I'll give you a long answer that details out the match, so to others, I apologize.
First I need to correct an error. Residency is now required: (from:
"Information about the National Resident Matching Program (NRMP) can be found on the web at
http://www.nrmp.org. It contains information about registration, deadlines, etc. This site describes, in brief, the basic process through which the Match is conducted.
The NRMP provides a uniform system by which residency candidates simultaneously "match" to first- and second-year postgraduate training positions accredited by the ACGME.
It is uniform in the sense that all the steps of the process are done in the same fashion and at the same time by all applicants and participating institutions. All students should enroll in the Match and are bound to abide by the terms of it. However, if a student is offered a position by an institution not in the Match, such as an Osteopathic position or an unaccredited position, his or her dean of student affairs can withdraw the student before the Match deadline for changes.
It is a violation of NRMP rules for either an applicant or a program to solicit information on how the other will rank them. If that information is solicited from you, you are under no obligation to, nor should you, provide it. It is not a violation for an applicant or a program to tell the other how one will be ranked. Any verbal indication of ranking is not binding, however, and the rank order list takes precedence. Students are advised to not rely on such verbal remarks when creating their rank order lists.
An applicant who certifies a rank order list enters into a binding commitment to accept the position if a match occurs. Failure to honor that commitment is a violation of the Match Participation Agreement signed during registration and triggers an investigation by the NRMP. If the violation is confirmed, the applicant may be barred from future matches for up to three years and the NRMP will notify the applicants medical school, the American Board of Medical Specialties, and all programs on the rank order list.
The Match is "nearly" all-inclusive because it lists almost all those positions in ACGME-accredited training programs that participate in the Match. Candidates for residency positions in Opthalmology, Neurology, Neurological Surgery, and Plastic Surgery will participate in the San Francisco Match, although some programs will participate in both matches. These candidates must, however, participate in the NRMP in order to secure a prerequisite postgraduate training for each of these specialties. Furthermore, programs sponsored by some branches of the Uniformed Services do not participate in the NRMP.
The entire NRMP Match process is conducted via the Web using the Registration, Ranking and Results System (R3). Users are able to access R3 through the NRMP Web page at
www.nrmp.org. Applicants will pay their registration fee online using a credit card or bank card, enter their rank order list and receive Match results via the Web.
The following section includes a detailed example from the NRMP, which illustrates how the Match works. In reading through this example, you will see how the Match accomplishes, in one day, what used to take weeks of back and forth negotiation between residency applicants and hospitals when no NRMP existed. It is possible not to get the position you preferred; it's possible not to match at all, but there are some simple guidelines that can help to ensure the best possible match for you.
- Do not overestimate yourself. Although you may feel sure that you will match at your top choice, you may increase your chance of not matching by listing only one program.
- Do not underestimate yourself. Even if you do not think you have much of a chance and if you really want to go somewhere in particular, go ahead and rank it first. The program may not get its top ten choices, and you might be number eleven on its list. It will not negatively impact your chances of matching to less competitive programs lower on your list. Remember no one but you will know what rank you matched to.
- Do not list programs that you do not want. You may end up at a program that you really did not want. Decide whether it is better to be unmatched than to be matched to a program that you don't want.
- Remember that the order in which you rank programs is crucial to the Match process. Upon casual consideration, one or more programs may seem fairly equivalent to you, but if you take the time to consider carefully, you may discover reasons you would rank one program over another. The Match computer is fair, but it is also indifferent to anything other than the Rank Order List provided. If you rank one program above another, it will put you in the first program if it can without stopping to consider that, after all, maybe geographic location is more important to you than a higher faculty to resident ratio.
- Don't make your list too short. On an average, unmatched students' lists were shorter than matched students' lists. Students selecting highly competitive specialties are advised to make longer lists.
These are just some of the guidelines that will help you as you begin the process of entering the Match. More specific information, a schedule of dates and registration materials from the NRMP will be made available to you on the NRMP Web site or through your Office of Student Affairs. Keep an eye out for notices regarding information from the NRMP.
Not everyone will match to a position. Applicants can find out from the Web or their deans if they are unmatched before Match Day so that they will have the opportunity to contact hospitals that did not fill and hopefully secure a satisfactory position.
It is not true that only "bad" programs do not fill. It is possible for any program not to fill if their rank list is at odds with the applicants who ranked it or is too short. There are likely to be several programs with unfilled positions after the Match that you would find desirable. In some cases, it may mean accepting a position in another specialty that you were considering as a second choice or were considering for the purpose of preparing you for the next year's Match. Your dean's office and the department chairman in your medical school, with information provided by the National Resident Matching Program, are prepared to help locate open positions for students who do not match."
So here is the gist: each medical student selects a number of programs to apply to through a uniform application process called ERAS. Their applications are electronically transmitted (after being factually verified by ERAS) to the programs an applicant chooses. Interviews are scheduled and completed based on the ERAS data. Then the applicants enter a "rank order list" of the programs they have interviewed, in the order of the applicants preference. The programs do the same (rank the applicants). An computer, using a system that favors the applicants' preferences then generates a "match list". This is a binding agreement between an applicant and the programs for the residency position. In the week prior to match day, both applicants and programs first find out if a "match" has been made. If it has not, then the dreaded "scramble" occurs. This is where un-matched students literally call programs that have not filled and vye for a spot. The "scramble" is also regulated by NRMP rules. After the scramble, on the same day nationwide ("Match day"), the results are annouced and the medical student learns where they will attend resdiency.
Now, there are a few things to remember. Some specialties require an intern year prior to entering training (e.g., dermatology, opthomology), other include the the intern year into their program (e.g., most emergency medicine, family practice) and still others require a "transitional year" which is essentially an intern year focused on a specific area of medicine (e.g., internal medicine, general surgery). Now, the ACGME has specific requirements for the first year of residency, be it included, an intern year, or a transitional year, to insure that all practicing physicians achieve competence in basic medical conditions. When entering the match for programs that require a transitional year or intern year, you have to apply for those positions as well.
If someone doesn't match, and can't scramble (a very rare condition - keep in mind that by virtue of undergoing the medical school application process, medical students are generally adept at academic survival), then some will enter intern year or transitional year programs and try again the next year. A very small number may take jobs outside of clinical medicine.
The question usually isn't "will a student match" but rather "will a student match into a specialty they want?" Unfortunately the answer is sometimes no, especially in competitive specialties such as dermatology, optomology or ortho surgery.
