The National Residency Matching Program (NRMP) was created to
resolve serious problems that were rampant before its creation.
Abuses were frequent on both sides, with applicants accepting
offers from multiple programs in order to make a late decision
about where they would go after all the offers were in. Programs
expecting 10 residents to appear to begin their training were
therefore often left short-staffed when a smaller number than the
number of residents they had accepted actually showed up.
Applicants suffered under the old system as well, when offers
were made by programs and they accepted but when such offers were
subsequently discovered to be merely verbal offers and there was
no legal contract obligating the program to take them.
To eliminate these kinds of unfortunate situations, all of the
organizations involved agreed to work through a newly charted
group called the NRMP. Under the NRMP new system, both applicants
and programs sign agreements and are required to abide by the
same rules. By signing the NRMP enrollment agreements, both
programs and applicants agree that if they participate in the
NRMP matching process, the position will be there for the matched
applicant, and the applicant is similarly obligated to begin
training at the program where they were matched to a position. By
and large, the system has worked very well, and with the advent
of electronic applications, the whole process has become more
streamlined for everyone. The rank order lists submitted by both
programs and applicants during the process are a way of ensuring
that everyone gets the best of what's available to them.
