Germane’s Comments and Timeline of the NRMP’s Proposed Two-Phase Match

The National Resident Matching Program (NRMP) has proposed a change to the current Match process, which, essentially, replaces the Supplemental Offer and Acceptance Program (SOAP) with an additional Match cycle or phase. Currently, nearly all first-year residency applicants enter the NRMP Main Residency Match process, whereupon they can be matched into a residency program. If unmatched through the initial algorithm, they have the choice to participate in SOAP, which gives them additional opportunities to secure a spot an unfilled program. SOAP occurs quickly after an applicant is not matched into a program, last four days/four rounds, and not much time or preference is able to be given to the applicant during this time. SOAP only applies to the Main Residency Match, for which the cycle runs from Sept - March. These proposed changes aim to replace the SOAP with an additional Match cycle that gives applicants more autonomy in the decision of their residency.

In short, common critiques of the current Match process are often aimed at the SOAP: through the SOAP, unmatched applicants can be offered positions outside of their preferred specialty; must make vital decisions within a short time frame; and, throughout the four rounds of SOAP, applicants are given take-it-or-leave-it offers for underfilled programs (while unaware if a more preferred program will be offered in a later round). The NRMP proposed changes seek to improve three metrics of the Match process—that can be mostly associated to the negative attributes of the SOAP: 1) improve applicant wellness and agency, 2) enhance decision-making for applicants, and 3) support a holistic approach to the overall Match process. The Two-Phase Match, as stated, will replace the SOAP with a second Match cycle (with its own registration, Rank Order Lists, etc.); therefore, unmatched applicants of the first cycle can have a structured system to Match into another program—with more time to do so as well.

Because two Match cycles would take place, the Match cycles are much shorter: for example, as of now, registration usually begins in September, and Match Day is mid-March; for the first phase of the Two-Phase Match, registration begins at the same time, but Match Day is mid-February. Due to this shorter timeframe, recruitment activities, such as interviewing, can be cut short by about a month. Because the first cycle will shorten the current process, virtual interviews may continue to be popular. The shortening of the first Match cycle may not affect many programs, but programs with numerous recruitment days will see the greatest impact. This, combined with recent trends pushing the ERAS and NRMP open dates a little further each year, can put a strain on program interviewing windows. Even with these downsides, it is easy to think that the benefits of an additional Match would outweigh these potential challenges.

As the NRMP aims to accomplish, Germane Solutions believes the implementation of a Two-Phase Match will benefit applicants who enter the Match. Most prominently, we believe that the current Match cycle gives timely autonomy for applicants to make decisions regarding their future residency, as well as reducing the stress of the Match process. By replacing the SOAP with an extra Match cycle, Germane Solutions believes that the Match provides more structure that will result in reduced stress and better outcomes for applicants and programs.

The following table depicts the current timeline for the 2023 Match and the timeline of the proposed Two-Phase Match, which would become effective for the 2024 Match. For more information on the Two Phase Match, you can view the NRMP’s articulation of this proposed change here.

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