All In Policy: Main Residency Match

Under the NRMP All In Policy, any program registering for the Main Residency Match® must register and attempt to fill all positions through the Match or another national matching plan.  Programs planning to participate in the Match cannot offer positions outside the Match prior to program director registration and program activation.  If a position is offered outside the Match prior to program registration and activation, the program is ineligible to enroll in the Match unless the program has been granted an exception to the All In Policy by the NRMP for the position in question.

Positions the All In Policy Applies To

The All In Policy applies to positions for which the NRMP offers matching services:

  • All PGY-1 positions as well as all PGY-2 positions in specialties accredited to begin at either the PGY-1 or PGY-2 level, regardless of whether the program begins in the PGY-1 or PGY-2 year
  • PGY-2 positions that are “reserved” for applicants eligible to begin advanced training in the year of the Main Residency Match
  • PGY-3 positions in Child Neurology

Positions NOT subject to the All In Policy include:

  • PGY-2 or higher positions in specialties accredited to begin only at the PGY-1 level
  • PGY-3 or higher positions (excepting Child Neurology) in specialties accredited to begin at either the PGY-1 or PGY-2 level
  • Positions in ACGME/AOA® dually-accredited programs that are unfilled at the conclusion of the American Osteopathic Association Match

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 year.

Exceptions are not approved for international medical graduates needing visas or for programs in rural and medically underserved areas. The 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 submitted by Rural Scholars, Family Medicine Accelerated Track, and Innovative Programs must be submitted using the All In Exceptions Form. All other requests may be submitted by email at or by U.S mail.

NEW! Once approved for an exception, programs are permitted to submit the All In Attestation for up to three years provided the program director and DIO annually affirm that the structure and function of the program have not unchanged.

>> View the All In Policy for SMS Fellowship Matches