To ensure you are building or maintaining good relationships with your matched applicants and the NRMP, be ready to take these post-Match steps. 

Engage the Onboarding Process

Once a Match concludes, programs should begin the onboarding process with any/all of the following activities:

  • Issue letters of acceptance to all matched applicants
  • Issue appointment contracts
  • Provide applications for licensure and guidance for submission
  • Address any ongoing needs with respect to visas (applicants on a J-1 visa can regularly check OASIS with the ECFMG)
  • Communicate with matched applicants about any required pre-training activities (e.g., drug screens, background checks)

Programs are required under the terms of the Match Participation Agreement to disclose eligiblity and onboarding requirements to applicants prior to the applicable Rank Order List Certification Deadline. Programs should obtain signed acknowledgement from applicants that said requirements were shared or be able to demonstrate that requirements were made available to applicants prior to the Deadline.

Issues with the Binding Commitment?

If for any reason a binding commitment cannot or will not be honored, the NRMP requires a program to request a waiver review. Waivers can be requested for unanticipated serious and extreme hardship or applicant ineligibility. Please keep the following in mind:

  • Once a waiver has been requested, programs cannot discuss, interview for, or offer the matched position to an applicant until a waiver has been granted.
  • The responsibility rests with the program to demonstrate the extent of any unanticipated serious or extreme hardship.
  • If a waiver is granted, the program may recruit for the position. If a waiver is not granted, the program is expected to honor the binding commitment.

The NRMP also will consider a one-year delayed start of training (‘deferral’) if mutually agreed to by the matched program and the applicant.

The binding commitment is in place for the first 45 days of training; accordingly, programs that terminate a matched applicant within 45 days of the start date specified in the appointment contract will be presumed to have breached NRMP policy unless evidence is submitted through the waiver process sufficient to show that training was offered in good faith and the NRMP determines there is a reasonable basis to release the program from the binding commitment. Please note that applicants who give notice of resignation, resign, or vacate a position within 45 days of the start date specified in the appointment contract also will be presumed to have breached NRMP policy absent a waiver from the NRMP.

Requests must be submitted on the Program Waiver/Deferral Form

Additional Resources

Waiver Policy
Waiver Case Summaries

Questions about the waiver process should be directed to (202) 400-2235 or