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  • Press Release

    AAMC Comments to NRMP® on Two-Phase Main Residency Match Proposal

    Media Contacts

    Brooke Bergen, Director, Public Relations & Member Communications

    AAMC (Association of American Medical Colleges) Chief Academic Officer Alison J. Whelan, MD, delivered the following testimony during a meeting of the National Resident Matching Program® (NRMP®) Board of Directors and leadership on Sept. 16, 2022:

    "Thank you for the opportunity to respond to the NRMP’s proposed plan to implement a two-phase Main Residency Match®. I am the chief academic officer of the Association of American Medical Colleges. The AAMC is a nonprofit association dedicated to improving the health of people everywhere through medical education, health care, medical research, and community collaborations. Our members comprise all 156 LCME accredited U.S. medical schools; 14 accredited Canadian medical schools; approximately 400 teaching hospitals and health systems, including Department of Veterans Affairs medical centers; and nearly 80 academic societies.

    We also developed and operate the Electronic Residency Application System®, or ERAS®, which streamlines the residency application process for applicants, schools of medicine, letter of recommendation authors, and residency program directors.

    The comments I am sharing today are in my capacity as chief academic officer at the AAMC. While these comments incorporate considerable input we have heard during listening sessions with our constituents, they do not necessarily represent the views of our entire diverse membership and constituency, as we have not surveyed our membership in its totality on this issue.

    The transition to residency is a complex process that encompasses the period between undergraduate medical education (UME) and graduate medical education (GME) and carries challenges for everyone involved. The AAMC recognizes the need to improve the entire process and to decrease stress and burden for all — including learners, medical school staff, faculty advisors, program directors, and program staff. The association (with and for our constituents) has been involved in innovative and collaborative work in this space while continuously listening and introducing ways to make further improvements.

    The AAMC is grateful to the NRMP for allowing us to join in this multiorganizational discussion related to additional innovations in the transition to residency space, especially as it relates to The Match®. We believe that seeking broad input from the academic medicine community in addressing critical issues is necessary to reach the best possible solutions. To that end, we solicited feedback about this new proposed process from our constituency through several discussion sessions last month. We thank the members of the NRMP leadership — staff and board members — who participated in several of these sessions. 

    The multiple listening sessions we hosted included learners, members of the AAMC Council of Deans, designated institutional officials, medical education deans, medical school faculty, program directors and program staff, and student affairs deans. Participants were asked to share any feedback related to the proposed two-phase Main Residency Match. There were many themes from these sessions, but I will expand upon five of those today:

    1. More details are needed: A persistent question we heard from our constituents about the proposal was, “What problem are you trying to solve … The Match or SOAP®?” There was a common request for more details about the two-phase match proposal.
    1. Potential for added student stress and anxiety, especially among those who do not match during the new Phase One: The community at large was concerned about the impact of increasing stress and anxiety for learners by extending what is currently a week-long process across multiple weeks. This potential increase in stress generally outweighed the perceived value of more time for unmatched applicants to regroup and reapply. In addition to the length of time, making those who did not initially match visible could cause additional stress, anxiety, and possible long-term stigma. This was a major concern of every group. Our communities emphasized the importance of maintaining learner privacy about their match results and avoiding a public two-tier system. An additional concern raised was whether this would result in a higher number of unmatched learners at the end of both phases, resulting in some learners failing to match twice. The AAMC has not seen evidence to support this concern but recognizes it could occur if there is substantial behavior change by applicants or programs.
    1. Potential for increased student costs associated with a two-phase match (applications, travel, etc.) and whether the application process would change.
    1. Potential to detract from spring learning experiences: There are concerns, particularly from members of the UME community, that a two-phase match could detract from the learners’ educational experiences, negatively impacting away rotations and other curricular activities during the fourth year. Additionally, we heard that many were concerned about the potential to negatively impact Match Day activities.
    1. Potential for significant impact on the GME community: Program directors, program coordinators, faculty and resident interviewers, and admissions committees spend many hours on the application review and interview process. Multiple match cycles and additional interviews spread over several weeks would place additional time and financial burdens on program directors, coordinators, and their faculty selection committees.

    The AAMC supports thoughtful, evidence-informed innovations and process improvements. Any innovation in the transition to residency naturally needs a strong evaluation plan with a laser focus on learners and equity. We would like to better understand the proposed plan to assess its impact on a variety of complex issues.

    We recognize that most changes to the transition to residency will have cumulative effects, and we must work cautiously and collaboratively, informed by the best evidence.

    We further recognize that any future changes may impact the transition to residency in ways that may not even be anticipated, so a longer-term evaluation plan would be helpful.

    Given the role of applications in The Match process, ERAS would play a role in any two-phase match. Therefore, we welcome further discussions about any proposed changes. If the NRMP moves forward with the two-phase match proposal, we will need the NRMP to work closely with us so we can understand how the application process, and ERAS specifically, would need to change, including any technical and programmatic changes.

    Our broad community continues to advocate for improvements in the transition to residency, and our organizations that support the transition must look for ways to improve the process for all those directly and indirectly affected, especially the learners. We appreciate the NRMP’s desire to improve The Match process, your willingness to seek input, and the transparency provided in the process. We look forward to continuing open communication with the NRMP about the process and the decision regarding the two-phase match to best support our constituents and all who are committed to improving the transition to residency."

    The AAMC (Association of American Medical Colleges) is a nonprofit association dedicated to improving the health of people everywhere through medical education, health care, medical research, and community collaborations. Its members are all 158 U.S. medical schools accredited by the Liaison Committee on Medical Education; 13 accredited Canadian medical schools; approximately 400 academic health systems and teaching hospitals, including Department of Veterans Affairs medical centers; and more than 70 academic societies. Through these institutions and organizations, the AAMC leads and serves America’s medical schools, academic health systems and teaching hospitals, and the millions of individuals across academic medicine, including more than 193,000 full-time faculty members, 96,000 medical students, 153,000 resident physicians, and 60,000 graduate students and postdoctoral researchers in the biomedical sciences. Following a 2022 merger, the Alliance of Academic Health Centers and the Alliance of Academic Health Centers International broadened participation in the AAMC by U.S. and international academic health centers.