yea the NRMP is pretty powerful. They have absolutely no oversight. Just read the match agreement, it is very vague and unlike any employment application in the country. for example...if you make one mistake in the application process and are found guilty of a match violation, you can be sanctioned (not allowed to work at) ANY NRMP affiliated program for a period of time, even if you find a spot outside the match application process. Also, you can be banned from using the match, which is basically career ending considering they have a monopoly on residency positions. They have these powers, but don't specify anywhere what violations receive what punishments, and basically it says in the agreement they can punish how they see fit...If you commit a violation, a report is sent to anyone and everyone affiliated with medicine in the country.
And its not like they are doing this to people who really deserve it. You can get a violation for switching programs even if your program agrees and the program you are switching to agrees. I was permanently banned from the match for not reporting dismissed misdemeanor charges (underage alcohol ticket) from over 8 years ago on my interview day. I honestly didn't think I had to report something dismissed, and I later informed the program I made a mistake when I learned from the state license board that dismissed charges were reportable. There is nothing on my record, and the program only knew because I told them. How does someone get a residency with out going through the match? its possible but EXTREMELY difficult...When I finally recieved my final report and punishment, even the director who filed the waiver was shocked and disagreed with the NRMP's actions. He has since apologized on multiple occasions and even provided me with a letter of recommendation I understand why I lost my position at the program, but never in a million years did I expect a permanent ban.
So they are not only at odds with anti-trust, but also breaking several state and employment laws. People make mistakes, even physicians. Your career shouldn't be ended over one account over one violation. Furthermore, losing a residency position is already a big enough red flag for any program director. Banning applicants from the match is just overkill...
Check out who they report a violation to (which is also at odds with employment laws. It is illegal to solicit why someone got fired. It is the future employers right to find out, but the previous employer can't go out and tell everyone else in the country why you were fired).
(1)the applicant's medical school official, with a request that the report be placed in the applicant's permanent file (2) the Educational Commission for Foreign Medical Graduates if the applicant is a student/graduate of a foreign medical school
(3) the NRMP institutional official and the director of the program to which the applicant matched
(4) the NRMP institutional official and director of the program to which the applicant has applied or switched (if known)
(5) the party who originally reported the violation
(6) the NRMP Executive Committee
(7) the American Board of Medical Specialties
(8) the applicant's residency program director if the violation occurred in a fellowship match
(9) the Federation of State Medical Boards if the applicant is to be permanently identified as a match violator or has been permanently barred from future NRMP matches
(10) any parties whom the NRMP has determined are relevant to its investigation.
also It is against NRMP rules to train at any NRMP affiliated program if you are sanctioned for a violation. They define training as anything to maintain your clinical skills. So during my sanction I wasn't allowed to do research or rotate just for education purposes until my sanction was over!!!! Sounds unbelievable right?
I have been humbled by this experience and as physicians, our career can end at any moment because of one mistake. License boards, malpractice, etc etc can all bring your career to a screeching halt. I am fortunate enough that I went to a small medical school, where the attending's know me and know I'm a good honest hard working physician. Thanks to my home school connections, I actually now have a better residency position outside the match, and will probably be published at least 3 times by the end of the year. I've been blessed since the horrible summer when I was permanently banned, but not everyone is as lucky as I am.
Oh and guess what, they are currently pushing for 100% of pgy1 and pgy2 positions to go through the match (right now I think about 86% or so go through the match).
If you are interested in helping changing some things that are at odds with employment laws for future applicants, please sign our petition.
http://www.gopetition.com/petition/42979.html
The NRMP needs students to speak up.
