Residency Match revamps placement of students not selected initially

Starting in 2012, the National Resident Matching Program will administer a new system to link unmatched students with unfilled residency positions.

By Carolyne Krupa — Posted Dec. 26, 2011

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The National Resident Matching Program is revising its annual residency match to improve how vacant residency slots are filled after the main match.

Starting in 2012, the NRMP will implement its Supplemental Offer and Acceptance Program, or SOAP. The program is designed to provide more equality for students who aren't selected for a residency in the main match by creating a formal process for applying for unfilled positions.

"Our goal is to make the Match Week Scramble less chaotic," said Mona Signer, MPH, executive director of the NRMP. "There are many more unmatched applicants than there are unfilled positions."

Match Week is a hectic time for students, said Tyler Cymet, DO, associate vice president for medical education with the American Assn. of Colleges of Osteopathic Medicine.

"It is a time of great anxiety and great stress for students," he said. "In many cases it will determine the rest of their careers."

In 2001, there were 5,627 unmatched applicants and 2,288 unfilled positions. By 2010, the gap had grown to 8,794 unmatched applicants competing for 1,060 unfilled positions, according to the NRMP.

An end to the "Scramble"

In previous years, unmatched students participated in the "Scramble," in which they frantically contacted programs with unfilled positions, trying to get a slot.

It was a highly competitive and disorganized process in which students often had to accept the first offer they got on the spot, Signer said. In 2011, most of the 1,060 available positions were filled within the first 24 hours.

"It was sort of a free-for-all. People would try to call and email and fax," said Sandra Sanguino, MD, MPH, associate dean for student programs and career development at Northwestern University Feinberg School of Medicine in Chicago. "Overall, what [the new approach] is going to do is put people more on a level playing field. Everyone who does not match will have an opportunity to apply to positions that have not been filled."

As a result of the change, Match Day will move from the third Thursday to the third Friday of March. In 2012, Match Day will be on March 16.

Before the Match, unfilled positions will be posted online March 12, the same day students learn if they will land a residency on Match Day. Unmatched students will submit applications for unfilled positions that day.

On March 14, residency programs with unfilled positions will finalize their preference lists of applicants, and the NRMP will begin making offers to applicants.

"After this first year, we'll see how many offer rounds are required," Signer said.

Unlike the Scramble, applicants could receive multiple offers in each round and will be able to consider their options before making a decision.

"Before, a student might accept an offer and two or three hours later, a better offer might come along," Signer said. "Sometimes the student will renege after accepting a position, or a program will withdraw an offer in favor of a better applicant."

Under SOAP, students and programs will be obligated to fulfill their commitments, she said.

All NRMP applicants will be notified about their eligibility for SOAP the Friday before Match Week. Dr. Cymet said he is concerned that will cause confusion and anxiety for many students, who will think being eligible for SOAP means they did not match.

Signer said the notice will make it clear that it is not related to whether the student matched. "We think they will want to prepare if they're not SOAP eligible," she said.

In 2013, the NRMP plans to implement a new All-In Policy, requiring residency programs to place all of their first- and second-year residency positions in the Main Residency Match. The NRMP is accepting comments on the change.

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External links

National Resident Matching Program (link)

NRMP report on All-In Policy, including instructions on how to submit comments (link)

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