Military Binding Contracts

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					           The Match
Joseph S. De Gaetano, DO, MSEd, FAAFP,FACOFP
      Associate Professor of Family Medicine
    Assistant Dean for Clinical Curriculum/GME
           Time to Decide!
• Focus on a specialty
• Set up fourth year electives
• Utilize class “experts”
   Two National Accrediting
 Organizations for Residencies
• ACGME
• AOA
    3 Major National Residency
             Matches
• Military
• Osteopathic
• Allopathic
            Military Match
• First match
• Completed by December of the M4 year
• Students who match in the military must
  take their government assignment and will
  automatically be withdrawn from the AOA
  and ACGME matches
                      NRMP
• The National Residency Matching Program
  (www.nrmp.org)
• only ACGME accredited residencies participate in the
  NRMP
• osteopathic students are considered independent
  applicants: NSU-COM does not manage your interaction
  with the NRMP
• An impartial venue for matching students to residency
  positions
• provides a uniform time for selection without pressure
• 30,000 applicants compete for 25,000 positions annually
  NRMP Residency Categories
• Categorical: programs that begin in the
  PGY1 year
• Advanced: programs that begin in the
  PGY2 year
• preliminary: programs that count as a
  PGY1 year and are a prerequisite for
  advanced programs
           NRMP Process
• Students apply to the NRMP and their
  residencies independently
• application is to the residency via ERAS
• ERAS is run by the AAMC: an electronic
  clearing house
• registering with NRMP does not
  register you with ERAS
    NRMP Matching Algorithm
• Always attempts to place a student in
  his/her most preferred site
• matches remain tentative until the official
  posting after the match is over
• the final preferences of program directors
  and applicants are reflected in the posted
  rank order list
• the final posting is a binding commitment
Guidelines for a Student’s Rank
          Order List
• Only list programs that you absolutely
  wish to attend
• list programs in sequence of preference
• an unlimited number of programs can be
  listed based upon a specialties
  competitiveness
   ACGME Program Directors
• Invite students for interviews
• institutional policies override NRMP policy
• however, any attempt for an applicant
  or program to supply specific rank
  order info. prior to the match is a
  violation of the match
• the NRMP rank order list takes
  precedence over any verbal
  commitments
Approximate NRMP Timeline in the
            M4 Year
• August: student registration opens
• December 1: applicant registration deadline
• January 15: applicants and programs begin to
  enter their rank order lists
• January 31: programs finalize their rank lists
• February 26 at 11:59 p.m. EST: student rank
  list deadline
• March 17: students notified if matched or
  unmatched on web at noon
  Approximate Timeline Continued
• March 18 at 11:30 a.m.: unfilled positions listed:
  unmatched students begin to scramble: contact
  between students and programs prior to this
  time is a violation
• March 20 at 1 p.m. EST: all student match
  results listed: notification to students prior to
  this time is a violation
• March 22-April 22: letters of appointment sent by
  hospitals to students
          NRMP policies
• Matches are legally binding
• failure to honor this commitment is
  a breach of contract
            Policies Cont.
• Teaching hospitals set their own deadline
  for their own application submission via
  ERAS
• any subversion of the matching
  process will automatically withdraw the
  applicant from the process
• verbal commitments are non-binding
• independent applicants must withdraw on
  their own from the match
            Policies Cont.
• Students with a commitment via the
  military match are automatically withdrawn
  from the NRMP
• students who are selected for a
  position via the AOA match are
  automatically withdrawn from the
  NRMP
• registration fees are non-refundable
                ERAS
Electronic clearinghouse for:
• Letters of recommendation
• Transcripts
• MSPE
• Separate registration from matches
• Utilized by Military, MD, and DO
  residencies
The Restructured Osteopathic
         Internship
   Three Options for the Class of
               2009
                Option 1
          Categorical Internship
•   Residency programs will grant credit for the 1st
    postdoctoral year of training.
•   Students will “Match” directly into the residency
    and the 1st postdoctoral year will be
    considered the first year of residency training.
•   Specialties- Anesthesiology, Family Practice,
    Internal Medicine, Obstetrics and Gynecology
    and Pediatrics have chosen this option.
                   Option 2
            Preliminary Internship
• Residencies who choose this option will require a
  preliminary 1st year of training as a prerequisite for entry
  into the 1st year of residency in the 2nd postdoctoral
  year of training.
• Matching successfully assures entry into both the
  preliminary year and the subsequent 2nd year in
  residency training.
• Both the preliminary year and residency will be offered in
  the same institution
• Specialties- Emergency Medicine, General Surgery,
  Neuromusculoskeletal Medicine/Osteopathic
  Manipulative Medicine, Neurology, Neurosurgery,
  Ophthalmology, Orthopedic Surgery, Otolaryngology,
  Pathology, Psychiatry, Radiology, Radiation Oncology,
  Urology have chosen this option.
               Option 3
    Traditional Rotating Internship
•   This option represents a traditional rotating internship and stands
    alone.
•   Specialties that have chosen this option prefer residents in their
    specialty to have completed a traditional rotating internship.
•   This option is available to students who are undecided on future
    plans or for students planning on entering ACGME training.
•   Students completing a traditional rotating internship and then
    selecting option 1 or 2 specialties must contact that specialty
    college to determine whether advanced standing will be granted.
•   This option will depend on available residency positions since
    most will have been filled with first year matched trainees
    advancing to the OGME-2 year.
•   Specialties- Dermatology, Occupational/Preventive Medicine,
    Physical Medicine and Rehabilitation and Proctology has chosen
    this option.
    The new rotation schedule for Option 3 –
      The Traditional Rotating Internship
•   1. At least six months of training rotations in any or all basic core disciplines.
    These include general internal medicine, general surgery, family practice,
    pediatrics, obstetrics/gynecology (ambulatory gynecology) and emergency
    medicine.
•   2. No less than two months of exposure in general internal medicine.
•   3. One-month exposure in emergency medicine.
•   4. At least one month in family practice in a hospital or ambulatory site or
    one-half day per week for a minimum of 46 weeks of ambulatory exposure
    in a family practice continuity of care type practice site.
•   5. No more than three months of elective exposure adequate to meet the
    individual needs of the interns and approved by the DME/internship
    program director.
•   6. All remaining time may be scheduled at the discretion of the base
    institution.
•   7. No more than one month may be spent in non-clinical experience
    (research, scholarly pursuits, administration, etc.).
•   8. Exposure must occur to the support disciplines of pathology, radiology,
    and anesthesiology. This may occur directly by rotation or indirectly by
    formal didactic conferences and/or exposure while on medical and surgical
    services. This exposure must be verified
 AOA accreditation of an ACGME
          Internship
• FL, WV, MI, OK, PA require an
  osteopathically accredited internship for
  licensure
• Resolution 42
                AOA Match
• Administered by the National Matching Service
  (NMS) for the AOA
• each student independently registers with the
  NMS and submits a rank order list
• all osteopathic students automatically receive
  registration packets from NSU-COM in June of
  their M3 year
• the deadline for registration is October of the
  M4 year
• Rank order lists are submitted electronically by
  the end of January
  Preparing for the AOA Match
• Students must also independently apply to
  residency programs
• ERAS is utilized by osteopathically accredited
  residencies
• verbal agreements are non-binding
• contracts signed before the match are non-
  binding
• Official match results are binding
• a student may rank order as many programs as
  they desire
       Notification of Results
• Students are notified by email of results in
  February of their M4 year
• a contract will be sent by mail to matched
  students from the hospital that selected
  them
• a student must sign the contract within 30
  days after receipt
• failure to sign violates the match rules
           Match Violations
• Students who violate match rules cannot take
  AOA training for one year after the violation
• the AOA will never approve allopathic training
  performed by students who violate the AOA
  match rules
• Only a residency training program can
  release a matched student from their
  contractual agreement.
• Contract disputes occur between the student
  and the program
          Failure to Match
• All students who do not match via the
  NMS will receive a listing of open AOA
  slots across the country via email
• students and programs independently
  contact each other to fill open slots

				
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