It is interesting what you can find while browsing your hard drive archives. As I pored through my mountain of blog drafts (okay, it’s more like a hill or even a knoll), I bumped into an article I had intended to use in February 2006, before the NRMP rank list deadline last year.

What is the NRMP and how is it like a dating service?

The NRMP (National Resident Matching Program) is an organization that oversees the residency matching process for all but a few medical specialties in the United States. Among a myriad others, these include anesthesiology, dermatology, emergency medicine, family medicine, general surgery, internal medicine, neurology, obstetrics and gynecology, pediatrics, psychiatry, radiology, … you get the picture. There are a few exceptions, such as urology, ophthalmology, plastic surgery, neurology, and neurological surgery, which are part of the San Francisco Matching Program.

The NRMP can be compared to an online dating service. Medical students apply to different residency programs in their desired area of specialty. After the interview process (a series of “big dates”), the students and residency programs submit their respective “rank order lists” (ROL). As the term implies, the applicant’s rank list is an ordered list of residency programs from most to least desired. The program’s rank list is, as you guessed correctly, a list of applicants in order of preference. There can only be one #1, one #2, one #3, and so forth.

Soon after the submission deadline for the rank lists, a computer performs the “matching” process, based on a time-tested algorithm. The computerized process supposedly takes a mere few minutes, but applicants must wait three weeks before hearing where they have matched. A reason given for the delay is that the results need to be re-checked to the nth degree. The match is a binding contract. In essence, this is a marriage that follows a series of dates, but determined by the matchmaker. And just like in the dating world, there is an unfortunate minority who do not match. They enter the “Scramble” to find a position somewhere somehow.

One week from now, over 20 000 residency applicants (and roughly 6000 who enter the Scramble) will discover where they are destined to train and live for at least the next few years. There will be many tears shed, both of joy and of pain.