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

Engage in the Onboarding Process

Once the Match concludes, matched applicants and programs should begin the onboarding process. Applicants should be prepared to engage in any/all of the following:

  • Signing and returning a letter of acceptance
  • Signing and returning the appointment contract
  • Completing an application for a license (types determined by programs and state medical boards)
  • Addressing any ongoing needs with respect to visas (applicants on a J-1 visa should regularly check OASIS with the ECFMG)
  • Completing any 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 Rank Order List Certification Deadline. If your matched program did not provide the information, please contact NRMP at

Unmatched? Options for Communicating with Unfilled Programs

For applicants who are unmatched at the conclusion of the Match, the NRMP maintains the List of Unfilled Programs in the Registration, Ranking, and Results (R3) system until May 1. Please note that the NRMP encourages programs to update the List as they fill positions. Because that responsibility rests with programs, the List may not always reflect unfilled status in real-time.

There are other resources you can consider, including Find A Resident, a service of the AAMC. At the conclusion of SOAP, unmatched applicants are free to reach out to programs as they choose to inquire about training opportunities.

Issues with the Binding Commitment?

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

  • Once a waiver has been requested, applicants cannot apply for, discuss, interview for, or accept a position in another program until a waiver has been granted.
  • The responsibility rests with the applicant or program to demonstrate the extent of the unanticipated serious or extreme hardship.
  • Waivers based on change of specialty must be requested by January15 prior to the start of training. Because of this timing, applicants who match to positions that begin in the year of the Match do not qualify for change of specialty waivers.
  • If a waiver is granted, an applicant may accept a position in another program or participate in a future Match. If a waiver is not granted, the applicant 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 applicant and the program.

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

Additional Resources

Waiver Policy
Waiver Case Summaries

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