All In Policy: Fellowship Matches

NRMP permits Specialties Matching Service® (SMS®) Match sponsors to voluntarily implement the All In Policy for their Fellowship Matches. If a SMS Match sponsor voluntarily implements the All In Policy, programs in the subspecialty that participate in the Match must register and attempt to fill all positions in the Match.

There are few important distinctions between the NRMP and SMS Match sponsors that voluntarily implement the All In Policy:

  • Under the SMS Match Participation Agreement, SMS Match sponsors must commit to active participation of at least 75 percent of the group’s eligible programs and a minimum of 75 percent of all available positions in the specialty. The NRMP does NOT require participation of all programs, even those in specialties that voluntarily implement the All In Policy.
  • NRMP monitors compliance with the All In Policy only for programs participating in the Fellowship Match. SMS Match sponsors may impose restrictions on programs that do not participate in the Match or may offer benefits to Match-participating programs; however, NRMP does NOT impose restrictions for non-Match participation and, when applicable, will levy only the sanctions outlined in Section 7.0 of the SMS Match Participation Agreement.

Match sponsors interested in implementing an All In Policy should contact NRMP at

Exceptions to the All In Policy

Requests for exceptions to the All In Policy must be submitted in writing and, if approved, apply only to the current Match. Exceptions may be granted for

  • Military appointees to civilian programs: Positions are reserved for applicants with a military obligation based on pre-existing arrangements between civilian programs and military branch GME offices.
  • Other circumstances as requested by the SMS Match sponsor and approved by the NRMP.

Exceptions are not approved for international medical graduates needing visas or for programs in rural and medically underserved areas. The Registration, Ranking, and Results® (R3®) system is flexible and can accommodate special circumstances including

  • International medical graduates with funding from their home countries.
  • Combined clinical-research programs where the first year is not clinical training.

Requests for exceptions may be submitted by email at or by U.S mail.

>> View the All In Policy for the Main Residency Match