Your guide to navigating the military match

Editor’s note: The following article was published in February 2023. We have updated it and are highlighting it in November 2024 as our monthly “throwback” article, our effort to share past columns to provide helpful advice and information to the osteopathic medical community.

The views expressed in this material are those of the author, and do not reflect the official policy or position of the U.S. Government, the Department of Defense or the Department of the Air Force.

When I was a student in the Health Professions Scholarship Program (HPSP) through the U.S. Air Force, the most burning questions on my mind were always focused on one thing: the Military Match or Joint Services Graduate Medical Education Selection Board (JSGMESB). In much the same way the National Resident Match Program (NRMP) works for civilians, the JSGMESB results are the single most important determinant of your immediate future as a military medical student.

While the key details of the JSGMESB are widely available, confusion remains widespread, and medical education forums are frequently inundated by questions from anxious medical students during key application periods. Unfortunately, few of the answers found on such websites are comprehensive or even reliable.

As somebody who has gone through this process, but is not directly involved with it, I want to share as many details as allowed in one place for the benefit of other military med students.

We’ll start with the basic scoring system, and then explore the timeline, the structure and some of the nuances.

Scoring system

There is a standardized scoring system and evaluation process the JSGMESB uses to place candidates. At the very least, as a military medical student, you should be able to anticipate where you will fall on this scale without knowing your exact total points.

To begin, every medical student candidate is scored by three individuals, including program directors (PDs), consultants (officers serving as advisors for a specific specialty) or other senior physicians involved with GME. A recent revision to the scoring sheet has changed the following categories where you can receive points related to the components listed below:

• Pre-clinical (didactics) performance
• Clinical (clerkships) performance
• Officer potential and anticipated success in chosen specialty
• Audition rotation
• Interview

One specific change to note from previous years that might surprise applicants is that research work is no longer a bonus point category. Scholarly activity and publications are now considered within the above components to determine your exact score.

Note also that these categories apply most specifically for fourth-year medical students; officers who apply after a preliminary year, a general medical officer (GMO) tour or even seasoned attendings looking to do another residency have their service record and additional factors considered as well by the JSGMESB.

How your match is made

Students are stratified in order of scores and preferences (your rank list). How this happens exactly varies between specialties, but as with everything else in life, it is a reasonable expectation to believe that applicants with higher scores tend to receive more desired outcomes.

One key difference between the NRMP and the military match is that in the military at least one year of training is guaranteed. When you apply to the military match, you actually submit two rank lists: one with your first and/or second choice categorical training desires, and another ranking one-year preliminary training (PGY-1 only) positions in internal medicine, general surgery or transitional year (traditional rotating internship) and preference for each of the military bases where these are offered. You can also rank “civilian deferred” (Civ-Def) positions, both categorical and PGY-1 only, which will allow you to participate in the NRMP/civilian matches.

So, in a sense, you will match into your specialty first (based on your score), then your actual training position second. Say, for example, there were 10 orthopedic surgery spots and 15 applicants. The 10 applicants with higher overall scores likely will be selected into orthopedic surgery, while the five with the lower scores will likely not. What happens to these five applicants? If they put a second specialty, they will be transferred into that specialty’s pool and their points will be compared to the applicants within that specialty (i.e., internal medicine or general surgery). If they did not put a second specialty, they will transfer directly to the PGY-1 only list.

How do you get assigned to your actual training location? After the points are determined, a more holistic review is conducted, usually in a direct conference call between the program directors. This is where special circumstances are taken into consideration. Be very deliberate if you have special circumstances to be considered in your interview and personal statement (i.e., spouse located at a certain location) because they are the ones who will ultimately hash out these details for you.

Be aware that this part of the process is unpredictable. You may not get exactly what you want, but in most cases, you will end up getting what you need (see the excellent musical number, “Dig a Little Deeper,” from Disney’s classic “The Princess and The Frog,” for reference).

Outcomes

Each branch of service has a yearly document that lists every confirmed and possible position for training that should be used as forecasting by applicants to their board. In the Air Force, for example, it is called the Health Professions Education and Requirements Board (HPERB).

There are several positions you can end up with in the military match.

The first is an active duty (AD) categorical military residency. Completing this will allow you to graduate as a fully trained, board-eligible physician. All military applicants are first considered for AD training spots regardless of what you rank. If you are not selected for a categorical residency, you transfer to the PGY-1 only selection pool. Your final selection in this pool is determined by a combination of senior personnel that may include operational medicine leaders and specialty consultants.

Completing a PGY-1 year qualifies you to serve as a General Medical Officer (GMO), a medical corps position in operational medicine. Results favor the staffing needs of the respective services, and which specialty (internal medicine, general surgery, transitional year) you are selected into for your intern year might surprise you. If you complete a PGY-1 only year, you will also have the ability to apply for the JSGMESB again.

A subset of applicants in both pools will be selected as Civ-Def if your specialty doesn’t have the capacity to train enough physicians in an active duty setting to meet the needs of your service. As mentioned, you can rank these options as a preference.

Being selected Civ-Def will essentially make you a civilian until you complete your residency, and you will still have to match in the NRMP first in order to train in that specialty. This is why it is highly recommended that all military students consider submitting an Electronic Residency Application System (ERAS) application even if their preferred training status is AD, in the event they are selected as Civ-Def in the JSGMESB. You should be aware that this can occur in the PGY-1 only pool as well, and applicants who may not expect to be selected as PGY-1 Only Civ-Def may find relatively limited PGY-1 training spots offered later in the NRMP process if they are applying late.

Certain specialties also have training spots that are “civilian sponsored” (Civ-Spon). This designation can give applicants a boost in the NRMP as their salary and benefits are paid by the military. Civ-Spon are highly prized by civilian residency programs; by accepting these applicants they will have access to a trainee they do not need to cover financially. 

Applicants need to know, however, that Civ-Spon residency training does not count toward your service payback time, or active duty service commitment (ADSC), and Civ-Spon training typically results in a longer required ADSC than completing an active duty military or civilian deferred residency. For instance, if an HPSP scholar receives four years of support for medical school, then completes a three-year AD or Civ Def residency, the scholar would ultimately owe four years of active duty service outside of residency. But an HPSP scholar receiving the same amount of support who completed a three-year Civ-Spon residency would owe seven years of active duty service outside of residency. 

Timeline

Understanding the timeline and deadlines of the JSGMESB is key for success in the military match. These dates are the same for each military branch, and all applicants to the JSGMESB apply through the Military Operational Data System (MODS), which is equivalent to ERAS in the civilian system.

Students first set up their Active Duty Tour (ADT) rotations in winter/early spring of their third year and will perform them the summer/early fall of their fourth year. Students use these rotations as “audition rotations” and their performance will factor into the JSGMESB score as above.

Interviews with each site’s PD or designated interviewing panel usually occur in-person during the ADT. Students can also request virtual or phone interviews with PDs at programs they could not rotate at. Be sure to check well ahead of time with your desired ADT location’s website or administrative assistant/program coordinator as each site may have specific protocols and requirements for rotation, and more popular sites may fill their capacity earlier in the year than other programs.

As of this writing, the initial MODS military residency application is due at the end of August. This is essentially the part of the application that generates your curriculum vitae (CV) and is the basis of your application. In other words, it is your foot-in-the-door of the JSGMESB, and you will not be able to finish the process if you don’t at least finish this preliminary step of the application.

There is still plenty of time to make changes to this document, attach new letters of recommendation, publications, awards, etc., as you may have not completed all of your ADTs. The final application deadline is mid to late October. Your application, with all documents, must be completed by then. Therefore, you must schedule your ADTs in an attempt to complete them before October. Applications are scored by the JSGMESB in November, and final results are announced in early December—usually by email, so check that junk folder!

If you are a military medical student at any stage of the journey, I wish you the best of luck in your endeavors! It is my sincere hope that this information helped clarify your questions and put some of your fears at ease.