Main Residency Match All in Policy

Under the NRMP All In Policy, any program registering for the Main Residency Match^® must register and attempt to fill all positions through the Match or another national matching plan.  The Policy applies to those positions a program wishes to fill, which may be fewer than the number of positions for which the program is accredited. Programs planning to participate in the Match cannot offer positions outside the Match prior to program director registration and program activation.  If a position is offered outside the Match prior to program registration and activation, the program is ineligible to enroll in the Match unless the program has been granted an exception to the All In Policy by the NRMP for the position in question.

Positions the All In Policy Applies To

The All In Policy applies to positions for which the NRMP offers matching services:

• All PGY-1 positions as well as all PGY-2 positions in specialties accredited to begin at either the PGY-1 or PGY-2 level, regardless of whether the program begins in the PGY-1 or PGY-2 year
• PGY-2 positions that are “reserved” for applicants eligible to begin advanced training in the year of the Main Residency Match
• PGY-3 positions in Child Neurology

Positions NOT subject to the All In Policy include:

• PGY-2 or higher positions in specialties accredited to begin only at the PGY-1 level
• PGY-3 or higher positions (excepting Child Neurology) in specialties accredited to begin at either the PGY-1 or PGY-2 level

Exceptions to the All In Policy

All requests for exceptions to the All In Policy must be submitted in writing. Exceptions can be approved for:

Military appointees to civilian programs: Positions reserved for applicants placed in civilian training programs as part of the Joint Service Graduate Medical Education Selection Board, or Military Match, can be approved for exceptions to the All In Policy. Such exceptions are based on 1) pre-existing arrangements between the civilian training programs and military branch GME offices and 2) confirmation of those positions needing exception as transmitted from the military GME office directly to the NRMP. Applicants who are provided funding by their military branch but not placed through the Military Match process into a civilian training program do not qualify for exceptions to the All In Policy. Those positions must be filled through the Match, and programs can create special tracks for military-funded applicants in the R3 system.

Other Exceptions: Exceptions are not approved for international medical graduates needing visas. Exceptions for programs in rural and medically underserved areas are considered on a case-by-case basis. The R3 system is flexible and can accommodate special circumstances in the Match, including

• International medical graduates with funding from their home countries
• Combined clinical-research programs where the first year is not clinical training

Requests for exceptions submitted by Rural Scholars, Family Medicine Accelerated Track, and Innovative Programs must be submitted using the All In Exceptions Form. All other requests may be submitted by email at policy@nrmp.org or by U.S mail.

Once approved for an exception, programs are permitted to submit the All In Attestation form for up to three years provided the program director and DIO annually affirm that the structure and function of the program have not unchanged. Forms must be submitted to the NRMP no later than November 30. Please return completed forms and requested documentation to policy@nrmp.org.