NRMP, ACGME, The Match

[CoolDocGal]

Registered in the NRMP for ACGME programs. Some ACGME programs are not in the match. I matched somewhere. Now a program that was not in the NRMP, has said they have an opening. How can I go about getting that spot? If it is a NRMP violation, what is the worst that can happen? Anything with the Boards and/or AGCME?

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[gutonc]

Registered in the NRMP for ACGME programs. Some ACGME programs are not in the match. I matched somewhere. Now a program that was not in the NRMP, has said they have an opening. How can I go about getting that spot? If it is a NRMP violation, what is the worst that can happen? Anything with the Boards and/or AGCME?

Be less vague or we can't help you.

 

[CoolDocGal]

So, I registered in the NRMP for a particular ACGME specialty. But some programs in that specialty actually were not in the match. I went through the match and I matched somewhere. But now now a program that was not in the NRMP, has declared they have an opening (which was not there before).

How can I go about getting that spot? Since the open spot was never in the match, is it a problem?
Is this a NRMP violation and if so, what is the worst that can happen?
Can the NRMP cause any issues with board eligibility? Can they cause issues with the ACGME?

 

[Smurfette]

If you've already matched somewhere and have changed your mind and want to go somewhere else, that is a match violation. It doesn't matter if the program you go to uses the match or not...YOU are the violator. You'd have to see if your program would be willing to let you out of your match agreement. But you would violate the match and this would affect your ability to use the NRMP match for fellowship or other programs in the future, if you should decide to pursue one in a field that uses the match. Think of it as being banned from using the NRMP, which means any programs in any field that use the NRMP are not available to you.

If you train at an ACGME sponsored program, it should not affect your ability to be board certified.

 

[CoolDocGal]

If you've already matched somewhere and have changed your mind and want to go somewhere else, that is a match violation. It doesn't matter if the program you go to uses the match or not...YOU are the violator. You'd have to see if your program would be willing to let you out of your match agreement. But you would violate the match and this would affect your ability to use the NRMP match for fellowship or other programs in the future, if you should decide to pursue one in a field that uses the match. Think of it as being banned from using the NRMP, which means any programs in any field that use the NRMP are not available to you.

If you train at an ACGME sponsored program, it should not affect your ability to be board certified.

Hi Smurfette, Thank you for the information. Yes, I have matched already. But what if I were never going to use the NRMP ever again? Just done with my training?

Will it affect any other area of my career? I would be transferring from one ACGME program to another AGCME program in the same specialty. So no issues with boards?

Thanks!

 

[gutonc]

Hi Smurfette, Thank you for the information. Yes, I have matched already. But what if I were never going to use the NRMP ever again? Just done with my training?

Will it affect any other area of my career? I would be transferring from one ACGME program to another AGCME program in the same specialty. So no issues with boards?

Thanks!

Hard to believe but you have now posted 3 different posts on the same topic and managed to get more opaque with each one...strong work.

Let me see if I can figure this out. You matched last year for an advanced specialty that you are scheduled to start this coming July. Subsequently, a program in that same advanced specialty that you feel that you would prefer to attend has a spot available. You want that spot (in spite of either not matching there in the first place or not knowing about it) and want to ditch your matched spot for this new, magical position.

How'd I do?

Do you have a signed contract in hand from Magical Unicorn Rainbow Fart program? Do you even have an interview there or are they even aware that you exist?

To answer your other questions:

No, no issues with boards. Issues with fellowships (assuming they exist in your extremely vague specialty) and potentially losing both spots if your matched program finds out what you did and reports you to NRMP and MURF Program. If MURF program is outside of the match, it is very likely that it is in a small specialty. Trust me, the PDs at Matched Program and MURF program know each other...they may not be golf buddies, but they definitely talk to each other.

But...assuming you can get through all of this and complete your residency program...no...you shouldn't have any issues getting BC.

 

[CoolDocGal]

Hard to believe but you have now posted 3 different posts on the same topic and managed to get more opaque with each one...strong work.

Let me see if I can figure this out. You matched last year for an advanced specialty that you are scheduled to start this coming July. Subsequently, a program in that same advanced specialty that you feel that you would prefer to attend has a spot available. You want that spot (in spite of either not matching there in the first place or not knowing about it) and want to ditch your matched spot for this new, magical position.

Thank you for your insight and time. Yes, I interviewed at both programs last year. The open spot program has contacted me saying they would like to offer me the spot.

Do you have a signed contract in hand from Magical Unicorn Rainbow Fart program? Do you even have an interview there or are they even aware that you exist?

I do not have a contract signed at either program yet.

To answer your other questions:

No, no issues with boards. Issues with fellowships (assuming they exist in your extremely vague specialty) and potentially losing both spots if your matched program finds out what you did and reports you to NRMP and MURF Program. If MURF program is outside of the match, it is very likely that it is in a small specialty. Trust me, the PDs at Matched Program and MURF program know each other...they may not be golf buddies, but they definitely talk to each other.

But...assuming you can get through all of this and complete your residency program...no...you shouldn't have any issues getting BC.

Thanks for the information. What is the worst that can happen with a match violation?

 

[Buzz Me]

Thanks for the information. What is the worst that can happen with a match violation?

Do you really want to know?

The worst that could happen is your former program blacklists you, ensuring that you have a near-impossible time trying to get a new residency spot or subsequent job in that field for the rest of your career.

Or they could sue you.

 

[CoolDocGal]

Do you really want to know?

The worst that could happen is your former program blacklists you, ensuring that you have a near-impossible time trying to get a new residency spot or subsequent job in that field for the rest of your career.

Or they could sue you.

Thanks, Buzz Me. Sue? On basis of the match. Wow. Good to know.

 

[Buzz Me]

Thanks, Buzz Me. Sue? On basis of the match. Wow. Good to know.

Personally, I'd actually be more worried about being blacklisted. Medicine is a small community, especially when you're talking about specialty fields. And program directors talk.

 

[CoolDocGal]

Personally, I'd actually be more worried about being blacklisted. Medicine is a small community, especially when you're talking about specialty fields. And program directors talk.

Much appreciate the information. Please pardon my ignorance, but what entails blacklisting? How would it affect the prospects of academic versus private job?

 

[Law2Doc]

Much appreciate the information. Please pardon my ignorance, but what entails blacklisting? How would it affect the prospects of academic versus private job?

Blacklisting is where a PD spreads the word amongst all his colleagues in the field that you screwed him and that they ought not ever hire you. In a very small field this can be problematic, as he probably knows everybody well, and they always have other options without the black mark. in a big field, it probably has more limited, perhaps regional, scope.

In terms of being sued, it probably never happens, but theoretically if a program can't fill your spot they would be damaged, in terms of losing subsidization and resident man-hours, and you would be at risk for being liable for their loss. Since for most advanced fields it's pretty trivial to fill the first year spot this probably isn't a big worry though.

 

[NotAProgDirector]

Back to the question at hand, what really matters here is whether the new program you're interested in uses the match to fill most of their spots, or not.

There are two possible scenarios here. In the first, Program A doesn't use the match, ever. Program B does. You interviewed at both, and then matched at program B. Now program A has an open off-cycle spot (i.e. starting in July 2012,rather than this coming match which is for July 2013 Advanced).

In the second, both Program A and Program B use the match. You applied to both. You matched in B for July 2012. Now, Program A has a spot open for July 2012, which is "not in the match" because this year's match is for July 2013 Advanced.

If you are talking about scenario 1, then theoretically you could switch programs. You'd resign your spot in Program B. It would be a match violation. You would be banned from the match for 5 years. You'd join Program B. You'd finish training. Done. Win. Or, as above, medicine is a small world and there is some chance that the PD of Program B would get really angry, call the PD of Program A, and you might find that your whole career comes to a crashing halt. That would be bad, and you would not be able to match into anything.

If you're talking about scenario #2, then you cannot do this at all. That's because, not only would you be violating the match, but so would Program A. And they will be withdrawn from the match, and they will not like that.

Can it be done in a "safe" way? Perhaps. If you get both PD's to agree, then you might be able to do it "under the radar". You simply go to Program A, and never tell the NRMP anything. Or, you could ask the NRMP for a waiver with support of both PD's, but they have become very stringent recently -- and I can understand why. Imagine you come to me, and say "Sorry dude, I really want to go to this cool new open spot rather than your program". What exactly am I supposed to do? I could be a jerk and tell you that you have to honor your match commitment, and then you'd probably be bitter and angry at me. Or I could be a wimp and let you go,leaving me with an open spot and trying to find someone good to fill it -- which usually goes unfilled, or I take someone significantly less competitive, or I try to "steal" someone from another program and simply pass the problem off to them. So, the NRMP plays the "bad cop" and enforces the rules.

 

[Buzz Me]

Which is why everyone is supposed to understand the binding nature of the Match contract, and honor it.

 

[Socrates25]

Do you really want to know?

The worst that could happen is your former program blacklists you, ensuring that you have a near-impossible time trying to get a new residency spot or subsequent job in that field for the rest of your career.

Or they could sue you.

I'd bet everything I own they wont sue her. The most likely "worst" thing that could happen is that the NRMP puts you on the "violator" list and you cant participate in the NRMP process any longer, meaning you are blocked from fellowship matching.

Probably a much less likely but potentially nightmare situation would be the non-NRMP program finding out you violated the NRMP match, and they decide to rescind your acceptance.

I'd touch base with the non-NRMP program and tell them you've already matched and get a feel for how they react to it. If they arent bothered by it and you are ABSOLUTELY sure you never want to participate in the NRMP again, then go for it. But make sure you've got a signed contract in-hand before you take that step.