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Physicians and Students for change in the NRMP Match Agreement
Petition Background (Preamble):
My first grievance is the ability of the NRMP to permanently ban an applicant from the match, and the low threshold at which the NRMP uses this power. With the vast majority of positions going through the match, the permanent ban gives the NRMP the power to effectively end a young physician's career before it has even started. Dishonesty or any other match violation, intentional or unintentional, should be punished, but ending a young physician's career goals is excessive. I believe the permanent ban should be reserved for very serious offenses or separate repeat offenses.
Second, I believe the NRMP should release all data on the number of waivers, respective violations, and the punishments received for each violation. Our judicial system is fair from case to case and not overly harsh because it is based on very public, past precedence. NRMP has a very tight lipped policy on this data citing “we do not want this data to be taken out of context." Making this data public would ensure a fair violation system and force the NRMP to justify the punishments it lays out for violations (ie the permanent ban). Once again, releasing this data would not reduce the integrity of the match. If anything it would increase the integrity because residents and directors would be more cognizant of the consequences of match violations.
My final grievance is the loose wording the NRMP uses in its match agreement. For example a sanction bans an applicant from “training” at an NRMP affiliated program. In the past the NRMP has interpreted training to mean anything career related, including research positions. The term “training” in the National RESIDENT Match Program contract, should only include residency training. Allowing sanctioned applicants to perform research would not reduce the integrity of the match, it would merely allow applicants to improve their resume and maintain their clinical knowledge base until their sanction is complete.
The NRMP was established in 1952 to protect medical students' rights. During this time, there were far fewer medical students than positions, and program directors used aggressive tactics to force applicants into a contract. Since that time, the NRMP has grown tremendously, and the once benevolent dictator, in my opinion has lost sight of its goals. Also, there are now far more medical students and applicants than open residency positions. The NRMP’s contract poses much more of a threat to your career than any aggressive program director. Those in a powerful position, like the NRMP, directors, and state license boards, should not hide behind legality, but should make decisions based on logic and a certain level of compassion. The Match Agreement does not require draconian career ending powers to maintain integrity. There is no logical reason for permanently banning one time violations, preventing sanctioned applicants from performing research, or concealing data pertinent to a transparent violation system. The NRMP is once again pushing for 100% of PGY1 and PGY2 positions to go through the match, which would put an end to signing outside the match. Medical students, you might not fully appreciate these points yet but they will affect you very soon. Residents, you have already gone through the match but please voice your opinion for the younger generation. Also, first comes the push for 100% of PGY1 and PGY2 positions, next comes 100% of fellowships. Most people survive the match unscathed, but we should make a point to help those who don’t.
The Match Agreement should insure match integrity but also perform its original objective, protecting medical students and applicants. Please sign this petition, pass it along to your friends, colleagues, residents, and attendings. Send it to contacts at other medical schools. If you are involved in the AMA, please support our resolution.
1. Section D.1.b of Policies Procedures for Reporting, Investigation, and Disposition of Violations of NRMP agreements: The Permanent Ban should be removed and reserved specifically for falsifying a degree or license, or separate repeat match violations.
2. The NRMP should move toward complete transparency of all statistics on waivers, violations, and consequences of violations for both programs and applicants. Prior precedence should be open information and is necessary for a fair violation policy.
3. Section 7.2.2 of the Match Participation Agreement: Change “training” to “residency training”. “Training” is open to interpretation. A sanction resulting from a Match Violation should not prevent a physician from accepting a faculty, staff, or research position at a NRMP affiliated program.
The Physicians and Students for change in the NRMP Match Agreement petition to Medical Students, Physicians, Residents, Faculty, Staff was written by NRMP_Policy and is in the category Education at GoPetition. Contact author here. Petition tags: nrmp, medical, student, physician, resident, match, agreement