Sincerely yours, -Jeff

Beginning in the early fall of each year, residency training candidates undertake the challenging task of seeking the proram where they will begin their residency training the following July. Concurrently, graduate medical education program directors begin to review applications and to interview and evaulate candidates for their available residency positions.

What is the Match?

The NRMP Match was established to provide a mechanism whereby program directors and applicants could consider all their options before making final commitments, and to establish a uniform date and time for the announcement of residency positin appointments. After completing thei respective evaluations, programs and applicatns each prepare a final listing of their choices, in preference order, which are then used by the Match to place applicants into residency positions. The success of the match depends on a high level of trust among all particpants in the Matching Program.

What is a "Match Violation"?

The NRMP has established principles and policies to guide particpants (programs and applicants) through the Match application and rank order process. These policies form the basic underpinning of a fair, open, and orderly Match process. The failure of a participant in the Match to comply with one or more of these policies is called a Match violation. Match violations negatively impact all participants in the Match. For example, the consequences of the Match violations can result in:

• an applicant pressured by a program director to reveal the program's place on the applicant's rank order list.

• a program director notified that a matched applicant will be a "no show" and finding that other applicants have all matched elsewhere.

• an international medical graduate pressured by a (or pressuring) a program director to sign a contract before Match Day.

• a student affairs dean counsling an unmatched sutudent who believed a program director's "promise" that he/she would be ranked first.

• a matched applicant who could have matched to a more preferred program that now has an open position because of an applicant "no show."

NRMP Statement on Professionalism The National Resident Matching Program maintains the highest professional standards in the conduct of the Match process and through its interactions with all participants in the Match: applicants, program directors, institutional officals and student affairs deans. The NRMP expects all participants in the Match process to conduct their affairs related to the Match in an ethical and professionally responsible manner. Applicants are expected to adhere to the policies of the NRMP in their search for a residency position. Program Directors, Instutional Officials and Deans of Student Affairs must honor the conditions of their agreement with the NRMP and also respect the right of applicants to freely investigate program options prior to submission of a final rank order list.

How do I Avoid Engaging in a Match Violation?

The policies and procedures of the NRMP Match process are available on the NRMP website; http://www.nrmp.aamc.org. Where registering for the Match, all participants certify they agree to conduct their affairs related to the Match consistent with these policies. Particpants can avoid engaging in a Match violation through the observance of practices that respect the right of programs and applicants to determine their selections in the absence of unwarranted pressure and to adhere to the highest ethical principles in all interactions with other Match participants.

Match Communications

Applicants and program directors may express a high degree of interest in each other and try to infulence decisions in their favor, but must not make statements implying a committment. although NRMP policies do not prohibit either an applicants or program director form volunteering how he/she prlans to rank the other, it is aviolation of the NRMP policies to request such information.

Program directors and applicants frequently engage in the practice of sending letters following the applicant's interview with the program. These letters often contain statements that can be misinterpted by either party. Match participants must understand that such letters are not binding and have no standing when final rank order lists are submitted.

Examples of Violations...

NOTE: The examples of match violations noted below are not intended to be all inclusive. Any additional questions or clarifications regarding Match violations should be directed to the NRMP.

1. Agreements Made by Match Participants Before the Match.

• A program accepts and signs an agreement with a U.S. Senior before Match Day.

• An applicant requests a contract before the annoucement of Match results.

  (Note from Jeff: It is the understanding of the Board that asking to see a sample contract is not a violation (this question was raised at our October meeting), the violation is asking for a promise or a binding contract. However, the language above is the offical language. We're working on clarification.)

• An applicant commits to a concurrent year training position outside the NRMP Match and does not withdraw from the NRMP Match. (This includes an applicant who matches to a concurrent year PGY1 position in another Match that preceds the NRMP Match.)

• A program director "guarnatees" an applicant that he/she will rank the applicant within the programs' quota, but only if the applicant will rank the program first on their rank order list.

• An applicant "guarantees" a program director that he/she will rank the program first on their rank order list, but only if the program director will rank the applicant within their program's quota.

• An unmatched applicant contacts a program in the Match to seek a position before 12:00 PM noon EST on Tuesday of Match Week.

• A program director, anticipaing being unfilled, contacts a student affairs dean on Monday of Match Week to find out which students did not match.

• A student affairs dean consults with faculty and other colleagues about possible openings before the beginning of the scramble period.

• An applicant decides not to honor the committment to his/her matched program, i.e., is a "no show" for the matched program.

• An applicant asks to be released from entering training in the program in which he/she matched in order to accept a position elsewhere, or for reasons other than serious hardship.

• An institution adds new appointment requirements that were not communicated to ranked applicants prior to the Match.

• A program director approaches an applicant who is matched elsewhere to explore the possibility of having the matched applicant switch programs.

• A program decides not to honor the commitment to a matched applicant who satisfies all the appointment requirements, except in cases of serious hardship.

• A program seeks a release from a commitment to a matched applicant in order to offer the position to another applicant for reasons other than serious hardship.

NRMP policies stipulate that programs and applicants can be released of their commitments in certain instances that cause "serious hardship" for programs and applicants, provided both parties agree to the release.

"Serious Hardship" refers to the occurence of a highly unusual, unexpected, and unpredictable situation or circumstances that renders the fulfillment of the match obligation as either impossible or would result in irreparable harm to any one of the committed match particpants. Examples of "serious hardship" include an applicant who failed to graduate on time; a closing of a program or institution; the death or serious illness of a family member that requires the applicant to alter their choice of residency location; or the loss of accreditation by a program or institution.

"Serious hardship" does not include taking advantage of a more "desireable" choice of a program or applicant after rank order lists are submitted.

What do I do When a Violation Occurs?

All partticpants in the Match affirm their commitment to conduct their affairs related to the Match process within the policies and procedures of the NRMP. These policies and procedures are available on the NRMP web site: http://www.nrmp.aamc.org

Participants should contact the NRMP with any knowledge or suspicion of a violation as soon as possible. In many instances, immediate notification allos time to rectify the violation. The NRMP will work with all participants to rectify difficult situations caused by violations of the Match. The cooperation of peers represent an important step toward ensuring a fair and equitable Match process.

The NRMP is currently working with the American Board of Medical Specialties to develop a system where confirmed applicant violations will be reported to the respective specialty board by the NRMP. The NRMP is also working with The Accreditation Council for Graduate Medical Education (ACGME) to develop a process where confirmed program and institutional violations will be reported to the ACGME and to the respective Residency Review Committee.

Important Contact Information

Website: http://www.nrmp.aamc.org

Telephone: 202-828-0676

Fax: 202-828-1121

e-mail: nrmp@aamc.org