Waiver Reviews and Violation Investigations
Case Summaries
Below are examples of waiver reviews and violation investigations conducted
by the NRMP. They are intended to help match participants understand the
NRMP's policies and procedures and to highlight relevant sections of Match
Participation Agreements that govern the Main
Residency MatchSM. These examples are illustrative
only and are not meant to be an exhaustive list of the types of reviews
and investigations conducted by the NRMP. All participants should review
the terms and conditions of the Match Participation
Agreement.
WAIVER
I. Waiver Granted - Applicant
Description
After the 2012 Main Residency Match, Mr. Ethan Hunt wrote
to the NRMP and requested a waiver of his commitment to the Internal Medicine
program at National Hospital. Mr. Hunt informed the NRMP that his mother
had been diagnosed with a serious illness after results of The Match had
been released, and that he wished to return home after graduation to be
with her. The NRMP initiated a waiver review and requested medical information
from Mr. Hunt along with information from the director of the program
to which Mr. Hunt had matched. Because Mr. Hunt was a medical student,
the NRMP also wrote to his school official to request information. After
reviewing all pertinent information, the NRMP granted Mr. Hunt a waiver
of his Match commitment.
Policy
Section 2.5 of
the Match Participation Agreement
for Applicants and Programs authorizes the NRMP to grant a waiver
of the binding commitment to an applicant if honoring the Match outcome
would cause serious and extreme hardship. Once a party has matched or
a position has been offered and accepted during the Match Week
Supplemental Offer and Acceptance ProgramSM
(SOAPSM),
a waiver may be obtained only from the NRMP; applicants and programs are
not authorized to release each other. Moreover, applicants may not apply
for, discuss, interview for, or accept a position in another program until
the NRMP has approved a waiver request. All waivers must be submitted
to the NRMP in writing, with a copy to the program with which the applicant
has a commitment. The NRMP solicits information from all relevant parties
prior to deciding whether to grant the waiver. If the waiver is granted,
the applicant may accept a position in another program and participate
in future NRMP Matches.
II. Waiver Granted - Program
Description
After the 2012 Main Residency Match, the Neurology program
at American Medical Center wrote to the NRMP requesting a waiver of its
commitment to Dr. Wai Lin. The start date for training had passed, and
Dr. Lin had not yet obtained the necessary visa to begin training in the
program. The NRMP initiated a waiver review and contacted Dr. Lin for
information. Dr. Lin confirmed that she had promptly submitted the paperwork
for her visa after learning her Match results, but her home country had
yet to approve her request. She asked the NRMP not to grant a waiver because
she believed that her visa would be approved soon. After reviewing all
pertinent information, the NRMP granted the Neurology program a waiver
of its Match commitment.
Policy
Section 2.1
of the Match Participation Agreement
for Applicants and Programs states that an applicant must meet all
requirements for entry into graduate medication education prior to the
scheduled start date of the matched position. Those requirements are prescribed
by the Accreditation Council for Graduate Medical Education ("ACGME")
in Section II of the ACGME Institutional Requirements, Residents, and
are incorporated into the Match Participation Agreement by reference.
Programs are not obligated to offer, nor will the NRMP require, a delayed
start date for training.
Section 3.5
authorizes the NRMP to grant a waiver of the binding commitment to a program
if honoring the Match outcome would cause serious and extreme hardship.
Once a party has matched or a position has been offered and accepted during
the Match Week Supplemental Offer and Acceptance Program
(SOAP), a waiver of the binding commitment may be obtained
only from the NRMP; applicants and programs are not authorized to release
each other. Moreover, programs may not discuss, interview for, or offer
the position to another candidate prior to or during the course of a waiver
investigation. All waivers must be submitted to the NRMP in writing, with
a copy to the each applicant named in the request. The NRMP solicits information
from all relevant parties prior to deciding whether to grant the waiver.
If the waiver is granted, the program may begin to recruit another qualified
candidate for the vacant position.
III. Waiver Denied - Applicant
Description
After the 2012 Match Week Supplemental Offer and Acceptance Program
(SOAP), Dr. Aaron Cross wrote to the NRMP and requested a waiver
of his commitment to the Surgery-Preliminary program at the American Medical
Institution. Dr. Cross had realized that he had accepted the position
in haste and that a career in Psychiatry was what he really wanted. The
NRMP denied Dr. Cross's request because a waiver based on change of specialty
was not timely. The NRMP informed Dr. Cross of his obligation to honor
the Match commitment. When Dr. Cross declined his matched position, the
NRMP initiated a violation investigation of his actions.
Policy
Section 2.5
of the Match Participation Agreement
for Applicants and Programs authorizes the NRMP to grant a waiver
of the binding commitment to an applicant who has matched to or accepted
an advanced position and who has elected to change specialties provided
the waiver is requested no later than the January 15 prior to the
start of training. If the NRMP denies the waiver request, the applicant
is expected to accept the position. If the applicant fails to do so, the
NRMP will initiate an investigation to determine whether the applicant
has violated the terms of the Agreement. Moreover, any applicant whose
waiver request is denied and who does not accept the position may be barred
from accepting or starting a position in any program sponsored by an NRMP
Match-participating institution for one year from the date of the NRMP's
final decision to deny the waiver. Any program at a Match-participating
institution, regardless of the program's Match participation status, that
offers a position to that applicant to commence training during the one-year
period is in breach of the Agreement, and the NRMP will initiate a violation
investigation of the program or the institution.
Section 5.1
states that the listing of an applicant by a program on its certified
rank order list or of a program by an applicant on the applicant's certified
rank order list establishes a binding commitment to offer or to accept
an appointment if a match results and to start training in good faith
(i.e., with the intent to complete the program) on the date specified
in the appointment contract. The same binding commitment is established
during the Match Week Supplemental Offer and Acceptance Program
(SOAP) if a program offers a position by listing an applicant
on its preference list and the applicant accepts that offer. Failure to
honor that commitment is a breach of the Agreement and may result in penalties
to the program or applicant. In addition, applicants who terminate or
resign their positions within 45 days of the date specified in their appointment
contracts will be presumed to have breached the Agreement and will be
subject to a violation investigation.
IV. Waiver Denied - Program
Description
After the 2012 Main Residency Match, the Obstetrics/Gynecology
program at National Medical Center wrote to the NRMP requesting a waiver
of its Match commitment to Dr. Selina Kyle. After Match Day, the program
director had obtained additional information about Dr. Kyle's prior residency
training, and he no longer was comfortable offering Dr. Kyle a position.
The NRMP initiated a waiver review and learned that Dr. Kyle had no prior
record of misconduct. Moreover, the information on which the program had
based its request for a waiver had been available to the program prior
to the ranking deadline, when the program could have deleted Dr. Kyle's
name from its rank order list. The NRMP denied the Obstetrics/ Gynecology
program's request for a waiver.
Policy
Section 5.1 of
the Match Participation Agreement
for Applicants and Programs states that the listing of an applicant
by a program on its certified rank order list or of a program by an applicant
on the applicant's certified rank order list establishes a binding commitment
to offer or to accept an appointment if a match results and to start training
in good faith (i.e., with the intent to complete the program) on the date
specified in the appointment contract. The same binding commitment is
established during the Match Week Supplemental Offer and Acceptance
Program (SOAP) if a program offers a position by listing an applicant
on its preference list and the applicant accepts that offer. Failure to
honor that commitment is a breach of the Agreement and may result in penalties
to the program or applicant.
VIOLATION
I. Violation - Applicant
Description
In the 2012 Match Week Supplemental Offer and Acceptance Program
(SOAP), Dr. Henry Jones accepted a position in the Anesthesiology
program at American General Hospital. After Match Week, the program informed
the NRMP that Dr. Jones could not qualify for a medical training license
because he was on probation for a prior criminal conviction. Dr. Jones
had not included the information on his ERAS application; instead, he
waited to disclose it on his application for licensure. The NRMP initiated
a violation investigation, collected information from relevant parties,
and determined that Dr. Jones had misrepresented himself to the program.
The NRMP identified Dr. Jones as a Match violator in the NRMP's Registration,
Ranking, and ResultsSM
(R3SM)
system for three years and barred him from participation in
future NRMP Matches for three years. The NRMP also barred Dr. Jones from
accepting or starting a position in any program at an NRMP Match-participating
institution for one year.
Policy:
Section 4.4
of the Match Participation Agreement
for Applicants and Programs states that applicants are responsible
for the completeness, timeliness, and accuracy of the information provided
to programs. The submission of information by an applicant during the
interview and/or matching process that is false, misleading, incomplete,
or plagiarized from another source is a violation of the Agreement.
Section 8.2
outlines for applicants and programs the consequences of a confirmed violation
of the Agreement. Applicants may be barred from subsequent NRMP Matches
and/or identified as a Match violator to participating programs for one
to three years or permanently, as determined by the NRMP.
II. Violation - Program
Description
During the 2012 Main Residency Match, applicant Sarah Connor
informed the NRMP that the Dermatology program at National Medical Center
had required her to identify the programs where she had or planned to
interview and to give the name of the program in which she was most interested.
The NRMP initiated a violation investigation of the program and solicited
information from other applicants who had interviewed with the program.
Other applicants confirmed that similar questions had been asked of them,
and the NRMP determined that a breach of the Agreement had occurred. The
Dermatology program was flagged as a Match violator in the NRMP's Registration,
Ranking, and Results (R3) system for three years
Policy
Section 6.0 of
the Match Participation Agreement
for Applicants and Programs prohibits applicants and programs from
soliciting verbal or written statements implying a commitment. In addition,
it is a breach of NRMP policy for programs to request information about
applicants' ranking preferences, for applicants or programs to suggest
or inform the other that placement on a rank order list or preference
list is contingent upon submission of a verbal or written statement indicating
ranking preferences, or for a program to require applicants to reveal
the names or identities of programs to which they have or may apply.
III. Violation - Applicant and Program
Description
During the 2012 Match Week Supplemental Offer and Acceptance Program
(SOAP), Dr. John McClane accepted a position in the Medicine-Preliminary
program at American General Hospital. In July 2012, Dr. McClane resigned
from his program, having accepted a position in a categorical Diagnostic
Radiology at another institution to begin in late August. The Medicine
program director informed the NRMP of Dr. McClane's actions, and the NRMP
initiated a violation investigation of Dr. McClane. After learning that
the Diagnostic Radiology program also was an NRMP Match-participating
program, the NRMP initiated a separate violation investigation of that
program. The NRMP conducted the investigations according to the NRMP
Policies and Procedures for the Reporting, Investigation, and Disposition
of Violations of NRMP Agreements. Although the Diagnostic Radiology
program director knew of Dr. McClane's participation in the Medicine-Preliminary
program, she had assumed she could offer Dr. McClane a position if it
did not commence until after Dr. McClane had completed 45 days in the
Medicine-Preliminary program. The NRMP concluded that a breach of the
Agreement had occurred. Dr. McClane was barred for one year from accepting
or starting a position in any program sponsored by an NRMP Match-participating
institution, flagged as a Match violator in the NRMP's Registration,
Ranking, and Results (R3) system for
one year, and barred from future NRMP Matches for two years. In addition,
the Diagnostic Radiology program was flagged as a Match violator for two
years.
Policy
Section 3.5
of the Match Participation Agreement
for Applicants and Programs states that programs shall use the Applicant
Match History in the Match Site to determine the appointment status of
any applicant considered for appointment to the program.
Section 5.1 states
that the listing of an applicant by a program on its certified rank order
list or of a program by an applicant on the applicant's certified rank
order list establishes a binding commitment to offer or to accept an appointment
if a match results and to start training in good faith (i.e. with the
intent to complete the program) on the date specified in the appointment
contract. The same binding commitment is established during the Match
Week Supplemental Offer and Acceptance Program (SOAP) if a program offers
a position by listing an applicant on its preference list and the applicant
accepts that offer. Failure to honor that commitment is a breach of the
Agreement and may result in penalties to the program or applicant. In
addition, applicants who terminate or resign their positions within 45
days of the date specified in their appointment contracts will be presumed
to have breached the Agreement and will be subject to a violation investigation.
Section 5.1
also states that any program that discusses or offers a position to an
applicant who has matched to or accepted a concurrent year position in
another program and who has not been granted a waiver by the NRMP will
be in breach of the Match Agreement. Programs are prohibited from interviewing
or discussing with an applicant any potential position unless the program
has first determined that the applicant is eligible for appointment. Programs
shall determine the applicant's eligibility by verifying the applicant's
appointment status in the Applicant Match History that is available in
the Match Site and/or by calling the NRMP to obtain that information.
IV. Medical School
Description
During the 2012 Match Week Supplemental Offer and Acceptance
Program (SOAP), the student affairs office at National
University College of Medicine contacted an unfilled program about Sydney
Bristow, a senior student who had not obtained a PGY-1 position. The program
had not yet received Ms. Bristow's application, and had not yet contacted
Ms. Bristow to express interest in her candidacy.
Policy:
Section 7.3.2
of the Match Participation
Agreement for Medical Schools states that it is a violation for the
school official, the school administrator, or any other individual or
entity to engage in any communication concerning SOAP-eligible
or SOAP-ineligible unmatched senior students or graduates
prior to contact from directors of unfilled programs. It also is considered
a violation of the Agreement for the NRMP school official, the NRMP school
administrator, or any other individual or entity to engage in any communication
with respect to an alternative position for any senior student or graduate
who has matched to a position or accepted a position during SOAP
and who has not received a waiver of his or her commitment from the NRMP.
The List of Unfilled Programs can be shared only with applicants who are
eligible to receive such information.
V. Institution
Description
After the 2012 Main Residency Match, the student affairs
dean at National University College of Medicine contacted the NRMP about
a senior who had failed to match to a PGY1 position. The senior had participated
in another national matching plan for his specialty training and had matched
to the Ophthalmology program at National Medical Center for July 2013.
The senior had been informed by the Medicine-Preliminary/ Ophthalmology
program at National Medical Center that he did not need to participate
in the 2012 Main Residency Match to obtain his PGY1 position.
At the advice of his school, the student had registered for the 2012 Main
Residency Match and had submitted a rank order list; however,
the Medicine-Preliminary/Ophthalmology program had been withdrawn from
The Match based on the program's decision to offer the Medicine-Preliminary/Ophthalmology
position outside The Match.
Policy:
Section
2.2.5 of the Match
Participation Agreement for Institutions requires institution officials
to ensure that prior to the release of the results of the Main Residency
Match, all of the programs sponsored by the institution, regardless
of Match participation status, offer positions to U.S. allopathic senior
students only through the Main Residency Match or another
national matching plan. If any of the programs sponsored by the institution
offers a position to a US allopathic senior outside the Main Residency
Match or another national matching plan, including a preliminary
position for a program that participates in another national matching
plan, the institution will be in breach of the Match Agreement.
Updated
08/28/2012
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