Frequently Asked Questions on the NRMP Fellowship Match

• About the NRMP Fellowship Match
• 2006 Match Participants

Why are hematology and oncology rejoining the Match now?
After hematology/oncology’s short-lived participation in the Match in the late 1980s, programs were largely left to set their own systems and schedules for offering fellowship positions. Over time this resulted in a kind of “date creep” which moved the process earlier and earlier in the internal medicine residency.

Program directors turned to ASCO and ASH for assistance with this situation about five years ago, but at that time the unresolved litigation involving the Match made both organizations hesitant to act. In the interim, the use of a voluntary Uniform Acceptance Date was proposed and implemented. In late summer of 2004, all lawsuits involving the Match were dismissed and conversations began in earnest between ASCO’s Oncology Training Program Committee and ASH’s Committee on Training Programs regarding rejoining the National Resident Matching Program (NRMP) Fellowship Match. Earlier this year the executive bodies of both organizations voted to support moving to a Fellowship Match. ASH and ASCO have formed a Joint Task Force to facilitate the enrollment of the requisite programs in time to participate in the spring 2006 Match for 2007 appointment year.

I see gastroenterology is also returning to the Match; what can we learn from them?
Much like hematology/oncology’s experience with the Match, GI found that lack of fair play and recruiting outside the Match undermined the integrity of the NRMP and that led to the failure of their earlier Match experience. Also, very much like the hematology and oncology program directors have found, GI discovered they were taking applications earlier and earlier, so early in fact that there was concern residents didn’t have enough time in their medicine residency to thoughtfully select a specialty. After much careful deliberation and a commitment by the national gastroenterology societies to promote a workable system that will serve the needs of both trainees and programs, GI has rejoined the NRMP Match. At this point, GI has exceeded the 75% participation rate requirement.

Who participates in the Medical Specialties Matching Program?
Cardiovascular Disease (1986), Pulmonary and Critical Medicine (1986), Infectious Disease (1986-1990; rejoined in 1994), Rheumatology (2005), and Gastroenterology (rejoining in 2006) are part of the Medical Specialties Matching Program. A list of participating institutions is available online; you can see how some programs have added specific tracks. Pediatric Hematology/Oncology and Gynecologic Oncology also use the NRMP Fellowship Match, although they are on different schedules.

How has the Match changed?
The Match has changed in two significant ways:

1. The Match is customized for hematology/oncology, providing the ability to prioritize research positions. Programs will be able to categorize their positions in a way that best fits their program. For example, a program may offer a “basic science research track,” “clinical investigator track,” “research track,” and/or “clinical track.” Programs that offer more than one track will have the option to have any track filled first, and if that track does not fill, revert to any other track. For example, a program may elect to have the research positions filled first. If left unfilled, the research positions can revert to clinical track positions and be filled with clinical track applicants. In a similar fashion, applicants can apply for one or more tracks, and list their preferences of reverting to a particular track if they do not match with their first choice. Programs that offer a single track will not go through this step-wise reversion process. Overall, how each program categorizes its positions and defines its tracks is up to the individual program, and it is the program’s responsibility to so inform their applicants. A multiple option match will offer greater flexibility for all programs and applicants.
   
   
2. The National Resident Matching Program (NRMP) has adopted strict standards and enforcement procedures to maintain the integrity of the Match. To encourage participation in the proper fashion, NRMP has a well-defined policy to address violations of match agreements. The policy has been in place since 2001 and is explicitly outlined on NRMP’s Web site. Examples of sanctions for violators include notification of the violating institution’s Graduate Medical Education office and the Accreditation Council for Graduate Medical Education (ACGME)-Residency Review Committee for Internal Medicine, and could include barring a program from future Match participation.

What’s the timeline?
The commitment to using the Electronic Residency Application Service (ERAS) for fellowship applications for the 2007 appointment year makes using the Match a natural progression. However, programs can participate in the Match without using ERAS for the application process. The timeline for both is listed below:

Must all programs commit to the Match?
The NRMP requires 75% of the specialty’s programs to participate in the Match, as this is the critical mass that allows the Match to work most effectively. This would mean that 75% of the hematology programs, 75% of the medical oncology programs, and 75% of the combined hematology/oncology programs would need to participate.

Must programs commit all positions to the Match?
To increase the success of the Match, programs are encouraged to commit all of their positions. The Match requires that fellowships commit 75% of available positions program wide. As noted above, each of the three subspecialties must meet the 75% requirement; the same would apply here. The new customization process described above is designed to minimize concerns about matching research positions.

How will I know what other programs are participating, and their level of commitment?
To the best of their abilities, ASCO and ASH will maintain on their Web sites a list of programs participating, the number of slots available and the number of slots being offered.

When is the quota change deadline?
On August 10, 2005, ASCO received a letter from the NRMP with updated information on the quota change deadline. Beginning with Matches that open for registration after December 31, 2005 (which would include hem/onc), the quota change deadline for all fellowship Matches will be two weeks in advance of the ranking deadline. Thus, programs would be required to finalize the number of positions offered in the Match two weeks before applicants and programs must submit their final, certified rank order list. This is a change from the quota change deadline being the rank order list deadline, which allowed programs to withdraw positions from the match at the last possible minute. This change on the NRMP’s part is in response to both complaints from applicants, and inquiries from Fellowship Match sponsors.

What about those applying as couples?
Applicants in the same Fellowship Match notify the NRMP of their desire to participate as a couple by providing their partner's AAMC ID through the NRMP R3 System and paying an additional $15 partner/couple fee. Applicants who are members of a couple can link their program choices on their rank order lists so that they can be matched into a combination of programs suited to their needs. Applying as a couple should not influence the selection decisions made by program directors.

How can I ensure diversity in terms of geography and demographics?
When the matching algorithm is run, a match will definitely occur if an applicant ranks a program first and the program ranks that applicant within its quota (the number of positions offered in the Match). Program directors who want to create geographic diversity should rank applicants from a geographic spectrum within their quota. If the applicant wants to come to that program, he/she will have ranked it first. The Match does not offer a system for stratifying applicants by geography or demographic category.

What are the benefits of the Match?
The Match:

• Encourages applicants and programs to consider all options before making commitments.
• Mitigates premature offers and applicants reneging on accepted positions.
• Encourages movement and a more dynamic training experience for applicants seeking fellowship positions outside of where they trained during their residency.
• Creates an impartial venue for matching program and applicant preferences.
• Offers the greatest access to the applicant pool.
• Establishes a uniform date for appointments to fellowships.
• Moves fellowship recruitment later in the applicants’ training, which will likely improve the applicants’ commitment to the subspecialty and probably decreases the occurrence of late decisions to not enter the accepted fellowship.

What are the fellowship Match fees?

Programs

• $200 institution fee*
• $25 per program
• $25 per matched applicant

Applicants

• $65 registration fee
• $15 partner/couple fee

* Paid once per institution, if there are other internal medicine specialties at your institution that participate in the Medical Specialty Matching Program, this fee is not duplicated.

How long is the term of the Match agreement?
While institutions can enroll for one year, it is necessary that programs recognize the overall value of participating in the Match and its benefits for both programs and applicants. Programs will be asked to consider long-term participation or renewed participation in order to sustain a well functioning program.

Where can I get more information?
The National Resident Matching Program Web site has a wealth of information about the policies, matching algorithms and mechanisms of the Fellowship Match, and is a great resource for general questions about the Fellowship Match. For specific hematology and/or oncology concerns, please contact ASH at training@hematology.org or ASCO at training@asco.org.

How do programs enroll?
ASCO and ASH are compiling a list of programs committing to participating in the Fellowship Match. That information will be submitted to the NRMP, at which point information and instructions on enrolling your training program will be sent to you directly by the NRMP in December. The registration process will then be online.

Please indicate your program’s participation in the Match by sending an e-mail to either ASH at training@hematology.org or ASCO at training@asco.org by September 30, 2005. An e-mail of receipt will be sent to you.