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New NRMP "all-in" policy and GMOs

Discussion in 'Military Medicine' started by BOHICA-FIGMO, Aug 17, 2011.

  1. BOHICA-FIGMO

    BOHICA-FIGMO Belt-fed Physician
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    http://www.nrmp.org/all-in.pdf

    In a nutshell, this policy seems to require residency programs NOT offer positions outside "the match(s)." It seems to be geared toward FMGs, but I wonder what impact it will have on folks who do their 4yr HPSP payback as a GMO then seek civilian residencies. Any thoughts?
     
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  3. orbitsurgMD

    orbitsurgMD Senior Member
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    It just seems that there won't be any handshake deals outside the match. If you are doing GMO and out, you would have to enroll in the match just like all 4th year students. Most do that anyway. Other than that, I don't see anything new.
     
  4. AF M4

    AF M4 Junior Member
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    Hard to say. I know of one GMO who got an anesthesia residency at a mid-tier program outside of the match. As I read the policy, the change is that some programs who participated in the match would hold a few residency slots outside of the match for distribution to other candidates. So if I were an IM program coordinator with 10 slots and I decided I wanted to lock in a GMO outside of the match, I would simply sign the GMO to a contract in January and put the other 9 slots up for grabs to the NRMP. Please correct me if I got this wrong.

    Theoretically, it doesn't have to have any effect. Now that I as the PD have to put all 10 slots up for the NRMP, I simply put the GMO in my #1 slot. Of course now we get into all of those NRMP rules about improper communication with applicants and so forth. But if a GMO is planning on going through the match anyway, it doesn't seem like this policy would have much if any effect.

    Every time you hear about a policy change, you should ask, "Who benefits?" We have three parties involved here:

    - the applicants. Seem to be worse off. In the above scenario, the GMO (or FMG if you like) now has to wait through months of uncertainty and have a great deal of trust in the PD of his program. The FMG will have to go through considerable expense to get a visa/travel without a guaranteed position, and the GMO may decide to go through the match to hedge his bets since he doesn't have a guaranteed contract in hand now and doesn't want to be stuck come Match Day. So it doesn't seem that this was done with the applicants in mind.

    - the programs. Kind of in the same boat as the applicants. They lose the certainty of having a desired applicant under contract for...what?

    - the NRMP. If you're a business, there's nothing like holding a monopoly. The NRMP can't like seeing potential paying customers go outside their system. The NRMP is quite happy making money by being the middleman, and in fairness does do a good job of being an honest broker about it. This is actually a bold power play, in that the NRMP regards itself as so essential that it can dictate terms to residency programs. The NRMP is the main beneficiary here, so long as most reputable programs agree to stay in the match.
     

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