All In Policy: Fellowship Matches

For Fellowship Matches opening after June 30, 2015, Specialties Matching Service® (SMS®) Match sponsors may voluntarily implement the All In Policy, which requires programs to attempt to fill all positions in the Match if they elect to register for the Match. The NRMP monitors compliance jointly with the Match sponsor under the terms of the SMS Match Participation Agreement. Match sponsors interested in implementing an All In Policy should contact NRMP at

 Fellowships Implementing the All In Policy


Under the All in Policy

 Any program registering for the Match must attempt to fill all positions through the Match.

  • Programs planning to participate in the Match cannot offer positions outside the Match prior to program director registration and program activation.
  • Once a position has been offered outside the Match, the program no longer is eligible to enroll in the Match unless the offered position falls into one of the exception categories for the Match.

 Important Reminders

  • Under Section 1.0 of 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 Match. SMS Match sponsors may impose additional restrictions on programs that do not participate in the Match or may offer benefits to Match-participating programs. 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.

Applying for an Exception

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 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 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

How to Apply

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

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