Policies and Procedures for Reporting, Investigation, and Disposition of Violations of NRMP Agreements

Purpose

The National Resident Matching Program (NRMP) assumes responsibility for instituting measures to protect the integrity of the matching process by requiring all match participants to behave ethically and responsibly during the matching process.

Policy

It is the policy of the NRMP to require each match participant to enter into an NRMP Match Participation Agreement and to investigate reported violations of the Participation Agreements, including but not limited to: failure to provide complete, timely, and accurate information during the interview and matching process; discrepancies in graduation credentials; attempts to subvert eligibility requirements or the matching process itself; failures to offer or accept appointments as required by the results of a match; and any other irregular behavior or activities that occur in connection with registration, the submission or modification of a rank order list, and/or the participant's commitment to honor the match outcome.

A. Reporting Procedures

1. Applicants, school officials, program directors, institutional officials, or any other person may report suspected violations of the Participation Agreements. The NRMP will not initiate an investigation until it has received a written or electronic report concerning the possible violation, in which the author of the report is identified. The person reporting the violation may request anonymity.



2. The NRMP will acknowledge all such written reports in order to make an initial verification of their authenticity within seven days of the receipt of the report.



3. Suspected violations must be sent in writing to:

Mona M. Signer, Executive Director
National Resident Matching Program
2450 N Street, N.W.
Washington, D.C. 20037-1127
FAX (202) 828-4797
nrmp@aamc.org

B. Confirmation and Investigation Procedures

Following the issuance of the acknowledgment letter, the NRMP will contact the party or parties (applicant, program director, school official, or institutional official) identified in the report or any other person with knowledge of the incident. These individuals will be informed of the nature of the reported violation and that it is being investigated by the NRMP. All parties identified in the report as relevant to the alleged violation will be requested to provide the NRMP their version of the incident in writing and, if necessary, their response to the allegation(s) within ten business days from the date of the NRMP's request.

1. All allegations will receive a full examination and evaluation. The NRMP is authorized to contact other individuals/institutions in the course of acquiring information/data about the alleged incident.
   
   
2. The NRMP will evaluate and/or further investigate the responses from the parties and, if appropriate, prepare a Preliminary Report as soon as practicable. The Preliminary Report will document the nature of the allegation and the results of the NRMP's investigation.

   a. If the results of the investigation indicate that a violation has not occurred, the case will be closed and all parties identified in the original report will be notified thereof in writing or electronically

   b. If the results of the investigation indicate that a violation may have occurred, the Preliminary Report will be distributed to the subject of the violation, the individual who reported the violation, and any other parties the NRMP considers relevant to the investigation. The parties will be given ten business days from receipt of the Preliminary Report to review and respond to the Preliminary Report and provide additional information to the NRMP.

   c. After receiving any additional information, a revised report will be prepared for consideration by a Review Panel of the NRMP's Violations Review Committee (VRC).
   

3. The Review Panel will determine whether a violation has occurred and, if so, the appropriate action for the violation. It will issue a Review Panel Report that reports the decision of the Review Panel

a. If the Review Panel determines that no violation has occurred, the Review Panel Report will become the Final Report and it will be issued to all parties listed on the Report.

b. If the Review Panel determines that a violation has occurred, the Review Panel Report will be sent to the subject of the violation investigation, and the NRMP shall note in the Registration, Ranking, and Results (R3) System that the subject of the investigation has a "pending action". The designation shall remain in place until the subject of the investigation has waived or exhausted the opportunity to contest the adverse action pursuant to Section E below. If he/she/it does not contest the Review Panel decision in accordance with the procedures specified below, the Review Panel Report will become the Final Report and it will be issued to all parties listed on the Report, as well as to those parties specified in paragraph D below. Unless otherwise determined by the Review Panel, the effective date of the Final Report will be the date that it is finalized for issuance to such parties.

An applicant or program may contest an adverse Review Panel Report in accordance with the procedures set forth in Section E below.

C. Interim Corrective Action

At any time the NRMP may withdraw from the Matching Program any applicant or program for whom the NRMP believes it has received credible evidence that they have violated the terms of the Match Participation Agreement. If an applicant or program is withdrawn from the Matching Program, the NRMP shall note in the Registration, Ranking, and Results (R3) System that the applicant or program is the subject of a "pending action". The designation shall remain in place until the applicant or program has waived or exhausted the opportunity to contest the adverse action pursuant to Section E below. Applicants or programs withdrawn from the Matching Program still will be afforded an opportunity to be heard in accordance with the relevant Participation Agreement.

D. Consequences If Allegations of a Violation are Confirmed

1. For completed investigations confirming a violation of a Participation Agreement by an individual applicant:

   a. The Final Report will be delivered to the applicant with copies to:

   (1) the applicant's medical school official, with a request that the report be placed in the applicant's permanent file

   (2) the Educational Commission for Foreign Medical Graduates if the applicant is a student/graduate of a foreign medical school

   (3) the NRMP institutional official and the director of the program to which the applicant matched

   (4) the NRMP institutional official and director of the program to which the applicant has applied or switched (if known)

   (5) the party who originally reported the violation

   (6) the NRMP Executive Committee

   (7) the American Board of Medical Specialties

   (8) the applicant's residency program director if the violation occurred in a fellowship match

   (9) the Federation of State Medical Boards if the applicant is to be permanently identified as a match violator or has been permanently barred from future NRMP matches

   (10) any parties whom the NRMP has determined are relevant to its investigation.

   b. In addition, the applicant may be barred from subsequent NRMP matches and/or identified as a match violator to participating programs for a period of up to three years or permanently, as determined by the NRMP. Violations committed prior to Match Day may result in the applicant being withdrawn from the match.

   c. The applicant also may be barred from accepting a position in another NRMP match-participating program that has a start date within one year from the date of the Final Report. If any NRMP match-participating program offers a position to that applicant to commence training during the one-year period or if the applicant accepts such a position, the NRMP will initiate an investigation to determine whether the applicant or the program has violated the terms of the Participation Agreement.

   d. The decision conveyed in the Final Report will be displayed permanently in the Registration, Ranking, and Results (R3) System Applicant Match History. Term limits of any sanction(s) imposed for the violation will be included to identify the length of time the action is in effect.

2. For completed investigations confirming a violation of a Participation Agreement by a program:

   a. The Final Report will be delivered to the program director with copies to:

   (1) the NRMP institutional official for transmittal to the institution's graduate medical education committee

   (2) the chair of the institution's graduate medical education committee

   (3) the Accreditation Council for Graduate Medical Education for distribution to the respective program's Residency Review Committee (RRC) and the Institutional Review Committee

   (4) the respective specialty program director association

   (5) the party who originally reported the violation

   (6) the NRMP Executive Committee

   (7) any parties whom the NRMP has determined are relevant to its investigation

   b. The program may be barred from future NRMP matches and/or identified as a match violator for up to three years or permanently, as determined by the NRMP. Violations committed prior to Match Day may result in the program being withdrawn from the match.

   c. An NRMP-match participating program is prohibited from offering a position to any applicant who is ineligible to accept a position in an NRMP match-participating program as the result of a confirmed violation by the applicant. Such prohibition applies to all positions which have a start date within one year after the date of the NRMP's Final Report confirming a violation by the applicant. If an NRMP match-participating program offers a position to an applicant who is ineligible to accept a position as the result of a confirmed violation and training would commence within the one-year period, or if the applicant accepts such a position, the NRMP will initiate an investigation to determine whether the applicant or the program has violated the terms of the Participation Agreement.

   d. The decision conveyed in the Final Report will be displayed permanently in the Registration, Ranking, and Results (R3) System Institution and Program Violations Report. Term limits of any sanction(s) imposed for the violation will be included to identify the length of time the action is in effect.

3. For completed investigations confirming a violation of a Participation Agreement by a medical school:

   a. The Final Report will be delivered to the NRMP medical school official with copies to:

   (1) the dean of the medical school

   (2) the dean of student affairs of the medical school

   (3) the Liaison Committee on Medical Education (LCME)

   (4) the party who originally reported the violation

   (5) the NRMP Executive Committee

   (6) any parties whom the NRMP has determined are relevant to its investigation

   b. In addition, the school's access to the password-protected Match Site area of the NRMP web site may be suspended or terminated, as determined by the NRMP.

4. For completed investigations confirming a violation of a Participation Agreement by an institution:

   a. The Final Report will be delivered to the NRMP institutional official with copies to:

   (1) the ACGME designated institutional official, if different

   (2) the chair of the institution's graduate medical education committee

   (3) the president or chief executive officer of the institution

   (4) the Accreditation Council for Graduate Medical Education (ACGME) for distribution to the Institutional Review Committee

   (5) the party who originally reported the violation

   (6) the NRMP Executive Committee

   (7) any parties whom the NRMP has determined are relevant to its investigation

   b. An institution that participates in the Matching Program is prohibited from offering a position in any of the programs sponsored by the institution, regardless of Matching Program participation status, to any applicant who is ineligible to accept a position as the result of a confirmed violation by the applicant. Such prohibition applies to all positions which have a start date within one year after the date of the NRMP's Final Report confirming a violation by the applicant. If any of the programs sponsored by the institution offers a position to an applicant who is ineligible to accept a position as the result of a confirmed violation and training would commence within the one-year period, or if the applicant accepts such a position, the NRMP will initiate an investigation to determine whether the applicant, the program, or the institution has violated the terms of the Participation Agreement.

   c. The decision conveyed in the Final Report will be displayed permanently in the Registration, Ranking, and Results (R3) System Institution and Program Violations Report. Term limits of any sanction(s) imposed for the violation will be included to identify the length of time the action is in effect.

Nothing in these Policies and Procedures shall prevent any party to a Participation Agreement from seeking arbitration to contest a Review Panel Report under the terms of such Participation Agreement. Any party seeking to contest a Review Panel decision must notify the NRMP of the intent to seek arbitration within 10 business days from that party's receipt of the Panel's report and must file a demand for arbitration with the American Health Lawyers Association (AHLA) Alternative Dispute Resolution Service within 30 calendar days of receipt of such report. If a party seeks arbitration to contest a Review Panel decision, the penalties imposed in and the distribution of the Review Panel Report will be suspended until the arbitration has concluded. If notice of a party's intent to seek arbitration is not received by the NRMP within 10 business days from that party's receipt of the Review Panel Report, or if the party does not file a demand for arbitration, including all paperwork and fees, with the AHLA within 30 calendar days of receipt of the Review Panel Report, that party is deemed to have waived and is barred from later filing a demand for arbitration or seeking other relief.

All notices, reports, and other communications under these Policies and Procedures shall be in writing and shall be deemed received (a) when delivered personally; (b) when received if deposited in the U.S. Mail, postage prepaid, sent registered or certified mail, return receipt requested; (c) 24 hours after being delivered to a nationally recognized and receipted overnight courier service; (d) 24 hours after being sent by e-mail, unless the sending party is notified that the e mail address is invalid or that the message was not delivered; or (e) when sent by facsimile, provided the sending party has received confirmation that the facsimile was transmitted successfully, to the NRMP at the address shown in Section A or to any other party at the address on file at the NRMP or designated by written notice to the NRMP.

Updated July 2008