The Ethics of the Match

Abstract

—Potter Stewart Honesty and enthusiasm should go hand in hand when determining a future in the field one has chosen. However, the National Resident Matching Program (NRMP) match process is a stressful time during which candidates and programs struggle to balance enthusiasm and honesty with self-interest. The NRMP match first started in 1952 to create a uniform date to accept residency offers. After Sir William Osler started the first residency program in 1889, competition among hospitals for incoming residents led to increasingly early offers of internships to students. Hospitals had limited information about students’ performance, and applicants had to accept or reject positions without knowing which other offers might be forthcoming [1]. The match algorithm addressed students’ struggles with short deadlines and hospitals’ need to scramble for available students [2]. However, decades after its creation, issues still arise in the process. In particular, postinterview, prematch communication has caused frustration for both program directors and applicants alike, as presented in a previous letter to the editor in JACR [3]. In another survey, 94% of programdirectors felt that theNRMP process placed their programs in the position of having to be dishonest