---
title: "The Match and the residency agreement"
canonical: "https://www.joinandwise.com/crossings/match-and-residency-agreement"
checked: "2026-10-21"
claim: "andwise:crossing/match-and-residency-agreement@2026-10-21"
license: "CC BY 4.0"
---

# The Match and the residency agreement

The residency agreement is the first employment contract most physicians sign, and the loan choices made around graduation decide which training months count toward forgiveness.

**The decision:** Submitting a rank order list, matching, and signing the residency (GME) agreement.

## What changes

- A match is a binding commitment under the NRMP Match Participation Agreement. Neither the applicant nor the program can release the other from it; only the NRMP can grant a waiver. ([NRMP, 2027 Match Participation Agreement](https://www.nrmp.org/wp-content/uploads/2026/09/2027-MPA-Main-Match-MedicalSchool.pdf); [NRMP help: declining a matched position](https://www.nrmp.org/help/item/what-happens-if-i-obtain-a-position-and-decide-not-to-accept-it-can-my-program-release-me-from-my-obligation-to-attend/); checked 2026-10-27)
- Residents are employees of their program as well as trainees. The residency agreement sets salary, benefits, leave, moonlighting rules, due process and the grounds for dismissal; where residents have a union, a collective bargaining agreement sets many of those terms. ([Andwise: resident union contract benchmarks](https://www.joinandwise.com/residency/union-contracts); checked 2026-10-21)
- Direct Loans have a six-month grace period after a borrower drops below half-time enrollment. Interest on unsubsidized loans accrues during grace. ([34 CFR 685.207, grace periods](https://www.ecfr.gov/current/title-34/section-685.207); [Federal Student Aid: interest rates and fees](https://studentaid.gov/understand-aid/types/loans/interest-rates); checked 2026-10-21)
- Residency forbearance is mandatory on request, granted up to 12 months at a time for the length of training. Interest accrues, and forbearance months earn no credit toward PSLF or toward RAP or income-driven forgiveness. ([34 CFR 685.205, forbearance](https://www.ecfr.gov/current/title-34/section-685.205); [Federal Student Aid: forbearance](https://studentaid.gov/manage-loans/lower-payments/get-temporary-relief/forbearance); checked 2026-10-21)
- On-time RAP payments, or required IBR payments, made while employed full-time by a nonprofit or government hospital count toward the 120 payments PSLF requires. ([34 CFR 685.219, Public Service Loan Forgiveness](https://www.ecfr.gov/current/title-34/section-685.219); [Public Law 119-21 (2025), Title VIII, §§81001 and 82001–82004](https://www.govinfo.gov/content/pkg/PLAW-119publ21/html/PLAW-119publ21.htm); checked 2026-10-21)
- Consolidating federal loans on or after July 1, 2026, for example to end grace early, produces a loan that only RAP or Tiered Standard can repay. ([Public Law 119-21 (2025), Title VIII, §§81001 and 82001–82004](https://www.govinfo.gov/content/pkg/PLAW-119publ21/html/PLAW-119publ21.htm); checked 2026-10-21)

## Who is paid for what

- **The residency program and its sponsoring institution.** Medicare pays teaching hospitals for graduate medical education: a direct payment from a per-resident amount, the weighted count of residents and Medicare's share of inpatient days, plus an add-on to each Medicare inpatient payment. Resident counts are generally capped at each hospital's 1996 level. ([CMS, direct graduate medical education (DGME) payments](https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/direct-graduate-medical-education-dgme); [CMS, indirect medical education (IME) adjustment](https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/indirect-medical-education-ime); [42 CFR 413.79, resident counts and the 1996 cap](https://www.ecfr.gov/current/title-42/section-413.79)) Not part of its role: Advising on loans, taxes or the first attending contract.
- **Federal loan servicer.** The Department of Education pays contracted servicers a monthly amount for each borrower account. Under the contracts in effect since April 2024, it can withhold up to 5% of a bill for each missed performance metric, up to 20% in total. ([GAO-16-523, federal student loan servicing (May 2016)](https://www.gao.gov/assets/gao-16-523.pdf); [GAO-26-108534, student loan servicing contracts (March 2026)](https://www.gao.gov/assets/gao-26-108534.pdf)) Not part of its role: Choosing a repayment plan for the borrower.

## Costs that come later

- Forbearance instead of payments during residency → PSLF and RAP forgiveness, where those months never count — https://www.joinandwise.com/decide/loans
- Moonlighting and outside-activity terms → PGY-2 onward, if outside income matters — https://www.joinandwise.com/contracts/clauses/outside-activities
- Moving to the matched program before the first paycheck → July of PGY-1 — https://www.joinandwise.com/residency/plan
- Consolidating to end grace early → The repayment plans open to the loan for the rest of its life — https://www.joinandwise.com/loans/repayment

## What is fixed and what moves

- Resident salary and benefits: Set by program or union contract. Programs set resident pay and benefits for each training year; collective bargaining agreements set them where residents have a union. ([Andwise: resident union contract benchmarks](https://www.joinandwise.com/residency/union-contracts))

## Deadlines

- 2027 Match: rank order lists certified by 9:00 p.m. ET on March 3, 2027; Match Day is March 19, 2027 — Set by the program or a licensing body
- End of grace: six months after dropping below half-time enrollment — Set by law
- Borrowers moved off the SAVE plan: at least 90 days from their servicer's notice to choose a plan; those who do not choose are placed in Standard or Tiered Standard — Set by law

## Tools

- [Match Day money plan](https://www.joinandwise.com/residency/plan): Take-home pay in the matched state, cash before the first paycheck, loan dates.
- [Resident pay per hour](https://www.joinandwise.com/residency/hourly): Hourly pay on 60–80 hour weeks.
- [Union contract benchmarks](https://www.joinandwise.com/residency/union-contracts): Provisions from ratified resident contracts.
- [Compare repayment plans](https://www.joinandwise.com/decide/loans): Which plan applies, what it costs in training, whether PSLF counts.
- [Starting residency](https://www.joinandwise.com/residency): Training licenses by state, credentialing and the move.

## Questions

### The program

- Is moonlighting permitted, and how is it counted toward duty hours?
- Which leave is paid, and how does leave change the training end date?
- What is the process for appealing a dismissal or non-renewal?

### The loan servicer

- Which repayment plan applies when grace ends?
- Do payments made during residency at this employer count toward PSLF?

## Sources

- [NRMP, 2027 Match Participation Agreement](https://www.nrmp.org/wp-content/uploads/2026/09/2027-MPA-Main-Match-MedicalSchool.pdf)
- [NRMP help: declining a matched position](https://www.nrmp.org/help/item/what-happens-if-i-obtain-a-position-and-decide-not-to-accept-it-can-my-program-release-me-from-my-obligation-to-attend/)
- [Andwise: resident union contract benchmarks](https://www.joinandwise.com/residency/union-contracts)
- [34 CFR 685.207, grace periods](https://www.ecfr.gov/current/title-34/section-685.207)
- [Federal Student Aid: interest rates and fees](https://studentaid.gov/understand-aid/types/loans/interest-rates)
- [34 CFR 685.205, forbearance](https://www.ecfr.gov/current/title-34/section-685.205)
- [Federal Student Aid: forbearance](https://studentaid.gov/manage-loans/lower-payments/get-temporary-relief/forbearance)
- [34 CFR 685.219, Public Service Loan Forgiveness](https://www.ecfr.gov/current/title-34/section-685.219)
- [Public Law 119-21 (2025), Title VIII, §§81001 and 82001–82004](https://www.govinfo.gov/content/pkg/PLAW-119publ21/html/PLAW-119publ21.htm)
- [CMS, direct graduate medical education (DGME) payments](https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/direct-graduate-medical-education-dgme)
- [CMS, indirect medical education (IME) adjustment](https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/indirect-medical-education-ime)
- [42 CFR 413.79, resident counts and the 1996 cap](https://www.ecfr.gov/current/title-42/section-413.79)
- [GAO-16-523, federal student loan servicing (May 2016)](https://www.gao.gov/assets/gao-16-523.pdf)
- [GAO-26-108534, student loan servicing contracts (March 2026)](https://www.gao.gov/assets/gao-26-108534.pdf)
- [NRMP, 2027 Main Residency Match applicant calendar](https://www.nrmp.org/match-calendars/main-residency-applicants/)
- [U.S. Department of Education: next steps for borrowers enrolled in the SAVE plan](https://www.ed.gov/about/news/press-release/us-department-of-education-announces-next-steps-borrowers-enrolled-unlawful-save-plan)

Reviewed 2026-10-27; oldest source check 2026-10-21. General information, not legal, tax or financial advice. The site describes what the law and rules say; it does not say whether a clause is enforceable or what you should do.