Policies and Procedures for Waiver Requests
The National Resident Matching Program (NRMP) assumes responsibility
for instituting measures to protect the integrity of the matching process
by requiring all Match participants to behave ethically and responsibly
during the matching process.
It is the policy of the NRMP to require each Match participant to enter
into an NRMP Match Participation
Agreement and for the NRMP to conduct a review of all waiver requests
submitted by participants. Under the terms of the
Agreement signed by all Match participants, 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 and
good faith intent apply to the Match Week Supplemental
Offer and Acceptance ProgramSM
if a program offers a position by listing an applicant on its preference
list and the applicant accepts that offer.
The NRMP reserves the right to grant to an applicant or a program a
waiver of the binding commitment. Applicants and programs are not authorized
to release each other from their binding commitment. The determination
to grant or deny a waiver request lies in the sole discretion of the NRMP
and is not subject to arbitration.
A. Request for Waiver
- Applicants, program directors, or institutional officials may contact
the NRMP to request a waiver. The NRMP will not initiate a waiver review
until it has received a written or electronic request. The request must
include the name(s) of the matched applicant(s) and program(s).
- Waiver requests must be sent in writing to:
Mona M. Signer, Executive Director
National Resident Matching Program
2121 K Street, NW
Washington, DC 20037
B. Confirmation and Examination Procedures
Following receipt of the waiver request, the NRMP will ask the requestor
to confirm in writing that he/she wishes the NRMP to process the waiver
and to provide the NRMP all information the requestor deems important
in support of the request. After receiving written confirmation from the
requestor, the NRMP will contact other party or parties identified in
the request and any other person(s) with knowledge of the circumstances
surrounding the request, and ask them to provide the NRMP with a written
statement within five business days.
- All waiver requests will receive a full examination
and evaluation by the NRMP. The NRMP is authorized to contact other
individuals/institutions in the course of acquiring information.
- Applicants who have matched to a program or
have accepted a position during SOAP shall not apply for,
discuss, interview for, or accept a concurrent year position in another
program prior to the NRMP issuing its decision as to whether to grant
the requested waiver. In addition, programs shall not discuss, interview
for, or offer the position to any other candidate until either: (a)
the applicant has informed the NRMP that he/she will not accept the
position if/when the NRMP denies the waiver and the program has been
so notified by the NRMP; or (b) the NRMP grants the waiver.
- An applicant, program director, or institutional
official may request a waiver if he/she believes the fulfillment of
the commitment to the results of a Match would cause serious and extreme
hardship. The burden shall be on the requestor to demonstrate serious
and extreme hardship. For purposes of the waiver process, the term serious
and extreme hardship means the significant and unexpected adversity
that honoring the binding commitment would bear upon the requestor's
- An applicant who matched to an advanced or
fellowship position or who accepted an advanced position during SOAP
also may request a waiver if he/she has elected to change specialties,
provided the waiver is requested no later than the January 15 prior
to the start of training in the advanced or fellowship program.
- If at any time during the course of a waiver
review the applicant, program director, or institutional official notifies
the NRMP in writing that he/she will not honor the binding commitment
if the waiver is denied, the NRMP may grant an immediate waiver to the
C. Consequences of Waiver Review Process
- At the conclusion of the examination and evaluation, the NRMP will
decide whether to grant or deny the waiver request.
a. If a waiver is granted, the applicant may
accept another position or participate in future Matches, and the
NRMP will not pursue the matter as a violation of the Match Participation
Agreement signed during registration. In addition, the program will
be free to recruit another candidate for the vacant position.
b. If a waiver is not granted, the applicant
and program will be expected to honor the binding commitment. Both
parties will have five business days from receipt of the NRMP's decision
to inform the NRMP whether the applicant will begin training in the
program. Failure to honor the binding commitment is a breach of the
Match Participation Agreement and grounds for a violation investigation.
All investigations are conducted in accordance with the Policies
and Procedures for Reporting, Investigation, and Disposition of Violations
of NRMP Agreements. The NRMP recommends that each applicant and
program read that document carefully.
- If a waiver is not granted and the applicant
does not agree to honor the binding commitment, he/she may be barred
from accepting or starting a position in any program sponsored by an
institution that participates in any NRMP Match if the position has
a start date within one year from the date of the NRMP's final decision
to deny the waiver. Further, an institution that participates in any
NRMP Match is prohibited from offering a position in any program sponsored
by the institution, regardless of the program's Match participation
status, to any applicant who is ineligible to accept a position as the
result of a denied waiver. Programs shall not discuss, interview for,
or offer an applicant any potential position unless the program first
has determined that the applicant is eligible for appointment. Programs
shall determine the applicant's eligibility by verifying the applicant's
Match status in the Applicant Match History that is available in the
system and/or by calling the NRMP to obtain that
information. If any of the programs sponsored by the institution discusses,
interviews for, or 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,
the program, or the institution has violated the terms of the applicable
Match Participation Agreement.
- If a waiver is not granted and the applicant
does not agree to honor the binding commitment, the applicant may be
subject to a violation investigation for failure to honor his/her binding
commitment. As a consequence of a confirmed violation, the applicant
(1) barred from future NRMP Matches for a period of one to three
years or permanently, as determined by the NRMP.
(2) identified as a Match violator to participating programs for
a period of one to three years or permanently, as determined by
In addition, the applicant's medical school will be notified of the
confirmed violation, with a request that it become a part of the applicant's
(3) barred from accepting or starting a position
in any program sponsored by an institution that participates in
any NRMP Match that has a start date within one year from the date
of the NRMP's issuance of the Final Report of the investigation.
- If a program is denied a waiver of its binding commitment by the NRMP
and does not agree to offer the position to the applicant, the program
may be subject to a violation investigation for failure to honor its
binding commitment. As a consequence of a confirmed violation, the program
(1) barred from future NRMP Matches for one to three years or permanently,
as determined by the NRMP.
In addition, the NRMP will notify the ACGME and appropriate review committee
and the program director association.
(2) identified as a Match violator to participating applicants
for one to three years or permanently, as determined by the NRMP
- If any program sponsored by an institution that participates in any
NRMP Match, regardless of the program's Match participation status,
discusses, interviews for, or offers a position to an applicant who
has a concurrent year position and who has not been granted a waiver
by the NRMP, the institution may be subject to a violation investigation
for failure to comply with the Participation Agreement.
D. Reconsideration of Initial NRMP Decision
A party whose request for a waiver has been denied may request reconsideration
of the determination. The party will have five business days from receipt
of the initial adverse decision to request reconsideration. The request
for reconsideration should state the basis for reconsideration and explain
why the initial decision of the NRMP is unreasonable under the circumstances.
The decision following reconsideration is final and not subject to arbitration.
Upon completion of the reconsideration process, if any, the NRMP will
issue a letter indicating the final decision regarding the waiver request.
Unless otherwise determined by the NRMP, the effective date of the final
decision will be the date of the letter that transmits the final decision
to the party(ies).
E. Match Violations
If the NRMP initiates a violation investigation to determine whether
an applicant, program, or institution has violated the terms of the applicable
Match Participation Agreement, the investigation and any confirmed violation
will be handled in accordance with the terms of the relevant Agreement
and the NRMP Policies and Procedures
for Reporting, Investigation, and Disposition of Violations of NRMP Agreements.
Updated August 2012