The Match

2006 Main Match Schedule

The Match and How It Works

The National Resident Matching Program provides a guaranteed, uniform, nearly all-inclusive system by which residency candidates are simultaneously "matched" to first-year postgraduate training positions accredited by the Accreditation Council on Graduate Medical Education.

It is guaranteed because it ensures that the applicant is matched to the highest ranked hospital on his or her list that offered the applicant a position. In other words, through the Match, you cannot end up accepting a position if a position you ranked higher was open to you.

It is uniform in the sense 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, his or her dean can send a withdrawal notice before the matching process begins. The NRMP agreement requires that participating hospitals offer all positions to students in all residency programs through the Match. They cannot withhold one or two positions for an early decision before the Match. In addition, participating hospitals and their program directors are prohibited from eliciting information or a commitment from applicants as to which hospitals they are going to rank or how they are going to order their ranked list. Similarly, NRMP applicants are prohibited from accepting positions outside of the Match and are cautioned not to share information about their ranked lists with program directors.

The Match is "nearly" all-inclusive because it only lists those positions in hospitals with ACGME accredited training programs which have agreed to participate in the Match. There are programs in certain specialties which have elected not to participate. For example, most programs in neurology, ophthalmology, otolaryngology, urology and neurosurgery do not participate although some programs in these specialties do. Candidates for residency positions in these specialties should participate in a separate Match process which takes place before the NRMP. They must also participate, in most cases, in the NRMP in order to secure the prerequisite postgraduate training for each of these specialties. There is also a separate Match for dermatology PGY-2 programs, however, it occurs after an individual has already entered his or her first year of postgraduate training.

When an applicant is "offered" his first choice position, the match is final. His/her name is removed from the list of all other programs and their Rank Order Lists are adjusted, as necessary to maintain their quotas by including the next person down the list. If an applicant matches to a lower-ranked program, the match is tentative. His/her name is removed from the lists of all programs ranked yet lower, but is maintained on the lists of his/her higher-ranked programs. If his/her name should subsequently be included within the quota of a program he/she has ranked higher; he/she will be moved to the higher choice position. No matter how many top-ranked applicants "decline" offers from a given program, lower-ranked applicants who rank that program first will be matched to it as long as they are included in the program's unfilled quota.

It is possible not to get the position you wanted; it's possible not to match at all, but there are some simple guidelines which can help to ensure the best possible match for yourself:

• Don't overestimate yourself. No matter how sure you are that you will match at your top choice, you cannot be penalized for listing additional programs. Those applicants who list only one or two programs are much more likely not to match.
• Don't underestimate yourself. Again, you are not penalized for listing programs that you consider to be a long shot for you. Even if you don't think you have much of a chance, if you really want to go somewhere, go ahead and rank it first. The program may not get its top ten choices, and you might be number eleven on the list.
• Don't list programs that you don't want to go to. You may end up at a program that you really didn't want only to find out that one of the programs that you did want, didn't fill and might have taken you.
• What if you don't match? Unmatched applicants are notified a day or two before the Match results are released, so 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 don't fill. It is possible for any program not to fill if its rank list is at odds with the applicants who ranked it. 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.

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