The residency match in radiation oncology

Centralized matching of postgraduate training positions has been successfully implemented nationwide since 1951. Specialty and subspecialty matches have proliferated in the 1970's and early 1980's, and Radiation Oncology was the last residency program that did not have a centralized match arrangement. Responding to pressures from training program directors who were dissatisfied with the non-centralized matching of resident applicants, made especially acute by a rapid increase in the number of students interested in Radiation Oncology, the first centralized matching program for Radiation Oncology--the Radiation Oncology Matching Program (ROMP)--began in 1989. Two years of experience with the ROMP are summarized in this paper. Interest in training positions in Radiation Oncology remains high, with approximately 1.3 to 1.5 qualified applicants per each residency position. The major problem with the current arrangement in ROMP is lack of full participation. In 1989, approximately 70% of first year positions were offered through ROMP, and in 1990 this was closer to 60%. While the majority of programs desire and participate in a centralized match, participation at less than an 85 to 90% level will likely cause the centralized match to disband. Reasons for and against a centralized matching process and a history of matching programs in other specialties are discussed.