Before residency training can begin, students and graduates must successfully navigate themselves through the Match.
The AOA and National Resident Program Matches are similar, but do have different policies.
It might be tempting to skim over the NRMP’s Match Participation Agreement— it is 41 pages long, but the repercussions for violating the match can be grave.
During the 2017 NRMP Match, 130 violation investigations were initiated. The main residency match saw 87 confirmed violations for applicants and 11 confirmed violations for programs.
DO students and graduates who violate the match can have their training severely impacted. In extreme cases, applicants can be banned from the Match for life. When students are aware of Match guidelines, they are also be able to recognize if a program commits a violation.
Violation 1: Not honoring a match
Once a match is made, applicants and programs are obligated to see it through.
“A student not honoring a match is one of the most common reasons for a match violation,” Ally Anderson, director of match policy at NRMP, says.
If an applicant expresses to a program that they are no longer interested in attending, the program or applicant is expected to request a waiver from NRMP. Only NRMP can release an applicant from a match commitment. The NRMP reviews these on a case-by-case basis.
If the waiver is denied, the applicant is expected to show up and train in the program. If a trainee resigns within 45 days of the start date of the appointment contract, they’ll be considered a match violator.
For this reason, students are encouraged to only rank programs they would want to train at.
This is a completely different process from the AOA Match. AOA programs and applicants can decide to release each other from a match without permission from the National Matching Service.
Violation 2: Contacting programs during SOAP
While participating in the Supplemental Offer and Acceptance Program, applicants are not permitted to contact a program about a position. The program must initiate contact first and the applicant must have applied to the program through ERAS.
“Applicants can’t cold-call or email programs they might be interested in,” Anderson says.
Violation 3: Not withdrawing from the NRMP Match
A common match violation for osteopathic students is not withdrawing from the NRMP match if they secure a position during the AOA Scramble.
Violation 4: Accepting a position outside of the Match
The NRMP requires any institution that participates in The Match to be “all in.” This means that programs are not allowed to pre-match applicants or save post-match positions for specific candidates.
What happens if you violate the Match
Match sanctions vary depending on the infraction.
Typically, applicants who don’t honor their match and do not obtain a waiver from NRMP are barred from the Match for a year and can’t accept a position from any institution that participates in the Match for a year.
Match violators are also identified as such in the NRMP system for a year.
Repercussions for match violators can range from 1 to 3 years or permanently. Programs can also be barred from the Match.
When programs break the rules
Programs are not allowed to ask the names, specialties, geographic locations, or other identifying information about programs to which applicants have applied or may apply to.
According to the Journal of Graduate Medical Education, 72 percent of applicants were asked at least one time about interviews at other programs.
Programs also can’t ask about any ranking information, but 15 percent of applicants were asked at least once how highly they would rank a program. Applicants can volunteer this information on their own.
“Anecdotally, violations are underreported. Programs probably ask ranking information more than we are aware of, but we do address them when they are reported,” Anderson says. “With the match ongoing, applicants are fearful of repercussions and unfortunately don’t report those situations.”
Asking applicants questions about topics such as their religious practices, race, or marital status is not considered a match violation under NRMP guidelines. Questions like these would fall under the purview of the U.S. Equal Employment Opportunity Commission.
Thirty-eight percent of applicants were asked about marital status during interviews.
“The Match wouldn’t investigate those issues. Those questions are not supposed to be asked, but asking someone if they’re married is not a Match violation,” Anderson says.
The NRMP also forbids programs from soliciting post-interview communication, but applicants usually initiate contact to programs first. Programs aren’t allowed to use any post-interview communication as a factor when making their rank order lists.
How to report a match violation
Students and programs can email NRMP or use the online form. A student’s identity would be protected from the program.
“We would most likely ask them some more questions before initiating an investigating of a program, but we would address it if it’s reported,” Anderson says.
Direct questions about the Match and its policies to NRMP.