6.0 Communications
    6.1 Between Institutions, Programs, and the NRMP
    6.2 Changes After Registration
    6.3 Quota Changes
    6.4 Schedules and Deadlines
    6.5 Completeness and Accuracy of Information
    6.6 Confidentiality

7.0 Matching and Appointing Rules
    7.1 Match Commitment
    7.2 Rank Order List Certification
    7.3 Program Changes

8.0 Restrictions on Persuasion

9.0 Match Violations
    9.1 NRMP Violations Policies and Procedures
    9.2 Consequences of Confirmed Violations
        9.2.1 Applicants
        9.2.2 Programs

10.0 Reversion of Unfilled Positions; Special Requirements
    10.1 Reversion Option
    10.2 Submission of Reversions to the NRMP
    10.3 Special Requirements

11.0 Fees and Fee Refunds
    11.1 Institution and Program Fees
    11.2 Fee Payment Procedures
    11.3 Fee Refunds; Overdue Fees

12.0 Use of Information

13.0 Representations and Warranties

14.0 Disclaimers

15.0 Limitation of Liability

16.0 Notices

17.0 Dispute Resolution

18.0 Limitation of Action

19.0 General

1.0 Introduction to the Matching Program

The NRMP Matching Program is a system for the confidential ranking and selection of applicants to graduate medical education program residency and fellowship positions. For purposes of this Agreement, the term "Matching Program" refers to all matches conducted by the NRMP, including both the Main Residency Match and all Specialty Matches. Institutions that register any programs in the Matching Program agree to select senior students of U.S. allopathic medical schools for all of their programs only through the Matching Program or another national matching plan. Positions may be offered to physician graduates of medical schools in the United States and elsewhere who meet the eligibility requirements set forth by the NRMP. Only programs from institutions that have registered with the NRMP and agreed to abide by the terms of this Agreement may participate in the Matching Program. Such programs also must register individually with the NRMP and agree to abide by the terms of the Match Participation Agreement Among Applicants, the NRMP, and Participating Programs or the Specialties Matching Service Match Participation Agreement Among Applicants, the NRMP, and Participating Programs.

The SMS Matching Program is provided by the NRMP to program directors' groups (i.e., associations of training program directors) whose programs offer entry level positions only to applicants who have completed two or more years of graduate medical education. To qualify for participation in the SMS Matching Program, the program directors' group representing the programs in a particular specialty must designate a specialty representative to be responsible for overseeing the SMS match process and to be the group's official representative to the NRMP on all matters regarding the group's programs that register for the SMS Matching Program. Each group participating in the SMS is expected to identify eligible programs and to assist the NRMP in communicating with such programs.

The NRMP requires the program directors' group of each specialty participating in the SMS Matching Program to execute annually an "NRMP Program Directors' Annual Participation Agreement" that commits 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 for that year. If a group fails to register 75 percent of its eligible programs and/or positions, the NRMP, at its discretion, may discontinue such group's participation in matches managed by the NRMP.

Positions may be offered through the SMS Matching Program to physician graduates of medical schools in the United States and elsewhere who meet the eligibility requirements set forth by the NRMP. Only applicants and programs that have registered with the NRMP and agreed to abide by the terms of the Specialties Matching Service Match Participation Agreement may participate in the SMS Matching Program.

The parties acknowledge that (a) the NRMP does not provide application services to applicants or programs; (b) applicants must apply directly to the programs with which they desire to match in addition to registering with the NRMP Matching Program and listing such programs on their certified rank order lists; and (c) the NRMP is not involved in establishing the terms of any residency or fellowship agreement and has no responsibility for providing applicants with any information concerning such agreements.

The purpose of the Matching Program is to provide a uniform time for both applicants and programs to make their selections without pressure. A match between an applicant and a program constitutes a binding commitment between the two parties in accordance with the terms of the Match Participation Agreement. Any breach of that commitment may result in penalties to the breaching applicant or program, as described in Section 9.0.

The NRMP maintains the highest professional standards in the conduct of the Matching Program and in its interactions with all participants: applicants, program directors, institutional officials, and student affairs deans. The NRMP expects all participants in the Matching Program to conduct their affairs in an ethical and professionally responsible manner and to respect the right of applicants to freely investigate program options prior to submission of a final rank order list.

2.0 Institutional Official

2.1 Designation

Each institution must designate an NRMP institutional official to be responsible for overseeing the match process and to be the institution's official spokesperson to the NRMP on all matters regarding the institution's registered programs. The NRMP requires program directors to route all inquiries and changes through the institutional official for transmittal to the NRMP.

2.2 Responsibilities

In addition to the general responsibilities of the NRMP institutional official for overseeing the match process and communicating with the NRMP, the institutional official is responsible for:

2.2.1. Providing all information required for the registration of the institution and each of its programs that desire to participate in the Matching Program and ensuring the accuracy of such information including, but not limited to, the number and type of positions offered by each program.

2.2.2. Ensuring that all of the institution's programs that desire to participate in the Matching Program execute a Match Participation Agreement prior to the applicable match registration deadline.

2.2.3. Communicating all quota changes, additions, withdrawals, and other changes in the positions offered by any of such institution's programs through the Match Site prior to the quota change deadline for each match. Exceptions to this deadline may be requested by the institutional official for cases of extreme emergency, such as loss of funding or accreditation, or to accommodate the results of earlier matching programs

2.2.4. Ensuring that all of its programs that offer positions to U.S. allopathic senior students are enrolled in the Matching Program or another national matching plan, and that all such programs select U.S. allopathic senior students only through the Matching Program or another national matching plan. If any position is offered to U.S. allopathic students outside the Matching Program 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 this Agreement and may suffer the penalties described in Section 9.0.

2.2.5. Ensuring that all of its programs that offer residency or fellowship positions through the Matching Program will be either (a) accredited by the Accreditation Council for Graduate Medical Education ("ACGME"), or (b) a combined program that is approved or recognized by the American Board of Medical Specialties or by the respective specialty board that is responsible for board certification of residents who successfully complete the combined program, or (c) in compliance with the eligibility requirements set forth in section 4.1.2 of this Agreement. Eligibility must be met by the relevant rank order list certification deadline. Special tracks may be offered within some types of programs, including locations or particular kinds of training (i.e., research vs. clinical) within the accredited program.

2.2.6. Checking the accuracy of all information submitted by program directors for registration and subsequent changes and confirming such information and changes through the appropriate pages of the Match Site.

2.2.7. Appointing an institutional administrator, if so desired, to assist in the oversight of the match process at the institution and in communicating with the NRMP

2.2.8. Ensuring that each of the institution's programs organizes a resident or fellow selection process that is consistent with the relevant Schedule of Dates.

2.2.9. Promptly communicating to the program directors all information sent from the NRMP that is relevant to such program directors.

2.2.10. Ensuring that each of the institution's programs provides complete, timely, and accurate information to interviewees, including a copy of the contract the applicant will be expected to sign if matched to the program if such contract is available, or a copy of the contract currently in use. The NRMP institutional official also must ensure that each of the institution's programs provides institutional policies on visa status and eligibility for appointment to a residency or fellowship position, as applicable. This information must be communicated to interviewees in writing prior to the rank order list certification deadline.

2.2.11. Ensuring that the institution's programs do not ask for verbal or written commitments from applicants indicating how they intend to rank any program. Any violation of this requirement will be a breach of this Agreement for which the program may suffer the penalties described in Section 9.0.

2.2.12. Arranging for prompt payment to the NRMP of all fees owed by the institution or any of its programs.

2.2.13. Ensuring that all of the institution's passwords are kept confidential and notifying the NRMP immediately if the institution has any reason to believe that any of the institution's passwords have been discovered or used by a third party or that there has been any other breach of security. .

3.0 Institutional Administrator

3.1 Designation

The NRMP institutional official has the option of designating an institutional administrator to assist with the oversight of the match process at the institution. The NRMP institutional administrator usually is a staff person in the graduate medical education office of the institution.

3.2 Responsibilities

The NRMP institutional administrator may enter or change selected institution and program reference data, which may require subsequent approval by the institutional official. In addition, the NRMP institutional administrator may view all of the institution and program data available through the Match Site.

4.0 Program Participation

4.1 Eligibility

4.1.1 Eligibilty: Main Residency Match

In order for a registered institution to enroll its program(s) in the Main Residency Match, as of the relevant rank order list certification deadline each such program must either (a) be accredited by the ACGME or (b) be a combined program that is approved or recognized by the American Board of Medical Specialties or by the respective specialty board that is responsible for board certification of residents who successfully complete the combined program.

4.1.2 Eligibilty: SMS Matching Program

The NRMP may, in accordance with the policies and advice of the sponsoring program directors' group, be selective in determining which programs are eligible to participate in the SMS Matching Program for that specialty. Only programs in a specialty for which an SMS Match is being conducted may offer positions through the SMS. Positions are titled "residency" or "fellowship" depending upon the specialty for which the SMS Match is being conducted.

To be eligible to offer positions through an SMS Match, as of the rank order list certification deadline for such SMS Match a program must be either (a) accredited by the ACGME, or (b) affiliated with an ACGME-accredited program in the primary discipline, or (c) lead to certification or endorsement and oversight by a board recognized by the American Board of Medical Specialties. Each institution and program executing this Agreement or the Specialties Matching Service Match Participation Agreement affirms that it will meet one of those requirements by the rank order list certification deadline.

4.2 Exclusive Commitment to the Matching Program

The institution agrees that all of its programs eligible for participation in the Matching Program will select senior students of U.S. allopathic medical schools only through the Matching Program or another national matching plan. If any position is offered to U.S. allopathic students outside the Matching Program or another national matching plan, including a preliminary position for a program that participates in another national matching plan, the institution and the program will be in breach of this Agreement and may suffer the penalties described in Section 9.0.

4.3 Categories of Program Positions

The following categories of positions are included in the Matching Program:

4.3.1 Categorical (C) PGY-1 positions in programs that provide the training required for board certification in the specialties

4.3.2. Categorical primary care positions in medicine and pediatrics (M)

4.3.3. One-year preliminary (P) positions in transitional or specialty programs

4.3.4. Advanced (A) positions in specialty programs that begin the year after the Matching Program and subsequent to one or more years of preliminary training (PGY-2)

4.3.5. Physician (R) positions in specialty programs that begin in the year of the Matching Program for physicians with prior graduate medical education

4.3.6. Sub-specialty (F) positions in programs that begin training subsequent to the completion of a resident training program

4.4 Withdrawals / Fee Refunds

Institutions may not withdraw any program from the Matching Program or change the number of positions offered by a program through such Matching Program after the applicable quota change deadline, except for situations beyond the control of the institution or program, as determined by the NRMP.

At any time, the NRMP may withdraw from the Matching Program any program that falls into one or more of the following categories:

(a) Programs that do not meet the eligibility requirements set forth in Section 4.1 of this Agreement

(b) Programs for which the NRMP believes it has received credible evidence that the program has violated the terms of the Agreement. Upon withdrawing a program from the Matching Program, the NRMP shall note in the Registration, Ranking, and Results System that the program is the subject of "pending action". The designation shall remain in place until the program has waived or exhausted the opportunity to contest the action pursuant to the Violations Policy.

Further, all programs at an institution with unpaid NRMP fees will be withdrawn from the Matching Program if such fees are not remitted to the NRMP prior to the scheduled opening of the Match Site for registration. Institutions and programs that are withdrawn from the Matching Program, either by their choice or by the NRMP, will not have their fees refunded or waived.

4.5 Waiver of the Match Results: Programs

Programs and applicants are not authorized to release each other from their binding match commitment. A decision to grant or deny a waiver is at the sole discretion of the NRMP and is not subject to arbitration. The NRMP recommends that each program director, institutional official, and applicant read carefully the Policies and Procedures for Waiver Requests ("Waiver Policy") that shall govern the NRMP's handling of waivers and which are incorporated by reference in and are an integral part of this Agreement.

Any participant in the Matching Program shall promptly notify the NRMP of any waiver requests he/she/it receives directly from any other participant. Programs are expected to use the Applicant Match History in the Match Site to determine the match status of any applicant considered for appointment to the program.

The NRMP, in its discretion, may grant to a program a waiver of its binding commitment to an applicant if the NRMP determines that fulfillment of a program's commitment to the results of the Matching Program would cause serious and extreme hardship for the program. The waiver request must (a) be made in writing by the program director or the NRMP institutional official with a copy to each applicant whose position is included in the waiver request; (b) specify each such applicant; and (c) specify the method the program will employ to assist each such applicant to secure another residency position in the event the waiver request is the result of program closure or a change in program complement. The NRMP will investigate the waiver request to determine whether or not the waiver is appropriate.

Programs shall not negotiate with or offer the matched position to another candidate prior to or during the course of a waiver investigation. If the NRMP receives information that a match-participating program has negotiated with or offered the matched position to another applicant prior to receiving a waiver from the NRMP, the NRMP will initiate an investigation to determine whether the program or applicant has violated the terms of this Agreement.

Upon completing its investigation, the NRMP, in its sole discretion, may grant a waiver to the program releasing it from the commitment to one or more of the applicants whose positions were included in the waiver request, or it may deny the request.

4.5.1 Waiver Approvals: Programs

If the waiver is granted to the program by the NRMP, the applicant may accept a position in another graduate medical education program and the matched program may offer the vacant position to another qualified applicant, unless the waiver request was based on financial hardship, a reduction in resident complement, or loss of accreditation.

4.5.2 Waiver Denials: Programs

If the waiver is not granted to the program by the NRMP, the program will be expected to offer the matched position(s) to the applicant(s) included in the program's waiver request. If the program does not offer the matched position(s), the NRMP will initiate an investigation to determine whether the program has violated the terms of applicable Match Participation Agreement.

If an applicant requests a waiver from the NRMP and/or the matched program, the program shall not negotiate with or offer the position to any other candidate until either (a) the matched applicant has informed the NRMP in writing that he/she will not accept the matched position if his/her waiver request is denied by the NRMP and the program has been notified by the NRMP that it has been granted a waiver, or (b) the waiver is granted by the NRMP. If the NRMP receives information that the program has negotiated with or offered the position to another candidate before it has been notified by the NRMP that either of the foregoing conditions has occurred, the NRMP will initiate an investigation to determine whether the program has violated the terms of the applicable Match Participation Agreement.

An NRMP match-participating program is prohibited from offering a position to an applicant who is ineligible to accept a position in an NRMP-match participating program because his/her waiver request was denied by the NRMP. Such prohibition applies to all positions which have a start date within one year from the date of the NRMP's decision. If an NRMP match-participating program offers a position to a matched applicant whose waiver was denied and training would commence during the one-year period, or if the applicant accepts such a position, the NRMP will initiate an investigation to determine whether the applicant or the program has violated the terms of the applicable Match Participation Agreement.

If the NRMP initiates an investigation to determine whether a program or applicant has violated the terms of the Agreement, the NRMP will follow the procedures set forth in Section 9.0. of this Agreement.

4.6 Program Closures and Reductions in Resident Complement

If a program has reason to close and/or reduce the number of residents or fellows, it must follow the procedures specified in Section II by the Accreditation Council for Graduate Medical Education ("ACGME") in Section II of the ACGME Institutional Requirements, as amended from time to time, or any successor requirements. The program must notify the NRMP of the method it will employ to assist each matched applicant in securing another graduate medical education position. Failure to adhere to those requirements will be a breach of this Agreement.

5.0 Applicants

5.1 Eligibility: Main Residency Match

In order for an applicant to participate in the Main Residency Match, the NRMP requires that such applicant affirm that he or she meets all requirements for entry into graduate medical education as prescribed in Section II of the ACGME Institutional Requirements, Residents. The eligibility of U.S. seniors to participate in the Main Residency Match is communicated directly to the NRMP by their NRMP school officials. With respect to all other applicants in the Main Residency Match, it is the policy of the NRMP to contact the relevant United States or Canadian schools in order to verify enrollment or graduate status and to contact the Educational Commission for Foreign Medical Graduates ("ECFMG") concerning whether an applicant who is a student at, or a graduate of, an international medical school has passed the examinations necessary for ECFMG certification. The NRMP does not attempt to verify visa status.

It is the policy of the NRMP to withdraw from the Main Residency Match all applicants whose eligibility is not confirmed prior to the applicable rank order list certification deadline. The parties acknowledge that the NRMP cannot guarantee the eligibility of an applicant and that it is the responsibility of each institution to verify independently that each applicant considered for a position at such institution meets all of the institution's requirements. Those requirements must be communicated to applicants in writing prior to the relevant rank order list certification deadline. It is recommended that each program obtain a signed acknowledgement of such communication from each applicant who interviews with such program.

5.2 Eligibility: SMS Matching Program

To participate in the SMS Matching Program, prior to the scheduled start date of the position for which the applicant is applying, the applicant must have completed all of the training required for such position and must meet all of the requirements for entry into graduate medical education as prescribed by the Accreditation Council for Graduate Medical Education ("ACGME") in Section II of the ACGME Institutional Requirements, Residents, which are incorporated into this Agreement by reference. Each applicant executing the SMS Match Participation Agreement affirms that he or she will meet those requirements prior to the applicable program start date.

5.3 Other Requirements

Each sponsoring institution (e.g., a teaching hospital) may have additional requirements for eligibility for its programs. The NRMP is not responsible for ensuring that any or all of the requirements have or will have been met by an applicant prior to the scheduled beginning of the term of the position to which the applicant matched or for communicating such requirements to applicants.

5.4 Couples

To review the NRMP procedures with respect to individuals who wish to seek positions as a couple, click here. Applicants registered as a couple are treated by the Matching Program only as a couple. If two applicants who registered as a couple do not obtain a match as a couple, the Matching Program will not try to find a separate match for either of them individually.

5.5 Withdrawals

5.5.1 Withdrawal by the Applicant

Applicants may withdraw from the Matching Program under certain conditions, but only if the NRMP receives the withdrawal request prior to the applicable rank order list certification deadline through the Match Site Withdrawal screen for the Matching Program. Applicants who have accepted a position through any other national matching service or by agreement outside the Matching Program must withdraw from the Matching Program. Failure to withdraw from the Matching Program will be a breach of the applicable Match Participation Agreement and may subject the applicant to the penalties described in Section 9.0 of this Agreement.

U.S. seniors may not withdraw themselves from the Main Residency Match. U.S. seniors may be withdrawn only by the NRMP medical school official.

5.5.2 Withdrawal of Applicants by the NRMP

At any time, the NRMP may withdraw from the Matching Program any applicant who falls into one or more of the following categories:

(a) Applicants with unpaid NRMP fees. The applicant registration procedure requires that all fees be paid in U.S. dollars by credit card or by bank checking account through the Match Site at the time of registration. The applicant will be allowed to register only after credit card or checking account information is entered through the Match Site and processed successfully.

(b) Applicants for whom the NRMP believes it has received credible evidence that they have violated the terms of this Agreement. Upon withdrawing an applicant from the Matching Program, the NRMP shall note in the Registration, Ranking, and Results System that the applicant is the subject of "pending action". The designation shall remain in place until the applicant has waived or exhausted the opportunity to contest the action pursuant to the Violations Policy.

5.5.3 Withdrawal Deadlines / Fee Refunds

Applicants may not withdraw from the Matching Program after the applicable rank order list certification deadline. Applicants who are withdrawn from the Matching Program, either by their choice or by the NRMP, will not have their fees refunded.

5.6 Waiver of the Match Results: Applicants

Applicants and programs are not authorized to release each other from their binding match commitment. A decision to grant or deny a waiver is at the sole discretion of the NRMP and is not subject to arbitration. The NRMP recommends that each applicant and program read carefully the Policies and Procedures for Waiver Requests ("Waiver Policy") that shall govern the NRMP's handling of waivers and which are incorporated by reference in and are an integral part of the applicable Match Participation Agreement.

Any participant in the Matching Program shall promptly notify the NRMP of any waiver requests he/she/it receives directly from any other participant.

The NRMP, in its discretion, may grant to an applicant a waiver of his/her binding commitment to a program if the NRMP determines that the fulfillment of his/her commitment would cause serious hardship. An applicant who matched to an advanced or fellowship position also may request a waiver if the applicant has elected to change specialties, provided the waiver is requested no later than the January 15 prior to the start of training. The applicant must request the waiver in writing and must send the request to the NRMP with a copy to the program to which the applicant matched. The NRMP will investigate the waiver request to determine whether or not the waiver shall be granted.

If, following initiation of the waiver review process by the NRMP, the applicant notifies the NRMP in writing that he/she will not accept the matched position if the waiver is not granted, the NRMP may grant an immediate waiver to the program so that it can recruit another qualified candidate for the matched position.

Applicants shall not negotiate for appointment to or accept a position in another program prior to or during the course of a waiver investigation. If the NRMP receives information that an applicant has negotiated for appointment to or accepted a concurrent year position in another program prior to receiving a waiver from the NRMP, the NRMP will initiate an investigation to determine whether the applicant or program has violated the terms of the applicable Match Participation Agreement.

Upon completing its investigation, the NRMP, in its sole discretion, may grant a waiver to the applicant releasing him/her from the commitment to the program, or it may deny the waiver request

5.6.1 Waiver Approvals: Applicants

If the waiver is granted to the applicant by the NRMP, the applicant may accept a position in another graduate medical education program and the matched program may offer the vacant position to another qualified applicant.

5.6.2 Waiver Denials: Applicants

If the waiver is not granted to the applicant by the NRMP, the applicant will be expected to accept the matched position. If the applicant does not accept the matched position, the NRMP will initiate an investigation to determine whether the applicant has violated the terms of this Agreement.

If the waiver is not granted to the applicant by the NRMP and the applicant notifies the NRMP in writing that he/she will not accept the matched position, the NRMP will grant a waiver to the matched program so that it can recruit another qualified applicant for the matched position.

An applicant whose waiver request has been denied and who does not accept the matched position may be barred from accepting a position in another NRMP match-participating program that has a start date within one year from the date of the NRMP's decision. If any NRMP match-participating program offers a position to that applicant to commence training during the one-year period, or if the applicant accepts such a position, the NRMP will initiate an investigation to determine whether the applicant and/or the program has violated the terms of this Agreement.

If the NRMP initiates a violation investigation of the applicant or program, it will follow the procedures set forth in Section 9.0 of this Agreement.

6.0 Communications

6.1 Between Institutions, their Programs, and the NRMP

Complete, timely, and accurate exchanges of information are essential to the residency and fellowship application and matching process. To facilitate such communication, the NRMP institutional official is responsible for all communication with the NRMP on behalf of the institution's sponsored programs. All changes made by a program concerning positions must be approved by the NRMP institutional official responsible for such program and communicated directly to the NRMP through the appropriate page of the Match Site.

After registration of the institution, the NRMP institutional official must update the institution and program information in the NRMP database, including reversions and descriptions of special institution and program requirements. It is the NRMP institutional official's responsibility to ensure that each program director checks the accuracy of quotas, reversions, and special requirements. This information is to be reviewed by the NRMP institutional official and any corrections or changes are to be communicated to the NRMP through the appropriate page of the Match Site.

For the SMS Matching Program, the program directors' group representing the programs in a particular specialty desiring to participate in the Specialties Matching Service must designate a "specialty representative" to be responsible for overseeing the match process and to be the group's official representative to the NRMP on all matters regarding the group's programs that register for the SMS Matching Program. The specialty representative will be responsible for negotiating the terms of the services to be provided for the specialty by the NRMP, and must have the authority to execute the "NRMP Program Directors' Annual Participation Agreement" on behalf of the group and to commit to the NRMP the active participation in the SMS Matching Program of 75 percent of the programs in such specialty and 75 percent of the available positions in a given year.

6.2 Changes After Registration

All changes should be submitted in writing to the NRMP through the appropriate screen of the Match Site, including:

My Institutional Information

My Institutional Administrator Information

Approve Changes

My Program Information

My Program Directors

6.3 Quota Changes

The deadline for making changes to quotas for the Main Residency Match is January 31 of the year of the Main Match in question. All other matches have quota change deadlines specific to that match. In order to ensure that applicants will be aware of the accurate number of positions available in programs in advance of the rank order list certification deadline, exceptions will be made only in extreme circumstances, e.g., loss of funding, change in accreditation status, bankruptcy, or to accommodate the results of a prior match. Requests for exceptions must be made in writing by the NRMP institutional official.

Program quota changes should be communicated by the NRMP institutional official to the NRMP via the Approve Changes page of the Match Site. NRMP institutional officials and program directors should consider whether a quota change has an effect on reversions and special requests. The NRMP will not automatically adjust reversions due to quota changes. Any necessary adjustments should be requested by the NRMP institutional official through the appropriate page of the Match Site.

Quota changes for NRMP matches will not be accepted after the applicable quota change deadline (see Schedule of Dates). The quota on file with the NRMP for each program at 11:59 p.m. eastern time on the applicable quota change deadline for each match will be the number of positions offered through such match for that year.

Programs cannot reduce their quotas to zero. Any registered program that does not want to offer positions through a particular match must officially withdraw through the Program Information page of the Match Site. The program's withdrawal must be confirmed by having the NRMP institutional official notify the NRMP through the Approve Changes page of the Match Site by 11:59 p.m. eastern time on the applicable quota change deadline to ensure that such program is not listed on the Match Site as a participant in such match.

6.4 Schedules and Deadlines

An annual Schedule of Dates is published by the NRMP for each match and is incorporated in this Agreement by reference. Time is of the essence in this Agreement and adherence to those dates is essential. All required institution and program information must be received by the NRMP by the published deadlines.

Unmatched applicants and programs participating in the Main Residency Match may not contact each other about unfilled positions prior to 12:00 noon eastern time on Tuesday of Match Week. Matched applicants and programs may not contact each other prior to the general announcement of Matching Program results at 1:00 p.m. eastern time on Thursday of Match Week.

In addition, it is a violation of the applicable Match Participation Agreement if any registered program or institution shares the information about unfilled programs with any individual who is not registered for the match or allows an individual who is not registered for the match to use the registrant's unique code number and password to access the secure web site to obtain information about unfilled positions.

6.5 Completeness, Timeliness, and Accuracy of Information

The institution and its programs must act in good faith to provide complete, timely, and accurate information to interviewees. Programs shall provide a copy of the contract the applicant will be expected to sign if matched to the program if such contract is available, or a copy of the contract currently in use. Programs also must provide all institutional policies regarding eligibility for appointment to a residency or fellowship position. The contract and all other information must be communicated to interviewees in writing prior to the relevant rank order list certification deadline.

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 will be considered a violation of the applicable Match Participation Agreement.

The NRMP is not responsible for ensuring the accuracy of information exchanged between applicants and programs. However, if the NRMP believes it has received credible evidence that an applicant, program, or institution has violated the terms of the applicable Match Participation Agreement, the NRMP is authorized to take appropriate action, as described in Section 9.0 of this Agreement, including, but not limited to, withdrawal of the applicant or program from the Matching Program and reporting the violation to the American Board of Medical Specialties or the ACGME in accordance with Section 9.0.

6.6 Confidentiality

The information submitted to the NRMP on both applicant and program rank order lists is confidential. It is the policy of the NRMP not to disclose such information in any manner that permits individual identification of either applicants or programs.

7.0 Matching and Appointing Rules

7.1 Match Commitment

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. Each such appointment is subject to the official policies of the appointing institution in effect on the date the program submits its rank order list and is contingent upon the matching applicant meeting all eligibility requirements imposed by those policies. Those requirements must be communicated to applicants in writing prior to the rank order list certification deadline. It is recommended that each program obtain a signed acknowledgement of such communication from each applicant who interviews with such program.

Failure to honor this commitment by either party participating in a match will be a breach of the applicable Match Participation Agreement and may result in penalties to the breaching party, as described in Section 9.0 of this Agreement.

Any program that negotiates with or offers a position to an applicant who matched to a concurrent year position in another program and who has not been granted a waiver by the NRMP will be in breach of the applicable Match Participation Agreement and may be subject to penalties, as described in Section 9.0 of this Agreement. Prior to offering a position to an applicant, programs must take reasonable steps to ascertain the applicant's match status, including contacting the NRMP to obtain that information and verifying the applicant's eligibility in the Applicant Match History that is available in the Match Site.

After the general announcement of match results, each program will forward letters of appointment to all applicants who have matched with that program. Applicants are expected to return one copy of the letter of acceptance to the program before the deadline stated in the letter.

7.2 Rank Order List Certification

To participate in the Matching Program, programs must (a) register with the Matching Program and (b) submit certified rank order lists electronically using the Match Site. Use of the Match Site requires Internet access using common browser programs, as described in the User Guide. Rank order lists cannot be submitted by mail or in any way other than through the Match Site.

Access to the Match Site is limited to registered institutions, programs, applicants, and other authorized users. Each authorized user must enter a unique code and password.

The rank order list ("ROL") can be entered in more than one session and can be modified multiple times prior to the ROL certification deadline. Parties are encouraged to finish this process at least a week before the ROL certification deadline, prior to the peak utilization period when the Match Site may be less accessible.

THE NRMP DOES NOT GUARANTEE THE AVAILABILITY OF THE MATCH SITE AND WILL NOT MODIFY IN ANY WAY THE RANK ORDER LISTS OF APPLICANTS OR PROGRAMS.

7.3 Program Changes

Programs may make quota changes, additions, withdrawals, and other changes in the positions they desire to fill through the Matching Program. Such changes must be approved by the NRMP institutional official and made on the Match Site by the quota change deadline. Exceptions to this deadline may be requested by the institutional official for cases of extreme emergency, such as loss of funding or accreditation, or to accommodate the results of earlier matching programs. In such cases, a written request for relief should be made to the NRMP.

8.0 Restrictions on Persuasion

One of the purposes of the Matching Program is to allow both applicants and programs to make selection decisions on a uniform schedule and without undue or unwarranted pressure. Both applicants and programs may express a high degree of interest in each other and try to encourage future ranking decisions in their favor, but must not solicit statements implying a commitment. Although applicants and programs may volunteer how they plan to rank each other, it is a breach of this Agreement to request such information. In addition, only the final preferences of programs and applicants, as expressed on their final certified rank order lists, will determine the offering of positions and the placement of applicants through the Matching Program. It is a breach of the applicable Match Participation Agreement for a participant in the Matching Program to make any verbal or written contract for appointment to a concurrent year residency position prior to the Matching Program.

9.0 Match Violations

9.1 NRMP Violations Policies and Procedures

The NRMP requires all Matching Program participants to behave in an ethical and responsible manner during the matching process and to comply with the terms and conditions of the applicable Match Participation Agreement. It is the policy of the NRMP to investigate alleged breaches of the Match Participation Agreements, including but not limited to: failure to provide complete, timely, and accurate information during the interview and matching process, discrepancies in graduation credentials, attempts to subvert eligibility requirements or the matching process itself, failures to offer or accept an appointment as required by the results of a match, and any other irregular behavior or activities that occur in connection with registration, the submission or modification of a rank order list, and/or the participant's commitment to honor the match outcome.

The Policies and Procedures for Reporting, Investigation, and Disposition of Violations of NRMP Agreements ("Violations Policy") shall govern the NRMP's handling of match violations and are incorporated by reference in and are an integral part of this Agreement.

At any time the NRMP may withdraw any applicant or program from the Matching Program if the NRMP believes it has received credible evidence that the applicant or program has violated the terms of the applicable Match Participation Agreement. Withdrawn applicants or programs shall be afforded an opportunity to be heard in accordance with the Violations Policy.

Upon withdrawing an applicant or program from the Matching Program, or upon confirmation by a Review Panel that the applicant or program has violated the terms of the applicable Match Participation Agreement, the NRMP shall note in the Registration, Ranking, and Results (R3) System that the applicant or program is the subject of "pending action". The designation shall remain in place until the applicant or program has waived or exhausted the opportunity to contest the adverse action pursuant to the Violations Policy.

9.2 Consequences of Confirmed Violations

The consequences of a confirmed violation of this Agreement, or the Match Participation Agreement Among Applicants, the NRMP, and Participating Programs, or the Specialties Matching Service Match Participation Agreement are set forth in the Violations Policy. They include the following:

9.2.1 Applicants

If the NRMP's investigation of an alleged violation indicates that an applicant has committed a violation of the applicable Match Participation Agreement, the processing of the applicant's rank order list may be interrupted. The NRMP at its discretion may withdraw the applicant from the Matching Program.

If a matched applicant is the subject of a violation investigation, the program to which the applicant matched may not fill the position until the Final Report has been issued and/or a waiver has been granted by the NRMP.

The NRMP's Final Report on the confirmed violation will be delivered to the applicant with copies to:

(1) the applicant's medical school with a request that the Final Report be placed in the applicant's permanent file

(2) the ECFMG if the applicant is a student/graduate of an international medical school

(3) the NRMP institutional official and the director of the program to which the applicant matched

(4) the NRMP institutional official and the director of the program to which the applicant has applied or switched (if known).

(5) the party who originally reported the violation

(6) the NRMP Executive Committee

(7) the American Board of Medical Specialties

(8) the applicant's residency program director if the violation occurred in a fellowship match

(9) the Federation of State Medical Boards if the applicant is to be permanently identified as a match violator or permanently barred from future NRMP matches

(10) any parties whom the NRMP has determined are relevant to its investigation.

In addition, the applicant may be barred from subsequent NRMP matches and/or identified as a match violator to participating programs for up to three years or permanently, as determined by the NRMP. The applicant also may be barred from accepting a position in an NRMP match-participating program that would commence training within one year from the date of issuance of the Final Report. Further, any matched applicant who does not accept his/her matched position and has been denied a waiver of his/her match commitment may be barred from accepting a position in an NRMP match-participating program that would commence training within one year from the date of the NRMP's decision on the waiver.

The decision conveyed in the Final Report will be reflected permanently in the Match Site Applicant Match History. Term limits of any sanction(s) imposed for the violation will be included to identify the length of time the action is in effect.

9.2.2 Programs

If the NRMP's investigation of an alleged violation by a program indicates that a program has committed a violation of this Agreement or the applicable Match Participation Agreement, the processing of the program's rank order list may be interrupted. The NRMP at its discretion may withdraw the program from the Matching Program.

The NRMP's Final Report on the confirmed violation will be delivered to the program director with copies to:

(1) the NRMP institutional official for transmittal to the institution's graduate medical education committee

(2) the ACGME for distribution to the respective Program's Residency Review Committee (RRC) and the Institutional Review Committee

(3) the respective specialty program director association

(4) the party who originally reported the violation

(5) the NRMP Executive Committee

(6) any parties whom the NRMP has determined are relevant to its investigation

In addition, the program may be barred from future NRMP matches and/or identified as a match violator for up to three years or permanently, as determined by the NRMP. The decision conveyed in the Final Report will be reflected permanently in the Program Violations Report in the Match Site. Term limits of any sanction(s) imposed for the violation will be included to identify the length of time the action is in effect.

A program is prohibited from offering a position to an applicant who is ineligible to accept a position in an NRMP match-participating program because his/her waiver request has been denied or because of a confirmed violation of the applicable Match Participation Agreement. If a program offers a position to such applicant, or if an applicant accepts such a position, and training would commence within one year of the date of the NRMP's waiver decision or the date of issuance of the Final Report, the NRMP will initiate an investigation to determine whether the applicant or program has violated the terms of the applicable Match Participation Agreement.

10.0 Reversion of Unfilled Positions; Special Requirements

10.1 Reversion Option

The NRMP gives institutions the option to revert (donate) unfilled positions in one program ("a donor program") to another program ("a receiver program") during the matching process. If a donor program does not fill its quota, a designated number (equal to or less than the quota) of its unfilled positions will be added automatically to the quota of a receiver program. Receiver programs may be located at the same or a different institution. If the receiver is at a different institution, the donor program submits the reversion using the Maintain Reversions screen of the Match Site. The institutional officials at both institutions must approve the reversion through the Approve Changes screen. Institutions can use reversions to provide a degree of protection against the possibility that positions in prerequisite training programs for other institutional programs will go unfilled.

Donor programs donate a specific number of their unfilled positions to a receiver program. The number of positions indicated may not exceed the donor program's quota. Positions will be donated only if they do not fill during the matching process.

Receiver programs accept a designated number of unfilled positions from a donor program. Positions are added to the receiver program's quota only if the donor program is unable to fill its positions during the matching process.

10.2 Submission of Reversions to the NRMP

If a program wishes to revert positions, the reversions must be requested by the program director through the Maintain Reversions page and approved by that program's NRMP institutional official on the Approve Changes page of the Match Site. Reversions can be changed, added, or deleted by the program director or NRMP institutional official after registration, but they must be received by the NRMP by the rank order list certification deadline.

10.3 Special Requirements

The Matching Program can accommodate other special program requirements. If a special need is not addressed below, program directors should contact the NRMP at (202) 828-0676 to determine whether the request can be accommodated.

10.3.1 Linked and Restricted Programs

Program directors can link advanced programs to a designated preliminary program to limit enrollment in a preliminary program to that group of applicants who matched into a specific advanced program. Applicants should be told to rank the advanced program on their primary rank order lists and the preliminary program on the supplemental rank order list that corresponds to that advanced program. In addition, the preferred applicants must be ranked on the rank order lists of both the advanced program and the preliminary program. During the matching process, the preliminary program will be considered only if the applicant matches to the advanced program and the preliminary program appears on a supplemental rank order list associated with the linked advanced program. Because of this restriction, the preliminary program will not appear in the List of Unfilled Programs of the NRMP match results.

10.3.2 Even / Odd Quotas

Programs that must match to an even (2, 4, 6, etc.) or an odd (1, 3, 5, etc.) number of candidates can so indicate on the Maintain Program Information page of the Match Site. This restriction is typical in the instance of combined programs (e.g., Medicine/Pediatrics, Medicine/Emergency Medicine, Pediatrics/Physical Medicine and Rehabilitation, etc.,) that, because of the structure of the residency schedule, cannot accommodate an uneven number of residents.

10.3.3 Reversion Sequencing

Some programs elect to revert or donate their unfilled positions to two programs. For this type of reversion, the NRMP must know the exact sequence in which the unfilled positions are to be reverted. The sequence of reversions is entered on the Maintain Reversions page.

11.0 Fees and Fee Refunds

11.1 Institution and Program Fees

Each institution must pay an institution registration fee, a program registration fee for each of its registered programs, and a matched applicant fee for each applicant with whom a program matches successfully. The NRMP will send an invoice to the institution for those fees, which must be paid within thirty (30) days of the invoice date. After the conclusion of a match, an invoice for all incurred expenses, registration fees, and matched applicant fees will be issued by the NRMP to the institutional official, who will be responsible for ensuring prompt payment.

11.2 Fee Payment Procedures

All fees must be paid in U.S. dollars by credit card or by check or money order drawn on a U.S. bank made payable to the NRMP. By electing to pay by credit card, the institution authorizes the NRMP to supply the cardholder's bank with information it requires about this Agreement in order to resolve inquiries regarding related credit card charges. The NRMP may attempt to contact the institution if the institution's check is returned or its credit card is not approved. If the credit card is not approved for the amount necessary to cover the applicable fees or if the check is returned, the institution and all of its programs will be barred from future NRMP matches, unless payment or replacement card information is received by the NRMP and processed successfully prior to the scheduled opening of the Match Site for registration for such future matches.

11.3 Fee Refunds; Overdue Fees

The basic registration fees paid by institutions and programs are not refundable. Subsequent withdrawal of a program or its sponsoring institution does not void the institution's financial obligation to pay the non-refundable registration fees. However, overpayments will be refunded upon request.

Institutions and programs that owe fees for any previous match or whose sponsoring institution owes fees for any previous match year will be barred from future matches unless payment is received by the NRMP and processed successfully prior to the scheduled opening of the Match Site for registration for such future matches.

12.0 Use of Information

The NRMP releases individual applicant match results to each program that ranked the applicant on its ROL and, in the case of any program participating in a specialty match, to its specialty program director association's liaison to the NRMP, and to those program directors who request such information to verify whether the applicant was matched. The match results of U.S. medical school students and graduates, U.S. osteopathic school students and graduates, and Canadian students and graduates also are released to their respective schools of medicine or osteopathy.

In addition, each institution authorizes the NRMP to use any information provided to the NRMP by such institution or any of its programs in any study approved by the NRMP, provided that no information clearly and uniquely identifiable with such institution or program is disclosed in reports resulting from such study.

13.0 Representations and Warranties

Each institution represents and warrants to the NRMP, on behalf of itself and all of its programs, that all of the information provided, or that will be provided, by such institution and each of its programs to the NRMP is complete, timely, and accurate to the best of such institution's knowledge at the time such information was or will be provided and at the time of certification of each such program's rank order lists.

14.0 Disclaimers

The parties acknowledge that the fees charged by the NRMP for participation in the Matching Program include no consideration for any assumption by the NRMP of the risk of any damages that may arise in connection with the participation of any institution's programs in the Matching Program or utilization of the Match Site.

(a) the NRMP,

(b) the current managing agent for the NRMP, the Association of American Medical Colleges, or any successor managing agent (the "Managing Agent"),

(c) any vendor providing equipment, software, or services to the NRMP or the Managing Agent ("Vendor"), nor

(d) any director, officer, employee, affiliate, or agent of the NRMP, the Managing Agent, or any Vendor,

wwill be liable for any loss, damage, cost, or expense whatsoever, direct or indirect, regardless of the cause, that may arise out of, or be in any way related to, the use of the Matching Program, the Match Site, or the automated systems and services utilized by the NRMP or the Managing Agent to implement the Matching Program or to send notices, including, but not limited to: (a) the suspension or termination of, or the inability to use, all or any part of the Match Site; (b) the erroneous transmission of any data or the transmission of any erroneous data; (c) any failure or delay suffered or allegedly suffered by any party in receiving or sending any rank order list or other information or in certifying a rank order list, however caused; (d) the delivery or transmission of any virus, worm, or other disruptive device; or (e) any other cause in connection with the furnishing of services or notices by the NRMP or the Managing Agent or the performance, maintenance, or use of, or inability to use, all or any part of the Match Site. The foregoing will apply regardless of whether a claim arises in contract, tort, negligence, strict liability, or otherwise.

The automated systems and services utilized by the NRMP or the Managing Agent to implement the Matching Program and the Match Site are provided "AS IS" and "AS AVAILABLE." NONE OF THE NRMP, THE MANAGING AGENT, ANY VENDOR, OR ANY OF THEIR DIRECTORS, OFFICERS, AGENTS, EMPLOYEES, OR AFFILIATES MAKES ANY WARRANTY OR REPRESENTATION OF ANY KIND, EXPRESS OR IMPLIED, WITH RESPECT TO SUCH SERVICES, THE MATCH SITE, OR THE MATCHING PROGRAM, OR TO THE ACCURACY, COMPLETENESS, SECURITY, TIMELINESS, OR RELIABILITY OF THE INFORMATION TO WHICH ANY PARTY HAS ACCESS OR TRANSMITS OR RECEIVES THROUGH THEM OR THROUGH ANY OTHER AUTOMATED SYSTEM. ALL IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, TITLE, AND NON-INFRINGEMENT ARE EXPRESSLY EXCLUDED. No oral or written information or advice given by the NRMP, the Managing Agent, any Vendor or any of their directors, officers, agents, affiliates, or employees will create a warranty, and no party may rely on any such information or advice. There is no assurance that the information the parties have access to through the Match Site will be accurate, complete, secure, timely, or reliable, or that the Match Site or the automated services utilized by the NRMP or the Managing Agent will be error-free or operate without interruption. In particular, and without limiting the generality of the foregoing, the NRMP makes no warranty that certified rank order lists processed through use of such automated services will be properly executed. Each program and applicant is solely responsible for verifying that its/his/her certified rank order list has been duly entered and certified.

15.0 Limitation of Liability

IN NO EVENT WILL THE NRMP, THE MANAGING AGENT, OR ANY VENDOR OR AFFILIATE BE LIABLE FOR ANY DAMAGES AS A RESULT OF ANY NEGLIGENT ACT OR OMISSION OF THE NRMP, THE MANAGING AGENT, OR ANY VENDOR OR AFFILIATE, IRRESPECTIVE OF WHETHER THE INJURED PARTY IS AN INSTITUTION, A PROGRAM, OR A THIRD PARTY.

16.0 Notices

All notices to the NRMP, other than those given in accordance with Section 9.0, must be given either by email at nrmp@aamc.org or through the Match Site and are effective upon receipt. The NRMP is not responsible for delays in email or Internet service. Any notices or documents received by the NRMP after the relevant deadline date will not be considered.

All notices to institutions or programs, other than those given in accordance with Section 9.0, will be given either by email to the email address provided by such party to the NRMP upon submission of such party's registration at the Match Site or through the Match Site while the institution or program is logged on to the site. Such notices to institutions or programs given by email will be deemed given twenty-four (24) hours after sending, unless the sending party is notified that the email address is invalid or that the message was not delivered. All notices given during an institution's or program's session on the Match Site will be deemed given at the time of such session.

17.0 Dispute Resolution

Except for the granting or denial of a waiver as noted in Sections 4.5 and 5.6 of this Agreement, all disputes arising out of, or related to, the Matching Program, this Agreement, or the breach thereof, between or among the NRMP and any applicant or program participating, or seeking participation, in the Matching Program must be settled by arbitration in accordance with the rules of the American Health Lawyers Association Alternative Dispute Resolution Service then in effect, unless the parties to the dispute mutually agree otherwise. Notwithstanding the foregoing, no arbitrator shall have power to adjudicate any dispute as a class arbitration or as a consolidated arbitration without the express consent of all the parties to any such dispute. Notice of the demand for arbitration must be filed in writing with all other parties to the arbitration and with the American Health Lawyers Association. A demand for arbitration in a matter that is covered by the Violations Policy must be made in accordance with the Violations Policy. The arbitrators must conduct all arbitration proceedings in the Office of the NRMP in Washington, DC or at such other location as mutually agreed upon by the parties. Each party will share equally in the cost of arbitration, except that the party requesting arbitration must pay the filing fee in its entirety. The award by the arbitrator or arbitrators will be final and must be in writing. Judgment upon the award rendered may be entered in any court having jurisdiction thereof, so long as the arbitrators acted in good faith. The arbitrator shall not have the power to make an award that is inconsistent with the provisions of this Agreement or with District of Columbia substantive law.

18.0 Limitation of Action

No claim or cause of action, regardless of form, arising out of or related to the Matching Program, the Match Participation Agreement Among Applicants, the NRMP, and Participating Programs, or the breach thereof, this Agreement, or the breach thereof, or any other dispute between the NRMP and any applicant, program, or institution participating, or seeking participation, in the Matching Program, may be brought in an arbitral, judicial, or other proceeding by any party more than 30 calendar days after the cause of action has accrued, regardless of any statute, law, regulation, or rule to the contrary ("Limitation Period"). The Limitation Period shall commence the day after the day on which the cause of action accrued. Failure to institute an arbitration proceeding within the Limitation Period will constitute an absolute bar and waiver of the institution of any proceedings, whether in arbitration, court, or otherwise, with respect to such cause of action. A cause of action that has become time-barred may not be exercised by way of counter claim or relied upon by way of exception.

In addition, any party who desires to contest a decision of a Review Panel of the NRMP must notify the NRMP of its intent to seek arbitration within 10 business days from that party's receipt of the Panel's report and must file a demand for arbitration within 30 calendar days of receipt of such report, in accordance with the terms of the Violations Policy. If notice of a party's intent to seek arbitration is not received by the NRMP within 10 business days from that party's receipt of the Review Panel Report, or if the party does not file a demand for arbitration within 30 calendar days of receipt of the Review Panel Report, that party is deemed to have waived and is barred from later filing a demand for arbitration or seeking other relief.

19.0 General

This Agreement is governed by the laws of the District of Columbia, excluding its choice of laws provisions.

The headings of the Sections of this Agreement have been inserted for convenience of reference only and shall in no way restrict or otherwise affect the construction of the terms or provisions of this Agreement. Unless indicated otherwise, references in this Agreement to Sections are to Sections of this Agreement.

If any provision of this Agreement is found in any arbitration proceeding or by any court of competent jurisdiction to be invalid, illegal, or unenforceable, that provision shall be modified to the minimum extent necessary to achieve the purpose originally intended, if possible, and the validity, legality, and enforceability of the remaining provisions will not be affected or impaired and are to be enforced to the maximum extent permitted by applicable law. If any remedy set forth in this Agreement is determined to have failed of its essential purpose, then all other provisions of this Agreement will remain in full force and effect.

Failure of any party to act or exercise its rights under this Agreement upon the breach of any other terms hereof by any other party is not to be construed as a waiver of such a breach or prevent such party from later enforcing compliance with any or all of the terms hereof. This Agreement contains the entire agreement between the parties with respect to the Matching Program and its results. Any representations, promises, or conditions not incorporated in this Agreement will not be binding upon any of the parties. No modification of this Agreement shall be effective unless in writing and executed by the party against whom it is to be enforced.

Updated September 2007