After preparing the application, the potential fellow electronically selects training programs to which to application is to be sent. The application is then sent to the program directors of the selected sites, who may then download the application for review. Program directors select applicants for interview based on this application. Interviews are conducted over a fairly uniform timetable for all participating programs. While completing interviews, applicants and training programs register for the match.
Dr. Landis’ Match Experience
As a former rheumatology fellow myself, I remember the pre-match system well. I applied in the New York City area, figuring that I had a better chance of obtaining a training position close to home. (Also, as each program had its own requirements and a unique deadline, I missed the application deadline for the West Coast programs before I even started applying.)
Midway through the process, I got my first offer. I turned it down, wondering if I was doing the right thing, and decided to bide my time until I heard from my first choice.
As I waited I briefly considered that perhaps I was meant to stay in internal medicine after all, but in the end I accepted a fellowship position at New York University Medical Center, which was where I wanted to be. —JL
The match itself is conducted by the National Resident Matching Program (NRMP), a private, not-for-profit organization. This corporation was chosen because of its vast experience with the residency match. NRMP uses a computer-generated algorithm to pair applicants with training programs in a way that favors the highest choice of the applicant. Applicants and program directors each create what is commonly known as a “rank order list.” For the applicant, it consists of a prioritized list of training programs; for the program directors, a similarly stratified list of previously interviewed applicants. Both lists are submitted online to the NRMP, which impartially conducts the actual matching process.
The results are released for training programs and applicants on a predetermined date (at which point both parties usually let out a collective sigh of relief). It is possible that a training position may go unfilled—even in the face of a surplus of applicants. In this situation the unmatched applicants have the option of calling program directors of the unfilled training programs to directly ascertain a spot. This process is not-so-fondly referred to as “scrambling.”
A Level Playing Field
The matching process is straightforward enough, but there is a caveat. The integrity of the match rests upon both parties adherence to the “cardinal rule” of the NRMP. That is, there are no behind-the-scenes handshakes, winks, or other preconfigured agreements between applicants and program directors to rank each other first.