ABOUT THE NATIONAL RESIDENT MATCHING PROGRAM
The National Resident Matching Program® (NRMP®), also known as The Match®, is an independent, non-profit organization whose responsibility is to place the nation’s medical talent into clinical training programs, ensuring a steady pipeline of highly qualified professionals are building the necessary skills to care for patients across the country. The Match is unique among national medical education organizations: its engagement with young physicians and training programs isn’t passive but active, leveling the playing field by giving applicants and programs equal agency and voice in the recruitment and selection process.
With its proprietary algorithm, itself the subject and study of Nobel Prize-winning research, the NRMP has built one of the most stable matching markets in the world. It encourages applicants and training programs to honestly identify where and who they want to train; offers ample space and time for applicants and programs to strategically consider their training options; and maintains advanced, secure technology for the confidential ranking of preferences. Match outcomes are accurate and the process stable because participants control who and how their preferences for training are ranked.
Since its formation 70 years ago, the NRMP has placed more than a million physicians into the nation’s medical workforce. It caters to students and graduates of allopathic (“MD”) and osteopathic (“DO”) medical schools as well as U.S. citizen and non-U.S. citizen students and graduates of international medical schools who are seeking residency and fellowship training positions across the country. The NRMP manages the Main Residency Match® for core residency training in nearly all accredited specialties and the Specialties Matching Service® for advanced fellowship training in more than seventy subspecialties.
The NRMP meets the needs of more than 60,000 medical students and graduates annually who compete for more than 40,000 clinical training positions. Given its unique role, the NRMP is able to provide unparalleled data resources and research to the graduate medical education community and beyond, informing efforts to improve the diversity of the physician workforce and highlighting geographic distribution of physicians and specialties across the nation.
MESSAGE FROM THE PRESIDENT AND CEO
The medical education community is undergoing dramatic change due to disruptive forces from several directions – applicant call for change, organizational change, and innovation are three such forces. Some of the change will be transformational, and some will continue to challenge the framework and traditions of the transition to residency.
Since my tenure began in October 2019, the NRMP has been challenged to think differently, critically, and to expand our perspective. Along with you, the COVID-19 pandemic forced us all to approach our work in new and sometimes uncomfortable ways, to reflect on how our processes should change in order to mitigate some of the challenges faced by the medical education community, and to rethink our assumptions about the stressors and issues arising throughout the transition to residency. The NRMP has been called upon to make sweeping changes in policy and Matching processes, some of which we acted upon, and some we did not due to concerns about the potential for exacerbating inequity, stress, and harm to Match participants and specialties. Throughout this time, the NRMP has remained steadfast in its mission and obligation to the medical education community to ensure that changes are rational, evidence-based, and have input from the medical education community.
Challenges aside, the NRMP has also experienced great success this past year. Consistent execution of accurate and successful Matching Programs and enforcement of the commitments reinforce stability in the transition to residency. The NRMP’s Matching Program remains in demand and has expanded to facilitate the subspecialty training of residents in specialties not previously participating in the Match. Match policy and Codes of Conduct were modernized, underpinning the rights and responsibilities of all Match participants, and we have implemented new policies and processes that continue to underpin efforts to decompress of some stressors associated with Match Week. The NRMP also partnered for research with multiple organizations to help clarify issues and understand concerns, and we implemented the collection of voluntary, primary source demographic data across all applicants to analyze and inform the community about trends during the transition and the equitable treatment of applicants across the transition to residency. These data collection and reporting are intended to illuminate patterns and practices, and will likely create some discomfort, but are critical to medical education’s understanding of the transition to residency and to the development of improved practices and solutions.
During fiscal year 2021, the NRMP realized a modest increase in revenue, a direct result of the increasing numbers of applicants, programs, and institutions participating in the Matching Program. The NRMP has not increased matching fees since 2018, and in fact in 2023, fees for applicants were decreased. At the same time, the NRMP worked to reduce expenses across administrative, legal, and general spending, and again, achieved a clean audit resulting from well-grounded financial management and reliable internal controls. These savings have enabled the NRMP to maintain a financially stable organization, ensure the resources required to maintain a high level of technology and cybersecurity, and engage in new and innovative business efforts.
The NRMP executive leadership and Board of Directors engaged in a year-long process of strategic planning, which was completed in January 2022 and is described throughout this report. In addition to a focus on the NRMP’s core business of matching services, the Board implemented an expansive research strategy and reinforced its commitment to advanced technology and robust cybersecurity principles, stringent process improvement, and exploration of innovative matching processes and services for a forward-leaning posture.
Finally, the NRMP staff formed a set of Core Values which dictate how we come to work each day, how we treat each other, and how we approach our relationship with the medical education community. While there is much more to Core Values than a few words, we are focused on demonstrating Dedication, Trustworthiness, and Collaboration to each other and to you. These Core Values guide our efforts to strengthen relationships that may be strained by distance and remote work, recognize excellence through a staff-led recognition program, and enhance the NRMP’s program of professional development so that we give you our best selves every day.
The majority of the NRMP’s team has worked remotely since March 2020 and the team now includes members all over the country. With the adjustment to this “new normal” the team continues to display fortitude, creativity, and a can-do spirit. We remain focused on our mission and committed to advancing continuous process improvement and policy improvements that clarify the rights and responsibilities of Match participants. We have, and will continue to implement technologies that harden, streamline, and secure Match data and processes. And, we look to expand the research agenda and lean into partnerships and initiatives that allow for a better understanding of the transition to residency with the intent of helping the community to form solutions.
With so many positive advancements in the organization, I am confident in the future of the NRMP and in its ability to build on its history of credible and reliable service to the community. I look forward to sharing more of our work with you, collaborating on Match process, supporting the success of our Match participants, and continuing to serve you as President and CEO of The Match.
Donna L. Lamb, DHSc, MBA, BSN
MESSAGE FROM THE BOARD CHAIR
The NRMP is entrusted every year with the responsibility to connect tens of thousands of graduating medical students and graduates, both here and abroad, to residency training programs across the country. For 70 years, the NRMP has provided a reliable and accurate matching process. In recent years, the NRMP has expanded services with the collection of demographic data, the provision of detailed and interactive reports about the match outcomes, and hosting the annual Transition to Residency Conference. While “The Match” remains the core mission of the NRMP, the organization leverages its data and expertise to contribute in a significant way to the transition to residency process.
During my tenure as Board Chair, we have spent significant time and energy in ensuring the organization is positioned to succeed now – and for the future. Our work has focused on a core set of strategic initiatives that includes advancing thought leadership through dissemination of research, white papers, and data reports that will help the NRMP leverage understanding of physician workforce trends while also considering process improvements like the two-phase Match to operate more efficiently and effectively. The NRMP expects continued growth in services and an increasing contribution to the transition to residency process through provision and utilization of data. The work of the NRMP remains laser focused on ensuring that the physician pipeline remains strong and that our nation’s medical system is advantageously equipped with physicians to care for patients and their families.
On July 1, 2023, Dr. Deborah Clements stepped into the role as Board Chair, and I am certain that she will be an outstanding leader for the NRMP Board allowing the organization to maintain its momentum and stay focused on the core mission. We want to sustain a sharp concentration on serving our constituents through strong matching programs, robust policies, and low fees to continue delivering on our promise to be fair and transparent in all that we do. The goal of the NRMP is to continue to focus on young physicians looking to launch their professional careers so that they can ensure the well-being of our nation.
Donna D. Elliott, MD, EdD
SEVENTY YEARS STRONG
In October 2022, the NRMP launched a year-long celebration of its role in and contributions to the transition to residency. The theme of the celebration, building on the past, investing in the future, allowed the NRMP to showcase how its seven-decade success at innovating and adapting to the needs of the GME community have established a foundation on which to build new initiatives and engage with the community in new ways.
For 70 years, the NRMP’s mission and vision have remained largely unchanged: execute a highly efficient, transparent, and equitable Matching Program in support of the UME-GME transition, ensure accurate results, and deliver high-quality, meaningful Match outcomes data to the community. What has changed over time is the strategic, multidimensional approach the NRMP Board of Directors and the executive leadership have adopted to not only achieve on that mission and vision but also fortify the NRMP’s identity and demonstrate its value to the undergraduate and graduate medical education communities.
Unprecedented changes to the UME and GME landscape have included calls for sweeping change to The Match. The NRMP has weathered those calls, effecting change when it was clear it would improve experiences for participants while simultaneously building a set of strategic priorities that would reinforce the NRMP’s purpose and value. Since 2021, the NRMP Board and leadership have leveraged the NRMP as a thought leader and pursued outreach to and systems improvements for Match stakeholders, The NRMP also expanded its staff and modernized its policies to improve infrastructure and achieve better Match experiences for constituents. Such efforts have resulted in a stronger, more resilient NRMP, better connected and positioned to address the needs of the community.
Seventy years strong, and with a sustained commitment to championing purpose and value, NRMP governance and leadership continue to think and act strategically to foster a stronger, increasingly more equitable transition to residency. This includes expanding the role of the NRMP as a thought leader in the transition and informing national conversations about workforce and population health. Read on to learn how the NRMP’s strategic priorities inform and are informed by the communities it serves:
Engage in continuous quality improvement to ensure matching services deliver exceptional customer support and outcomes and effectively illuminate the rights and responsibilities of participants in The Match.
Leverage the role and impact of The Match in informing trends in the physician workforce and fostering equity in physician distribution that improves population health outcomes.
Pursue strategic research and data opportunities that highlight and address critical issues within the UME-GME continuum and guide meaningful conversations about improvements to the transition to residency.
Lead internal and community-based conversations; examine Match processes in new ways and reduce stressors, protect participants, and enhance equity of experience.
Construct platforms and enviornments that incorporate the latest technology principles and frameworks to keep participant data protected from threat and ensure the NRMP remains forward focused on delivering trusted and reliable results.
INSIGHT AND IMPACT
BEYOND MEDICAL MATCHING
With 70 years of success as its foundation, the NRMP is poised to expand its expertise in matching and selection to new markets to foster recruitment practices that establish greater equity for applicants and reduce bias in selection outcomes.
The NRMP is governed by a 20-member Board of Directors with deep experience in medicine, medical education, academia, and research. Directors include medical school deans and advisors, designated institutional officials, MD and DO program directors, MD, DO, and IMG resident physicians, MD and DO medical students, and public members. The NRMP Board is deeply committed to defining and guiding the strategic priorities of the NRMP to ensure the organization provides unparalleled service to constituents, informs national conversations about the transition to residency, and continues to evolve and adapt to the changing needs of medical students and training programs.
The Board of Directors also maintains two advisory groups: Board Liaisons and the Research Advisory Committee.
Board Liaisons represent partner organizations, societies, and military members who engage in an open dialogue with the Board annually to discuss issues pertaining to medical education and initiatives undertaken by their organization(s) or the military.
The Research Advisory Committee (RAC) works with the organization to discuss and inform research initiatives.