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

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

Two National Accrediting Organizations for Residencies ACGME AOA

3 Major National Residency Matches Military Osteopathic Allopathic

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of the M4 year Students who match in the military must take their government assignment and will automatically be withdrawn from the AOA and ACGME matches

NRMP The National Residency Matching Program ( 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

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

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

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

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

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

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 26 at 11:59 p.m. EST: student rank list deadline March 17: students notified if matched or unmatched on web at noon

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

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

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

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

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

The Restructured Osteopathic Internship Three Options for the Class of 2009

Option 1 Categorical 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.

Option 2 Preliminary 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.

Option 3 Traditional 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.

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

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

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

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

Notification of Results Students are notified by 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

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

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