The Match

1. The Match Joseph S. De Gaetano, DO, MSEd, FAAFP,FACOFP Associate Professor of Family Medicine Assistant Dean for Clinical Curriculum/GME

2. Time to Decide! • Focus on a specialty • Set up fourth year electives • Utilize class “experts”

3. Two National Accrediting Organizations for Residencies • ACGME • AOA

4. 3 Major National Residency Matches • Military • Osteopathic • Allopathic

5. Military Match • First match • Completed by December of the M4 year • Students who match in the military must take their government assignment and will automatically be withdrawn from the AOA and ACGME matches

6. NRMP • The National Residency Matching Program (www.nrmp.org) • only ACGME accredited residencies participate in the NRMP • osteopathic students are considered independent applicants: NSU-COM does not manage your interaction with the NRMP • An impartial venue for matching students to residency positions • provides a uniform time for selection without pressure • 30,000 applicants compete for 25,000 positions annually

7. NRMP Residency Categories • Categorical: programs that begin in the PGY1 year • Advanced: programs that begin in the PGY2 year • preliminary: programs that count as a PGY1 year and are a prerequisite for advanced programs

8. NRMP Process • Students apply to the NRMP and their residencies independently • application is to the residency via ERAS • ERAS is run by the AAMC: an electronic clearing house • registering with NRMP does not register you with ERAS

9. NRMP Matching Algorithm • Always attempts to place a student in his/her most preferred site • matches remain tentative until the official posting after the match is over • the final preferences of program directors and applicants are reflected in the posted rank order list • the final posting is a binding commitment

10. Guidelines for a Student’s Rank Order List • Only list programs that you absolutely wish to attend • list programs in sequence of preference • an unlimited number of programs can be listed based upon a specialties competitiveness

11. ACGME Program Directors • Invite students for interviews • institutional policies override NRMP policy • however, any attempt for an applicant or program to supply specific rank order info. prior to the match is a violation of the match • the NRMP rank order list takes precedence over any verbal commitments

12. Approximate NRMP Timeline in the M4 Year • August: student registration opens • December 1: applicant registration deadline • January 15: applicants and programs begin to enter their rank order lists • January 31: programs finalize their rank lists • February 26at 11:59 p.m. EST: student rank list deadline • March 17: students notified if matched orunmatched on web at noon

13. Approximate Timeline Continued • March 18 at 11:30 a.m.: unfilled positions listed: unmatched students begin to scramble: contact between students and programs prior to this time is a violation • March 20 at 1 p.m. EST: all student match results listed: notification to students prior to this time is a violation • March 22-April 22: letters of appointment sent by hospitals to students

14. NRMP policies • Matches are legally binding • failure to honor this commitment is a breach of contract

15. Policies Cont. • Teaching hospitals set their own deadline for their own application submission via ERAS • any subversion of the matching process will automatically withdraw the applicant from the process • verbal commitments are non-binding • independent applicants must withdraw on their own from the match

16. Policies Cont. • Students with a commitment via the military match are automatically withdrawn from the NRMP • students who are selected for a position via the AOA match are automatically withdrawn from the NRMP • registration fees are non-refundable

17. ERAS Electronic clearinghouse for: • Letters of recommendation • Transcripts • MSPE • Separate registration from matches • Utilized by Military, MD, and DO residencies

18. The Restructured Osteopathic Internship Three Options for the Class of 2009

19. Option 1Categorical Internship • Residency programs will grant credit for the 1st postdoctoral year of training. • Students will “Match” directly into the residency and the 1st postdoctoral year will be considered the first year of residency training. • Specialties- Anesthesiology, Family Practice, Internal Medicine, Obstetrics and Gynecology and Pediatrics have chosen this option.

20. Option 2Preliminary Internship • Residencies who choose this option will require a preliminary 1st year of training as a prerequisite for entry into the 1st year of residency in the 2nd postdoctoral year of training. • Matching successfully assures entry into both the preliminary year and the subsequent 2nd year in residency training. • Both the preliminary year and residency will be offered in the same institution • Specialties- Emergency Medicine, General Surgery, Neuromusculoskeletal Medicine/Osteopathic Manipulative Medicine, Neurology, Neurosurgery, Ophthalmology, Orthopedic Surgery, Otolaryngology, Pathology, Psychiatry, Radiology, Radiation Oncology, Urology have chosen this option.

21. Option 3Traditional Rotating Internship • This option represents a traditional rotating internship and stands alone. • Specialties that have chosen this option prefer residents in their specialty to have completed a traditional rotating internship. • This option is available to students who are undecided on future plans or for students planning on entering ACGME training. • Students completing a traditional rotating internship and then selecting option 1 or 2 specialties must contact that specialty college to determine whether advanced standing will be granted. • This option will depend on available residency positions since most will have been filled with first year matched trainees advancing to the OGME-2 year. • Specialties- Dermatology, Occupational/Preventive Medicine, Physical Medicine and Rehabilitation and Proctology has chosen this option.

22. The new rotation schedule for Option 3 – The Traditional Rotating Internship • 1. At least six months of training rotations in any or all basic core disciplines. These include general internal medicine, general surgery, family practice, pediatrics, obstetrics/gynecology (ambulatory gynecology) and emergency medicine. • 2. No less than two months of exposure in general internal medicine. • 3. One-month exposure in emergency medicine. • 4. At least one month in family practice in a hospital or ambulatory site or one-half day per week for a minimum of 46 weeks of ambulatory exposure in a family practice continuity of care type practice site. • 5. No more than three months of elective exposure adequate to meet the individual needs of the interns and approved by the DME/internship program director. • 6. All remaining time may be scheduled at the discretion of the base institution. • 7. No more than one month may be spent in non-clinical experience (research, scholarly pursuits, administration, etc.). • 8. Exposure must occur to the support disciplines of pathology, radiology, and anesthesiology. This may occur directly by rotation or indirectly by formal didactic conferences and/or exposure while on medical and surgical services. This exposure must be verified

23. AOA accreditation of an ACGME Internship • FL, WV, MI, OK, PA require an osteopathically accredited internship for licensure • Resolution 42

24. AOA Match • Administered by the National Matching Service (NMS) for the AOA • each student independently registers with the NMS and submits a rank order list • all osteopathic students automatically receive registration packets from NSU-COM in June of their M3 year • the deadline for registration is October of the M4 year • Rank order lists are submitted electronically by the end of January

25. Preparing for the AOA Match • Students must also independently apply to residency programs • ERAS is utilized by osteopathically accredited residencies • verbal agreements are non-binding • contracts signed before the match are non-binding • Official match results are binding • a student may rank order as many programs as they desire

26. Notification of Results • Students are notified by email of results in February of their M4 year • a contract will be sent by mail to matched students from the hospital that selected them • a student must sign the contract within 30 days after receipt • failure to sign violates the match rules

27. Match Violations • Students who violate match rules cannot take AOA training for one year after the violation • the AOA will never approve allopathic training performed by students who violate the AOA match rules • Only a residency training program can release a matched student from their contractual agreement. • Contract disputes occur between the student and the program

28. Failure to Match • All students who do not match via the NMS will receive a listing of open AOA slots across the country via email • students and programs independently contact each other to fill open slots