The Match

Joseph S. De Gaetano, DO, MSEd, FAAFP,FACOFP

Associate Professor of Family Medicine

Assistant Dean for Clinical Curriculum/GME

Time to Decide!

• Focus on a specialty

• Set up fourth year electives

• Utilize class “experts”

Two National Accrediting Organizations for Residencies

• ACGME

• AOA

3 Major National Residency Matches

• Military

• Osteopathic

• Allopathic

Military Match

• First match

• Completed by December of the M4 year

• Students who match in the military must take their government assignment and will automatically be withdrawn from the AOA and ACGME matches

NRMP

• The National Residency Matching Program (www.nrmp.org)

• only ACGME accredited residencies participate in the NRMP

• osteopathic students are considered independent applicants: NSU-COM does not manage your interaction with the NRMP

• An impartial venue for matching students to residency positions

• provides a uniform time for selection without pressure• 30,000 applicants compete for 25,000 positions annually

NRMP Residency Categories

• Categorical: programs that begin in the PGY1 year

• Advanced: programs that begin in the PGY2 year

• preliminary: programs that count as a PGY1 year and are a prerequisite for advanced programs

NRMP Process

• Students apply to the NRMP and their residencies independently

• application is to the residency via ERAS

• ERAS is run by the AAMC: an electronic clearing house

• registering with NRMP does not register you with ERAS

NRMP Matching Algorithm

• Always attempts to place a student in his/her most preferred site

• matches remain tentative until the official posting after the match is over

• the final preferences of program directors and applicants are reflected in the posted rank order list

• the final posting is a binding commitment

Guidelines for a Student’s Rank Order List

• Only list programs that you absolutely wish to attend

• list programs in sequence of preference

• an unlimited number of programs can be listed based upon a specialties competitiveness

ACGME Program Directors

• Invite students for interviews• institutional policies override NRMP policy• however, any attempt for an applicant

or program to supply specific rank order info. prior to the match is a violation of the match

• the NRMP rank order list takes precedence over any verbal commitments

Approximate NRMP Timeline in the M4 Year

• August: student registration opens• December 1: applicant registration deadline• January 15: applicants and programs begin to

enter their rank order lists• January 31: programs finalize their rank lists• February 26 at 11:59 p.m. EST: student rank

list deadline• March 17: students notified if matched or

unmatched on web at noon

Approximate Timeline Continued

• March 18 at 11:30 a.m.: unfilled positions listed: unmatched students begin to scramble: contact between students and programs prior to this time is a violation

• March 20 at 1 p.m. EST: all student match results listed: notification to students prior to this time is a violation

• March 22-April 22: letters of appointment sent by hospitals to students

NRMP policies

• Matches are legally binding

• failure to honor this commitment is a breach of contract

Policies Cont.

• Teaching hospitals set their own deadline for their own application submission via ERAS

• any subversion of the matching process will automatically withdraw the applicant from the process

• verbal commitments are non-binding• independent applicants must withdraw on

their own from the match

Policies Cont.

• Students with a commitment via the military match are automatically withdrawn from the NRMP

• students who are selected for a position via the AOA match are automatically withdrawn from the NRMP

• registration fees are non-refundable

ERAS

Electronic clearinghouse for:

• Letters of recommendation

• Transcripts

• MSPE

• Separate registration from matches

• Utilized by Military, MD, and DO residencies

The Restructured Osteopathic Internship

Three Options for the Class of 2009

Option 1Categorical Internship

• Residency programs will grant credit for the 1st postdoctoral year of training.

• Students will “Match” directly into the residency and the 1st postdoctoral year will be considered the first year of residency training.

• Specialties- Anesthesiology, Family Practice, Internal Medicine, Obstetrics and Gynecology and Pediatrics have chosen this option.

Option 2Preliminary Internship

• Residencies who choose this option will require a preliminary 1st year of training as a prerequisite for entry into the 1st year of residency in the 2nd postdoctoral year of training.

• Matching successfully assures entry into both the preliminary year and the subsequent 2nd year in residency training.

• Both the preliminary year and residency will be offered in the same institution

• Specialties- Emergency Medicine, General Surgery, Neuromusculoskeletal Medicine/Osteopathic Manipulative Medicine, Neurology, Neurosurgery, Ophthalmology, Orthopedic Surgery, Otolaryngology, Pathology, Psychiatry, Radiology, Radiation Oncology, Urology have chosen this option.

Option 3Traditional Rotating Internship

• This option represents a traditional rotating internship and stands alone.

• Specialties that have chosen this option prefer residents in their specialty to have completed a traditional rotating internship.

• This option is available to students who are undecided on future plans or for students planning on entering ACGME training.

• Students completing a traditional rotating internship and then selecting option 1 or 2 specialties must contact that specialty college to determine whether advanced standing will be granted.

• This option will depend on available residency positions since most will have been filled with first year matched trainees advancing to the OGME-2 year.

• Specialties- Dermatology, Occupational/Preventive Medicine, Physical Medicine and Rehabilitation and Proctology has chosen this option.

The new rotation schedule for Option 3 –

The Traditional Rotating Internship • 1. At least six months of training rotations in any or all basic core disciplines.

These include general internal medicine, general surgery, family practice, pediatrics, obstetrics/gynecology (ambulatory gynecology) and emergency medicine.

• 2. No less than two months of exposure in general internal medicine. • 3. One-month exposure in emergency medicine. • 4. At least one month in family practice in a hospital or ambulatory site or one-

half day per week for a minimum of 46 weeks of ambulatory exposure in a family practice continuity of care type practice site.

• 5. No more than three months of elective exposure adequate to meet the individual needs of the interns and approved by the DME/internship program director.

• 6. All remaining time may be scheduled at the discretion of the base institution. • 7. No more than one month may be spent in non-clinical experience (research,

scholarly pursuits, administration, etc.). • 8. Exposure must occur to the support disciplines of pathology, radiology, and

anesthesiology. This may occur directly by rotation or indirectly by formal didactic conferences and/or exposure while on medical and surgical services. This exposure must be verified

AOA accreditation of an ACGME Internship

• FL, WV, MI, OK, PA require an osteopathically accredited internship for licensure

• Resolution 42

AOA Match

• Administered by the National Matching Service (NMS) for the AOA

• each student independently registers with the NMS and submits a rank order list

• all osteopathic students automatically receive registration packets from NSU-COM in June of their M3 year

• the deadline for registration is October of the M4 year

• Rank order lists are submitted electronically by the end of January

Preparing for the AOA Match

• Students must also independently apply to residency programs

• ERAS is utilized by osteopathically accredited residencies

• verbal agreements are non-binding• contracts signed before the match are non-

binding• Official match results are binding• a student may rank order as many programs as

they desire

Notification of Results

• Students are notified by email of results in February of their M4 year

• a contract will be sent by mail to matched students from the hospital that selected them

• a student must sign the contract within 30 days after receipt

• failure to sign violates the match rules

Match Violations

• Students who violate match rules cannot take AOA training for one year after the violation

• the AOA will never approve allopathic training performed by students who violate the AOA match rules

• Only a residency training program can release a matched student from their contractual agreement.

• Contract disputes occur between the student and the program

Failure to Match

• All students who do not match via the NMS will receive a listing of open AOA slots across the country via email

• students and programs independently contact each other to fill open slots