NRMP, AAMC Invite Comments on Proposed 'Scramble' Revisions

By Barbara Bein
4/2/2009

The National Resident Matching Program, or NRMP, and the Association of American Medical Colleges, or AAMC, are seeking comments on proposed changes to the annual "Scramble," during which graduating medical students and other applicants who didn't match to their desired residency choices during the main residency Match can apply for remaining unfilled residency positions.

The proposal, (6-page PDF; About PDFs) which was developed by a nine-member work group established by the two organizations is intended to instill in the Scramble the same "trust, transparency, and integrity inherent in the Match." The work group comprised medical school student affairs deans, residency program directors, and recent graduates of U.S. and international medical schools.

One important proposed change would require applicants and programs to use AAMC's Electronic Residency Application Service, or ERAS, to handle applications in a coordinated, systematic fashion. There also would be a revised schedule during Match Week, including moving Match Day from Thursday to Friday.

Mona Signer, M.P.H., NRMP executive director, told AAFP News Now, "The problem is that unfilled programs are being overwhelmed with applications and it's difficult to sort through them in a timely fashion. Also, applicants are being asked to make career decisions in a very short time frame."

Among principles that would form the foundation of a revised Scramble process are

information about unmatched applicants and unfilled programs should be released simultaneously;
there should be a mandatory time-out period, during which unmatched applicants could send applications to programs, but unfilled programs could make no offers;
applicants should be required to submit their applications -- and programs to accept applications -- only through ERAS;
programs would offer positions during Match Week only through the NRMP Registration, Ranking and Results, or R3, System; and
functionality of the R3 System should be enhanced to allow programs to offer unfilled positions on the basis of their submitted preference lists.

According to Signer, the cutoff for the comment period has been extended to April 13. The NRMP Board of Directors will meet May 4 to discuss the proposal. Comments may be sent via e-mail to Signer or to Henry Sondheimer, M.D., senior director, student affairs and student programs for AAMC.

Implementation of any new system would come no earlier than 2011, Signer said.

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