Advice needed re: breaking contract

[tv12345]

I have read many forums on this topic at sdn, but have not found one that is exactly like my situation...so here goes...

I graduated 2007, did not match to EM, scrambled for a prelim surg position (which I am almost complete with), and found out this week that I matched to an advanced position in EM (starting 2009). I scrambled again this year for another PGY-1 position (surgery, but at another program). However, the EM program that I advance matched to is adamant about me not doing another year due to inadequate funding for their program.

1) Is it a match violation to break the contract for the new surg program which I just scrambled for?

2) If so, and this is reported to the NRMP, will this affect my application for licensing later on?

3) I have not signed a contract with the advanced program yet. Should I wait until I sign a contract with them prior to letting the Surg PD (for the new program which I just scrambled for this coming year) know?

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[GYN DOC]

Since you scrambled last year the rules of the match do not apply to you. The only people that are bound to nrmp match rules are first time graduating seniors. People who scramble at any time and foreign grads are not under the match regulations. However, if you're program finds out that you did the prelim surgery after they asked you not to then they have the right to break your contract. You can break your contract with the surgery program at any time. Its not a match violation. You'll just wont have good standing with that program but i you're not going to do er there at that hospital - who cares.
However, i believe that cme funding for prelims is on a year to year basis. I dont think you should have any funding issues but you should call nrmp to varify. THe er program may not be right and are just covering their buts. I would call first before i broke my contract with the surgery program. Your er program may be understanding if you find out there are no funding issues. A whole year without money can be taxing. Good luck!

 

[tv12345]

Thanks for the helpful advice, Gyn Doc. I was wondering if anybody has any ideas on what I could do for one year if I did not do another internship. The EM program I matched to suggested working in an urgent care for a year. However, I do not feel completely comfortable with one year of surgery under my belt going out to work yet. Also, I do not even have any state licenses yet.

 

[Life goes on]

I am in a similar situation like tv12345. I appreciate advise from the forum readers.
I am an FMG who graduated in 2003 but have no visa issues.I accepted prelim IM position in post match scramble 2008.(PS : I had not applied for the regular match in 2008 season)
My categorical residency choices are radiology or IM.
1) I know that IM is easy to get as my scores are good and now I have a prelim position.
I want to try applying to radiology also. But I realise that when I apply in 2009 match season, my application is actually for the radiology position starting in 2010. Will the programs accept that I will have a gap of 1 year after my prelim year? I know chances of matching to radiology program are low but nevertheless I want give a try to pursue my dream.
2) When I apply for 2009 match will I be in a postion to request LORs from the attendings such that they are available in ERAS on Sept 1st 2008? Or is at a better idea to request for letters in Sept? meanwhile I will send the LORs from home country and those from the physician in US whose outpatient practice I have been observing for past 2 months and replace them with LORs from attendings in the prelim program. I ask all these questions because I will have to search for PGY 2 position in some place other than where i will do IM prelim because of family reasons. Please advise me on the course that I should follow.
3) I heard that when I apply for PGY1 position again in 2009 match I may face problems due to funding reasons. Can anyone tell me how universal are these problems?

Thanx.

 

[Winged Scapula]

Since you scrambled last year the rules of the match do not apply to you. The only people that are bound to nrmp match rules are first time graduating seniors. People who scramble at any time and foreign grads are not under the match regulations.

Can you provide a link to this because I have been unable to find anything on the NRMP site which states that there is a distinction between Independent Applicants and US Seniors on this issue?

As a matter of fact, here: http://www.nrmp.org/res_match/faq/ind_apps_faq.html#17 states clearly that the rules of match violations are the same for Independent Applicants as they are for US Seniors. The document goes on further to state that applicants found to be match violators will have notification sent to ECFMG...which wouldn't make sense if Independent Applicants weren't able to violate the match.

Since the OP scrambled last year, that doesn't have any bearing on this year's application which he/she took part of as an NRMP registrant. And as such, he/she is bound by the match regulations for the EM position.

The NRMP is not clear about whether the scramble is part of the match and whether giving up a scramble position is a match violation. I suspect it is not but this has nothing to do with being an Independent candidate vs an US grad.

Therefore, he may be able to give up his Prelim Surg position into which he scrambled without a violation, but I believe it incorrect to tell people that the match rules only apply to US seniors.

 

[zinjanthropus]

the real question is whether there is even a problem to begin with - meaning, aren't prelim years funded for just 1 year at a time? it doesn't seem like this would interfere with the OPs funding in a pgy2-4 EM program, no matter how many prelim years he did

 

[Pir8DeacDoc]

we've had this discussion many times. I think the conclusion we reached was this....


Doing a prelim year doesn't start the clock running on number of years you are funded for because by it's nature it isn't a terminal residency. However, once you get into a terminal residency (i.e. General surgery).. your program will get one less year of funding for you because you did a funded year previously. So in this case you would get 4 years of full funding for GS instead of the usual 5. So while it doesn't define the number of years you will get funded (as it would if you took a categorical spot and then changed fields), it does take one year away from your ultimate complement.

 

[Samoa]

He scrambled for both prelim positions, therefore he can break the contract (if he's even signed one yet) with the second program without violating match rules.

 

[tv12345]

Hi All:

Thanks for the useful advice. I called the NRMP directly, and was told that scramble positions are like accepting positions outside of the match, and have NOTHING to do with the match. Hence, if I decide to break a scramble contract, that's between me and the program. However, if I decide to break my contract with the EM program I matched with, then that is a match violation.

As far as funding goes, I have been unable to get clear ideas on prelim years. I have heard different views from different DME's (Director of Medical Education) -> I have heard the view where since I am a prelim, the maximum # of years I will be funded is 4 years. Which means I can only do 1 year of TY, prelim, etc to not affect the future program. I've also heard the other side of the story where I'm supposed to be funded for 5 years since I entered a surgical residency. I emailed the AMA people, and they were of the idea that my total funding will be for four years.

 

[NotAProgDirector]

Hi All:

Thanks for the useful advice. I called the NRMP directly, and was told that scramble positions are like accepting positions outside of the match, and have NOTHING to do with the match. Hence, if I decide to break a scramble contract, that's between me and the program. However, if I decide to break my contract with the EM program I matched with, then that is a match violation.

That's what I thought. Thanks for confirming it.

As far as funding goes, I have been unable to get clear ideas on prelim years. I have heard different views from different DME's (Director of Medical Education) -> I have heard the view where since I am a prelim, the maximum # of years I will be funded is 4 years. Which means I can only do 1 year of TY, prelim, etc to not affect the future program. I've also heard the other side of the story where I'm supposed to be funded for 5 years since I entered a surgical residency. I emailed the AMA people, and they were of the idea that my total funding will be for four years.

As above, doing a PRELIM surgery year counts as "a year" but doesn't set the total number of years you have of funding. Once you start your EM residency, your total years will be set at 4. If you drop out of your second prelim, you will have full funding. If you don't, you will only have partial funding for your last year (which is 1/2 of "DME" and full IME, which honestly is most of the funding).

You'll have to decide what to do -- drop the prelim, do the prelim (the EM program can't drop you for this, you matched), or split the difference and do half (or some other amount) of the prelim.