Joint Advanced/​Preliminary (A/P) Programs

The NRMP’s Registration, Ranking, and Results (R3) system offers institutions and programs in the Main Residency Match the option to link an advanced PGY-2 program with a preliminary PGY-1 program to create a full course of training at the same institution for applicants interested in specialties that begin in the PGY-2 year.  In “joining” an advanced (A) PGY-2 program to a preliminary (P) PGY-1 program – Joint A/P – an applicant can only rank the joint preliminary PGY-1 program on a supplemental rank order list if that list is attached to the joint advanced PGY-2 program on the primary rank order list.  This ensures that only applicants who match to the advanced program can match to that preliminary program.

Creating a Joint A/P program in the R3 system is a two-step process:

  1. Institutional officials or program directors of preliminary PGY-1 programs create a new preliminary program track that identifies how many positions they are willing to join to the advanced PGY-2 program.
  2. Institutional officials or program directors of advanced PGY-2 programs link the new preliminary PGY-1 program to their advanced program.

When the matching algorithm is processed, an attempt is made to match an applicant to the joint advanced PGY-2 program listed on the primary rank order list.  If a match occurs, an attempt also is made to match the applicant to a position on the supplemental list attached to that joint advanced PGY-2 program.  The joint preliminary PGY-1 program must be ranked by the applicant on the supplemental rank order list and should be ranked first to maximize the ability to obtain a continuous course of training at one institution.  

Creating a Joint A/P Program support guide

Joint A/P Program Considerations

  • Joint A/P arrangements must be finalized by January 31, prior to the opening of the ranking function for the Main Residency Match.
  • Joint A/P arrangements require a new preliminary PGY-1 program; accordingly, directors of preliminary PGY-1 programs must adjust/reduce the traditional preliminary PGY-1 program quotas as needed to accommodate positions designated for the new preliminary PGY-1 program track.
  • Directors of advanced PGY-2 programs should remind applicants to rank the joint preliminary PGY-1 program on the supplemental rank order list that corresponds to the advanced program to maximize the applicant’s ability to obtain the full course of training.
  • For an applicant to match to both programs, the applicant must be ranked on both the advanced and the preliminary programs’ rank order lists. Typically the rank lists of both programs will be the same except for applicants the preliminary program does not wish to train.

There is no guarantee that positions in the Joint A/P program will fill because applicants may not list the designated preliminary PGY-1 position on a supplemental rank order list. Accordingly, directors of the new preliminary PGY-1 program track are encouraged to “revert”, or donate, the positions designated in the Joint A/P program back to the traditional preliminary PGY-1 program to minimize their chance of having unfilled positions. Learn how to create reversions for your program.