The National Resident Matching Program works by collecting ranked preference lists from both applicants and residency programs, running them through a computer algorithm that pairs each applicant with the highest-ranked program on their list that also wants them, and binding both sides to the result through a signed participation agreement. Registration happens through NRMP’s own R3 system, which is separate from the application services you use to send materials to programs. Once the algorithm produces a match, you are contractually obligated to take the position, and the program is obligated to give it to you.
Here is how the process moves from registration to placement, and what the commitment actually means once results come out.
Who Can Register
The Match is open to students in their final year at U.S. medical schools accredited by the LCME or COCA, and to recent graduates of those schools who have not yet started or completed residency training.1National Resident Matching Program. 2025 Main Residency Match Applicant Agreement
International medical graduates can also register. A point worth getting right: IMGs do not need full ECFMG certification to register for the Match. They do need to have passed the required medical science examinations and met clinical and communication skills requirements, with results verified by the Rank Order List certification deadline.2National Resident Matching Program. International Medical School Students and Graduates (IMGs) in the Match – What You Need to Know Full ECFMG certification (or an unrestricted U.S. medical license) is a separate ACGME requirement to actually start training once matched. Applicants confuse those two deadlines every cycle.
Registering With NRMP Is Not the Same as Applying Through ERAS
One of the costliest early mistakes is assuming that submitting an application through the Electronic Residency Application Service also puts you in the Match. It does not. ERAS (and ResidencyCAS, which handles Emergency Medicine and Obstetrics-Gynecology) is where you send your application materials to programs. The NRMP’s Registration, Ranking, and Results (R3) system is where you register for the Match itself, build your rank order list, and get your results.3National Resident Matching Program. Introduction to the 2026 Main Residency Match You have to register with each system separately.
Inside R3 you enter your USMLE or COMLEX identification number, your contact details, and your verified medical school credentials.4National Resident Matching Program. Registration, Ranking, and Results (R3) System NRMP recommends adding your AAMC ID to link records across platforms, but it is not strictly required.5National Resident Matching Program. Am I Required to Include My AAMC ID When I Register for an NRMP Match
2026 Deadlines and Fees
Applicant registration for the 2026 cycle opened September 15, 2025. Standard registration closes January 30, 2026. The Rank Order List Certification Deadline is March 4, 2026, at 9:00 p.m. ET, which is also the last point for late registration, SOAP eligibility, and Match withdrawal.3National Resident Matching Program. Introduction to the 2026 Main Residency Match
Standard registration costs $70, which covers up to 20 unique program codes across the primary and supplemental lists. Registering after January 29 adds a $50 late fee. Each program code ranked beyond 20 costs $30, up to a cap of 300 ranks. Couples pay an extra $45 per partner, due immediately when couple status is accepted. None of these fees are refundable.6National Resident Matching Program. Match Fees
Building and Certifying Your Rank Order List
Your rank order list is the heart of your participation in the Match. You list programs inside R3 in the order you actually want them, from most preferred to least. NRMP is explicit on the strategy question: rank in order of true preference, not where you think you are most likely to be accepted.7National Resident Matching Program. Rank Your Programs The algorithm is built so honest ranking is always your best move. Trying to guess where a program will rank you and adjusting accordingly only risks losing a spot you preferred more.
Each program is identified by a five-digit NRMP program code. Codes can be looked up through the AMA’s FREIDA database or on program websites. A wrong code can land you at a program or specialty you never meant to rank, so check every entry before certification.
When your list is complete, you certify it by entering your password in R3. Only certified lists are run through the algorithm. For the 2026 Match, that certification deadline is March 4, 2026 at 9:00 p.m. ET, and nothing can be changed after that. If you do not certify, your list is not included at all.7National Resident Matching Program. Rank Your Programs
How the Algorithm Pairs Applicants and Programs
NRMP runs the Roth-Peranson algorithm, a modified version of the deferred acceptance algorithm Gale and Shapley published in 1962. It walks through each applicant’s list from the top, tentatively placing them at their highest-ranked program. If that program’s slots are already full, the algorithm compares the new applicant against those tentatively held and bumps whichever applicant the program ranked lower. The bumped applicant moves down their own list and the process repeats until every applicant is placed at the best program willing to take them or has run out of ranks.
The design is “applicant-optimal,” meaning it produces the best feasible result for applicants given how programs ranked them. That is the structural reason honest ranking pays off: the algorithm is already working on your side.
Position Types Change What You’re Committing To
Not every slot in the Match is the same, and ranking the wrong kind without understanding it can leave you with incomplete training. NRMP uses letter codes to distinguish position types.8National Resident Matching Program. What Are the Types of Program Positions in the Main Residency Match
- Categorical (C) is a PGY-1 position that includes the full training needed for board certification in the specialty. It is the most direct path.
- Preliminary (P) is a one-year PGY-1 position in internal medicine, surgery, or a transitional year, meant to provide prerequisite training before an advanced position.
- Advanced (A) is a position in a specialty that begins the year after the Match and requires preliminary training first. If you match to an advanced position, you still need a separate preliminary spot.
- Reserved (R) is a PGY-2 position for physicians who already hold prior graduate medical education. Current medical students cannot take these.9National Resident Matching Program. The Match Terms and Topics
If you rank advanced programs, you can also submit supplemental rank order lists of preliminary programs, with each supplemental list linked to one or more advanced programs on your primary list, often grouped by geography so your two years of training are in reasonable proximity. The algorithm only consults a supplemental list after you have matched to the linked advanced program. If you match to an advanced position but the algorithm cannot place you anywhere on the linked preliminary list, you are still bound to the advanced spot and must find a first-year position through SOAP or post-SOAP recruitment. If none is secured by July 1, it is on you to request a waiver from the advanced program commitment.10National Resident Matching Program. About Supplemental Rank Order Lists
The Couples Match
Partners who want to train in the same area can register as a couple. Both must agree, and the $45 per-partner fee is due immediately on acceptance of couple status.6National Resident Matching Program. Match Fees The two rank order lists are submitted as synchronized pairs, with each row on one partner’s list tied to the same row on the other’s, and both lists must contain the same number of entries.11National Resident Matching Program. Couples in the Match
A couple’s match is only produced when both partners can be placed at a ranked pair of programs simultaneously. If no pair works, neither partner matches; the algorithm does not break the couple apart to try individually. A No Match code (999999999 for residency) can be entered on specific rows to indicate that one partner is willing to go unmatched if the other lands at a preferred program. Rows using the No Match code go at the bottom of the list.11National Resident Matching Program. Couples in the Match
What Programs Can and Can’t Say During Interview Season
NRMP enforces a code of conduct that constrains interview-season communication. Programs can tell you they are interested. They cannot ask you to disclose your ranking preferences, your ranking intentions, or which other programs you applied to.12National Resident Matching Program. NRMP Match Code of Conduct for Programs Post-interview contact for clarifying information is allowed, but it cannot be used to pressure or influence how you rank.
Programs also cannot make misleading statements about their own ranking plans. A program director saying “you’re ranked to match” to extract a commitment is a conduct violation. Any promise you make to a program about where you’ll rank them is unenforceable, and it should not change what you actually submit.
Match Week and SOAP
Match Week for the 2026 cycle runs Monday, March 16 through Friday, March 20. On Monday at 10:00 a.m. ET, you learn whether you matched, but not where. Applicants who did not match, or only partially matched, become eligible for the Supplemental Offer and Acceptance Program (SOAP).13National Resident Matching Program. 2026 Match Week and SOAP Schedule
SOAP runs through four rounds of offers on a compressed schedule. In each round, programs make offers inside R3 and applicants have a two-hour window to accept or reject. Rounds run roughly from 9:00 a.m. to 8:00 p.m. ET, with the list of unfilled programs refreshing after each.13National Resident Matching Program. 2026 Match Week and SOAP Schedule A rule worth memorizing: during SOAP, you and anyone acting on your behalf cannot contact a program until that program contacts you first. Programs initiate all communication.
Match Day falls on Friday, March 20 at 12:00 p.m. ET, when matched applicants learn the name and location of their program.14National Resident Matching Program. Match Week
The Result Is Binding
Every participant electronically signs the Match Participation Agreement at registration. It is a binding contract governed by the laws of the District of Columbia.15National Resident Matching Program. Match Participation Agreement for Medical Schools Once the algorithm produces a match, you are obligated to take the position and the program is obligated to give it to you. Neither side can exit without a waiver from the NRMP.16National Resident Matching Program. Waiver Policy
The arrangement’s legal footing was reinforced in 2004 when Congress passed the Pension Funding Equity Act, which included a provision exempting graduate medical education matching programs from federal antitrust laws. Under 15 U.S.C. ยง37b, sponsoring, conducting, or participating in a residency matching program cannot be treated as an antitrust violation, and evidence of such participation is inadmissible in federal court to support an antitrust claim. That provision ended a class-action lawsuit that had challenged the Match as an illegal restraint on physician labor markets.
Withdrawals and Waivers
You can withdraw from the Match any time before the Rank Order List Certification Deadline (March 4, 2026 at 9:00 p.m. ET for the 2026 cycle) by doing so in R3. After that deadline, withdrawal is not available. Failing to withdraw when you should have, such as after accepting a position outside the Match, is itself a breach of the agreement.3National Resident Matching Program. Introduction to the 2026 Main Residency Match
Once results are out, the only exit is a waiver or deferral granted by NRMP, with a formal request and supporting documentation. Change-of-specialty waivers must be submitted by January 15 before training begins and apply only to applicants who accepted an advanced or fellowship position.16National Resident Matching Program. Waiver Policy Other grounds, such as significant health changes or unanticipated changes in program status, are reviewed individually. NRMP does not publish an exhaustive list of qualifying reasons, so no applicant should assume a given circumstance will be approved.
Sanctions for Violations
Circumventing a match result without an approved waiver is a violation of the Match Participation Agreement. NRMP maintains a formal investigation process, and confirmed violations carry real consequences. Sanctions scale with severity:17National Resident Matching Program. Sanctions Guidelines
- A bar from SOAP participation, applied when applicants violate SOAP communication rules.
- A bar from accepting or starting a position at any program sponsored by an NRMP Match-participating institution.
- A bar from future Match participation: one year for reckless or intentional violations, two years when the violation disadvantaged other participants, or permanent for gross misconduct or fraud.
- Identification as a Match violator in the R3 system, a flag visible to programs for one year, two years, or permanently depending on severity.
For programs, confirmed violations can also trigger a report to the appropriate review committee at the Accreditation Council for Graduate Medical Education, which can affect accreditation status.18National Resident Matching Program. Program Noncompliance in the National Resident Matching Program – Prevalence and Consequences NRMP can reduce sanctions when mitigating circumstances exist, but enforcement is the default. A two-year bar from the Match at the wrong moment in training can redirect an entire medical career, which is why the ranking honesty the algorithm rewards is also the ranking honesty the contract requires.