chen
5. Hassan
6. Chen
6. Davis
6. Ford
7. Davis
7. Garcia
7. Davis
8. Ford
8. Garcia
The program director at Mercy Hospital ranks only two applicants, Chen and Garcia, for his two positions, although several more are acceptable. He has insisted that all applicants tell him exactly how they will rank his program and both of those applicants have assured him that they will rank his program very highly. He delights in telling his peers at national meetings that he never has to go far down his rank order list to fill his positions. The advantage of a matching program is that decisions about preferences can be made in private and without pressure. Both applicants and programs may try to influence decisions in their favor, but neither can force the other to make a binding commitment before the Match. The final preferences of program directors and applicants as reflected on the submitted rank order lists will determine the placement of applicants.
The program director at State feels that his program is not the most desirable to most of the applicants, but that he has a good chance of matching Ford and Hassan. Instead of ranking those two applicants at the top of his list, however, he ranks more desired applicants higher. He also ranks all of the acceptable applicants to his program. He is using the NRMP well.
The program directors at City and General have participated in the matching process before. They include all acceptable applicants on their rank order lists with the most preferred ranked high. Those program directors are not concerned about filling their available positions within the first two ranks. They prefer to try to match with the strongest, most desirable candidates. They are using the NRMP to maximum advantage.
Here's another example of the Matching Algorithm process at work, in tabular form.
APPLICANT
TRY TO PLACE IN
CURRENT PROGRAM STATUS
ACTION / RESULT
(Shaded boxes indicate the final matches when the process is completed.)
ANDERSON
1. City
City has 2 unfilled positions.
Tentatively match Anderson with City.
BROWN
1. City
City has 1 unfilled position.
Tentatively match Brown with City.
CHEN
1. City
City is filled with more preferred applicants.
2. Mercy
Mercy has 2 unfilled positions.
Tentatively match Chen with Mercy.
DAVIS
1. Mercy
Mercy did not rank Davis.
2. City
City is filled with more preferred applicants.
3. General
General has 2 unfilled positions.
Tentatively match Davis with General.
EASTMAN
1. City
Although filled, City prefers Eastman to its least preferred current match (Brown).
Brown is removed from City to make room for Eastman. Tentatively match Eastman with City.
Since Brown has just been removed from a previous tentative match, an attempt must now be made to re-match Brown.
BROWN
1. City
City is filled with more preferred applicants.
2. Mercy
Mercy did not rank Brown.
Brown remains unmatched.
FORD
1. City
City is filled with more preferred applicants.
2. General
General did not rank Ford.
3. Mercy
Mercy did not rank Ford.
4. State
State has 2 unfilled positions.
Tentatively match Ford with State.
GARCIA
1. City
Although filled, City prefers Garcia to its least preferred current match (Anderson).
Anderson is removed from City, to make room for Garcia. Tentatively match Garcia with City.
Since Anderson has just been removed from a previous tentative match, an attempt must now be made to re-match Anderson.
ANDERSON
1. City
City is filled with more preferred applicants.
Anderson remains unmatched.
HASSAN
1. State
State has 1 unfilled position.
Tentatively match Hassan with State.
The process is now complete: each applicant has either been tentatively matched to the most preferred choice possible, or all choices submitted by the applicant have been exhausted. Current tentative matches are now finalized.
Note that the applicants Anderson and Brown went unmatched because they listed too few choices. Applicant Hassan could have matched at City had he ranked choices in order of preference.
Also note that Mercy, which ranked only two applicants, and General, which ranked seven out of eight, had unfilled positions. General could have matched with Ford, who ranked it #2, had Ford been on its rank order list.
Summary of Guidelines for the Preparation of Applicant Rank Order Lists
1.
Applicants are advised to include on their rank order lists only those programs that represent their true preferences.
2.
Programs should be ranked in sequence, according to the applicant's true preferences.
3.
Factors to consider in determining the number of programs to rank include the competitiveness of the specialty, the competition for the specific programs being ranked, and the applicant's qualifications. In most instances, the issue is not the actual number of programs on the rank order list, but whether to add one or more additional programs to the list in order to reduce the likelihood of being unmatched.
4.
Applicants are advised to rank all of the programs deemed acceptable, i.e., programs where they would be happy to undertake residency training. Conversely, if an applicant finds certain programs unacceptable and is not interested in accepting offers from those programs, the program(s) should not be included on the applicant's rank order list.
NRMP Match Process
National Resident Matching Program
Because it provides a uniform date for decisions about residency selection for both applicants and programs, the National Resident Matching Program NRMP matches eliminate the pressure that might otherwise fall upon applicants and programs to make decisions before all of their options are known. The Match Participation Agreement outlines the guidelines and procedures developed to accomplish this objective and should be reviewed carefully.
The NRMP can best accomplish its goals when every program involved in the selection of applicants participates fully in the Match. The NRMP is a matching service and provides the mechanism for matching applicants to programs according to the preferences expressed by both parties on their individualized rank order lists.
There are three steps in a match: registration, ranking, and results. The entire match process is conducted on the web through the NRMP's Registration, Ranking, and Results (R3) System.
Registration
Each match has a separate schedule. To learn when registration begins, go to the Schedule of Dates for all NRMP matches. To register for any of the matches offered by the NRMP, an applicant must go to
http://www.nrmp.org and click on the Register/Login button. Beneath the login information will appear "Applicant Registration ". The process is three parts:
1.
Entering the applicant's personal and professional information. Included in this information must be a valid email address.
2.
After completing the first section, the applicant will be asked to agree to the Match Participation Agreement.
3. The final section is the payment. Registration fees are non-refundable, as stated in the Match Agreement. Fees are due at the time of registration and are payable only online by VISA, MasterCard, or TeleCheck. Other separately mailed forms of payment cannot be accepted by the NRMP.
Ranking
Applicants and programs submit their rank order lists directly on the NRMP web site. It is unlikely that a program will rank an applicant if the program did not grant an interview. Applicants submit, in the applicant's order of preference, a list of the programs where they have interviewed. Each program also submits a list of applicants in its order of preference. Those lists are then compared against each other, incorporating a computerized matching algorithm program.
Since January 1998, a new applicant proposing algorithm has been used in all NRMP matches. This algorithm assumes that offers made to applicants for by various programs are determined by the applicants' preferred order lists (rank order lists). Applicants match into the programs listed highest on their lists that also ranked the applicant and had not filled all of available positions with applicants the program preferred as determined by the program's rank order list.
There is one cardinal rule for both programs and applicants: neither must ask the other prior to the Match to make a commitment as to how each will be ranked. Each party may express a high level of interest in the other; however, references to how each will rank the other should be avoided and should definitely not be solicited. Neither programs nor applicants should consider these comments about interest as commitments. Candor and honesty are important for both programs and applicants.
Results
Results will be posted on Match Day at 1:00 PM eastern time on the NRMP web site or can be obtained by contacting the NRMP office. Information includes:
* Applicants - Where they matched
* Programs - Who matched to the program
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