In April 2020, the NRMP established a series of Frequently Asked Questions in response to COVID-19, providing much needed clarity about Match policy at a time of extreme uncertainty and unprecedented upheaval in medical school curriculum and program training requirements. FAQs addressed important topics including

• 2020 Match commitments would remain in force to provide applicants and programs with protection

• Medical schools could not require students to remain at the home institution to begin training and relocate at a later time

• Programs could change, but not require, a new start date for training for applicants
  

• Immunocompromised residents had to be supported in their transition to residency

• Programs that required quarantine were encouraged to incorporate alternative learning opportunities for residents so that they may begin training with their cohort

• Programs were encouraged to ensure equity in recruitment processes

The FAQs were updated throughout 2020 to provide real-time responses to changes in licensure testing and virtual interviewing, and their impact on the matching process.

The FAQs document on the NRMP website was downloaded more than 15,000 times in 2020.

NRMP leadership carefully monitored the impact of COVID-19 on the UME and GME communities throughout 2020 and evaluated, where appropriate, how internal processes could and should be changed to support constituents.  In late summer of 2020, the decision was made to modify the calendar for the 2021 Main Residency Match to provide greater flexibility to stakeholders as they navigated new experiences like virtual interviewing.  

• The standard registration deadline was extended to January 31, 2021 to reduce financial stress on applicants.

• The opening of the ranking period was extended to February 1, 2021, 14 days later, allowing applicants the benefit of knowing programs’ final participation status and quota (number of positions in the Match) before creating and certifying their lists.

• The Rank Order List Certification Deadline was extended to March 3, 2021, 7 days later, allowing applicants and programs additional time to interview and make decisions and potentially increasing the numbers of international medical graduates with confirmed ECFMG certification. The extension also reduced the time applicants and programs had to wait between certification and Match Week.

• The Supplemental Offer and Acceptance Program® (SOAP®) was extended from 3 rounds to 4,  potentially providing a much-needed opportunity for unmatched applicants to secure unfilled positions in a year heavily impacted by the pandemic and unanticipated changes in behavior.

Changes to the 2021 Main Match calendar were received positively in the GME community.  Some, if not all, may be permanent changes going forward. 

The 2020 Main Residency Match was the inaugural Single Match, the first year in which allopathic and osteopathic applicants participated in one Matching Program. The Single Match was the realization of a 6-year long partnership between the ACGME, AACOM, and the AOA to establish a single accreditation system. High points from the inaugural Single Match include 

• The number of first-year positions rose to an all-time high of 34,266, largely due to the final migration of osteopathic positions into the Main Match 

• The PGY-1 match rate for US DO seniors was a record-high 90.7 percent
  

• The PGY-1 match rate of all applicants, was 80.8 percent, the highest in nearly 20 years

In anticipation of the inaugural Single Match, the NRMP revamped the Results and Data book in May 2020 to provide more comprehensive reporting of osteopathic applicants. Changes in the report for US DO senior students included

• creation of a DO-exclusive Match Summary statistics table along tables tracking number of positions filled and PGY-1 matches by specialty

• modernization of tables tracking applicant participation by type, preferred specialty, and matches in preferred specialty

These enhancements were a welcome and necessary change for the osteopathic community and supported the changed status of US DO seniors students  who, alongside UD MD seniors, are now sponsored applicants in the Match. 

The NRMP Transition to Residency conference, originally scheduled to be hosted in Nashville, pivoted to a virtual platform in order to offer attendees the opportunity to gather in the shadow of the pandemic.  For the first time ever, learners were invited to participate in the meeting, and registration for learners was free. More than 500 individuals registered, and highlights from the meeting included

• Plenary presentations by Nobel laureate Dr. Alvin Roth, Surgeon General Dr. Vivek Murthy, and Hidden Brain author Shankar Vedantam
  

• Breakout sessions on a wide range of topics including the impact of COVID-19 on residency interviews, student experiences with microaggressions, pros and cons associated with preference signaling, and the impact of USMLE Step 1 pass/fail status on applicant assessment

• “Town Hall” style discussion with NRMP leadership about the role and focus of the NRMP in the transition to residency

• Interactive “Poster Power Hour” so attendees could engage poster presenters in Q&A about specific projects happening at academic centers around the country

Attendees reported satisfaction with the ability to connect with other educators, discuss challenges associated with COVID-19 and the Match, and engaging in open conversation about ways to improve the transition process.  Attendees also valued the opportunity to share best practices, understand more fully the Match data associated with availability of positions for US MD and DO seniors, and share ideas about navigating a virtual recruitment.

 80% of respondents to the meeting evaluation reported the meeting met or exceeded expectations, with more than 95% reported it likely or highly likely they would attend a future meeting.  The NRMP remains committed to using its stakeholder conference to raise critical questions and explore relevant issues in order to foster improvements along the UME-GME continuum.  

In light of its commitment to build a robust research agenda in 2021 and think in new ways about how to better inform the transition to residency, the NRMP turned to the community, issuing a public call for comment in September 2020 about broadening the NRMP’s current data collection efforts to include applicant demographic data. The NRMP received more than 500 responses reflecting on perceived risks and benefits associated with new data collection processes:

• Nearly 70% of respondents indicated unconditionally that they had no concerns with the collection of demographic data. “Conditional” risks focused on ensuring the data, if collected, were de-identified, handled respectfully, and vetted to avoid misuse

• The most frequently cited benefits of demographic data collection included the ability to improve diversity and inclusion efforts and hold programs accountable for them, understand how demographics influence the recruitment and matching processes, and articulate the presence or absence of discrimination/bias in the recruitment and matching processes

Respondents recognized and appreciated the NRMP’s attempt to improve the recruitment and matching processes and highlighted the strong need to use demographic data be better understand the prevalence of diversity, equity, and inclusion practices in the UME and GME communities.