The NRMP uses a computerized mathematical algorithm to place applicants into residency and fellowship positions. To make the matching algorithm work best for you, create your rank order in your true preferences, not how you think you will match. The process begins with an attempt to match an applicant to the program most preferred on that applicant’s rank order list, not on the program's rank order list. However, for a Match to occur, both the applicant and program must rank each other. If the applicant cannot be matched to that first choice program, an attempt is made to place the applicant into the second choice program, and so on, until the applicant obtains a tentative match or all the applicant’s choices on the Rank Order List (ROL) have been exhausted.

A tentative match means a program on the applicant’s ROL also ranked that applicant and either:

- - the program has an unfilled position, in which case there is room in the program to make a tentative match between the applicant and program, or

- - the program does not have an unfilled position, but the applicant is more preferred by the program than another applicant who already is tentatively matched to the program. In that case, the applicant who is less preferred by the program is removed to make room for a tentative match with the more preferred applicant.

Matches are considered “tentative” because an applicant who is matched to a program at one point in the matching process may be removed from the program later to make space for an applicant ranked higher by the program. When an applicant is removed from a tentative match, an attempt is made to re-match that applicant, starting from the top of the applicant’s ROL. This process is carried out for all applicants until each applicant has either been tentatively matched to the most preferred choice possible or all choices submitted by the applicant have been exhausted.

When the Match is complete, all tentative matches become final. View an example of how the matching algorithm works.

How the Matching Algorithm Works Video

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