Second Match Proposal

NRMP Second Match Frequently Asked Questions

What is the NRMP?
The National Resident Match Program (NRMP) was started in 1952 to facilitate and direct residency placement for medical school graduates. The intent was to replace the old system of residency selection that was fraught with secret agreements, coercion and nepotism. The NRMP has strived in the past 53 years to ensure a professional and ethical approach to the match that maintains a fair and unbiased application process for both the applicant and the programs involved.

What is the current Match set-up?
The current Match follows a strict timeline. Currently, application deadlines are the end of October, with interview season from November through early February. Rank Order Lists (ROL), which consist of the applicant's top-ten programs ranked in order of preference, are due the final Tuesday in February, and Match Day is the third Thursday in March.

What is the “Scramble”?
It is estimated that 7% (~1,000/15,000) of all Match applicants do not match across all specialties and must participate in the scramble.

If an applicant does not match in his/her chosen specialty, he/she is notified on the Monday before Match Day. The applicant then has 48 hours to “scramble” into another spot. This involves contacting programs that have not filled their spots and trying to obtain a full residency appointment or a transition year position. This is a very stressful period for the applicants involved as well as for the unfilled programs.

What is the Second Match Proposal?
The Second Match Proposal is an attempt to reduce the number of applicants that must undergo the “scramble”. The estimates state that the match rate after the Second Match would be ~99.5%. This new system would allow applicants and programs to rank their preferences again and alleviate the stress of the scramble. Supporters of the Second Match propose that this system is fairer to the applicants and programs, and would help to ensure that each party’s interests are served.

How would the Second Match affect applicants?
The Second Match would completely alter the current timeline. ROL’s would be due 2 weeks earlier; possibly reducing interview season by 2 weeks. It would also push Match Day back 2 weeks. The proposed timeline would have applicants who match in the “First Match” being notified if they matched on March 1, and Second Match participants on March 30. No applicant would know where he/she matched until April 1, Match Day. (Keep in mind, programs do not know who matched at their institution until Match Day, either.)

Also, this process would not completely eliminate the scramble. The conservative estimate is that ~0.05% of applicants would remain unmatched. And, thus, this group would still be required to scramble to obtain a position.

What is the NRMP’s position on the Second Match?
The NRMP voted in May 2005 against the implementation of the Second Match. The NRMP was opposed to this proposition because it would delay notification of the majority of applicants and programs to serve the interests of a small minority, as well as limiting interview season. Also, the initial intent of the Second Match was to eliminate the scramble, and the current proposal does not.

The NRMP surveyed applicants in 2005 about the proposed Second Match. Sixty percent of students and programs disagreed with the later Match Day, and 70% disagreed with a longer wait period before finding out where applicants matched. Sixty percent of program directors were opposed due to increased administrative cost and time. Seventeen of 19 professional organizations were in opposition for a myriad of reasons.

Most notably, and possibly most easily overlooked, is the fear that the Second Match will alter rank order behavior. Students may only rank their very top programs because they can “fall back” on the Second Match if they don’t match in the first round. This “safety net” approach may have a negative impact on average programs and on the integrity of the Match process. The Second Match may be viewed as a two-step process and applicants may try to optimize their chances by manipulating the process; completely undermining the intent of the Second Match.

What’s next in Match Reform?
The NRMP continues to explore options to decrease the number of unmatched applicants and to serve the interests of those applicants who must undergo the scramble. The NRMP is currently studying ways to improve the Second Match proposal and is ready and willing to work with all involved to improve the current Match process.

What is the AMA-MSS role?
The AMA-MSS supports the idea of a Second Match, but does not support the current template. The AMA-MSS encourages the NRMP to explore other options and continues to remind the NRMP of the stress and uncertainty the current scramble creates.

The AMA-MSS has a full voting member of the NRMP Board of Directors who serves as your voice of your concerns and ideas. Feel free to contact your representative, Jona Rushing (jona-rushing@uiowa.edu), with any questions, comments or suggestions.