Asking for a prematch

[Pollicis]

So, if a program gets in contact with you post-interview and expresses great interest in you, is it kosher to ask for a prematch (if you are an IMG).

thoughts?

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[mlw03]

i wouldn't outright ask, but if you're willing to accept you could say, "you guys will be my #1 and if offered a pre-Match contract, i'd gladly sign." that'll make your feelings known and then the ball is in the program's court.

 

[HCE]

i wouldn't outright ask, but if you're willing to accept you could say, "you guys will be my #1 and if offered a pre-Match contract, i'd gladly sign." that'll make your feelings known and then the ball is in the program's court.

Totally agree...this is not the time to be bashful.

 

[Doowai]

I was offered a prematch. I wrote to 3 other programs I am highly interested in and simply said, I am very interested in you but was offered a prematch.

2 of them told me they do not offer prematches and one offered me a prematch also.

So now I have to decided, do I take a prematch (and which one) or do the match.

 

[mlw03]

one thing i should have written before is that if you do take the aggressive approach, you better be prepared to accept the offer right then and there - otherwise you come off as kinda flaky and indecisive. but if you are willing, then i stand by my original suggestion.

dooowai - yeah, that's a tough situation. unless either of those 2 are your true #1 it's a gamble. i really don't know what i'd do in such a situation. good luck to ya.

 

[GYN DOC]

Whats a prematch? Isnt it a violation for the program to offer youa position before or outside of the match?

 

[Top Gun]

I was offered a prematch. I wrote to 3 other programs I am highly interested in and simply said, I am very interested in you but was offered a prematch.

2 of them told me they do not offer prematches and one offered me a prematch also.

So now I have to decided, do I take a prematch (and which one) or do the match.

Do you like the program a lot? Do you think you'd be happy there? If yes to both of the above, take the prematch. That way, you'll guarantee yourself a spot for next year, and you won't have to worry about how the Match results will turn out. Make sure you get a written contract though. And if you want the prematch badly enough, act on it quickly.

 

[165808]

Whats a prematch? Isnt it a violation for the program to offer youa position before or outside of the match?

Premathes are for IMGs, DOs, or other independant students. American MD Seniors cannot prematch, according to NRMP.

 

[Doowai]

Do you like the program a lot? Do you think you'd be happy there? If yes to both of the above, take the prematch. That way, you'll guarantee yourself a spot for next year, and you won't have to worry about how the Match results will turn out. Make sure you get a written contract though. And if you want the prematch badly enough, act on it quickly.

Thanks for the advice. The simplification you provide helps alot. I like them, I think I could be happy there. Yes. The weather sucks at these 2 places though.

I have two others that are higher choices because:
1) one of them would allow me to moonlight in my second year and the money would be huge since I have 4 children. Weather sucks here though
2) The other offers more things to learn and the weather is so nice. I am kind of sensitive to sunshine, and cloudy days really bring me down. I don't want to end up like the mass of depressed doctors I read about on here.

 

[katarina]

For IMGs, the big fear is not to match at all, so I guess most of us would view a prematch offer as a godsend. I thought I'd feel the same way, but this is my story -

I got prematch offers at 2 places - one at a place I didn't like at all, and another at a program I did like a lot and wouldn't mind training at. I turned the first one down flat, but had a really tough time with the other one. The thing is, I was lucky enough to be invited for an interview at this top tier program, and I absolutely loved it there. I liked the city, the attendings, the PD, the residents, the program, you name it. Being a much-coveted program, they don't offer (nor do they need to offer) prematches. Getting an interview there is tough enough.

So I was in a bind for a while, as the other program gave me just a week to decide whether to accept or not. A lot of people practically screamed at me to accept, as it was a sure shot at a position, and would spare me the aggravations of waiting for March 20 to come around. But in the end, I just couldn't bear to let go of the chance to match at my dream program. I mean, it's definitely a long shot, me being an IMG and all, but I just can't go on wondering forever if I could have gotten in there. I mean, I'd rather be rejected (i.e. not match there) than not know.

Yeah, yeah I'm either brave or stupid, and I've been called both. But now the die has been cast, and there's nothing to do but wait. In the meantime, here's a sample of the questions that keep me awake at night while waiting for March to come around -

1) Will the program that offered me a prematch (the one I like) still rank me even if I turned them down? I still really like it there, and I'll probably end up ranking them within my top 5, so it'll be a shame if they don't rank me at all.

2) What are the chances I won't match at all? I'm planning on ranking 11 places, and yes I've read in the NRMP reports that ranking 7 to 9 programs is enough to match with a 99% probability, but geez, it's still scary as hell.

3) Will I actually match to my dream program? Sigh, I know it's futile to worry, since only time will tell, but still I keep replaying my interview day in my mind and thinking of stuff I said or did that would increase/decrease my chances with them. How crazy is this?

Aaargh! I don't know about you guys, but I've been getting more neurotic by the day ever since September 1. God help us all...

 

[Leukocyte]

I am a USIMG. I scrambled last year...no luck. In my opinion, the scramble is useless for IMGs. It is VERY tough to get anything, unless you are a IMG with top credentials. I applied to EVERY POSSIBLE open spot in the scramble, and paid nearly $4,000 to enlist the services of the so called "scarmble companies"...but nothing came out of it. Also a friend of mine last year (also a USIMG) was offered a prematch, but he declined it because the PD at his number one choice TOLD him he is going to rank him at the top of his list. Well, March 12 came and he was unmatched. He tried to scramble also, but like me, he got nothing. So when I applied this year, I promised my self that if I get offered a pre-match ANYWHERE, I will take it with no questions asked.

Halfway through my interview trail I received a pre-match offer at my #7 choice on my potential ROL. Guess what, I accepted it that instant. Sure it would have been nice to be at my #1, or #4, hell of even my #6, but the PAIN that I went through last year in the scramble sealed the deal for me. I have NO regrets. After 2 years in the match, I have reached some personal conclusions:

-The "match" is getting tougher EVERY year. The number of applicants (espesially FMGs) is INCREASING year by year.

-The "match" is REALLY designed for AMGs, and top notch FMGs.

-After the UK "closed" its doors to FMGs. Many of FMGs from the Near and Far East are now coming to the US for residency. Many of these FMGs have been practicing medicine for many years in their home country. Many are very smart with excellent stats.

-My personal opinion/advice is: If you are an AVERAGE IMG, and got a pre-match offer, TAKE IT NOW.

That being said...

1) Will the program that offered me a prematch (the one I like) still rank me even if I turned them down?

Generally yes, but it really depends on the PDs personality. He might take your refusal as a sign of un-interest, and rank someone else instead in your position. Also keep in mind that programs that offer pre-match have LESS POSITIONS OPEN FOR THE MATCH....So you do the math.

2) What are the chances I won't match at all? I'm planning on ranking 11 places, and yes I've read in the NRMP reports that ranking 7 to 9 programs is enough to match with a 99% probability, but geez, it's still scary as hell.

Please take into account that the NRMP report includes AMGs, NOT just FMGs. Also in that report the NRMP states that "U.S. seniors consistently have the highest match rate and the longest average ROLs". Please take a look at the study again. As far as your chances of not matching, well that depends on your stats and application strength AND the OBJECTIVE evaluation of the PD and faculty.

3) Will I actually match to my dream program?

Again, that depends on your stats and application strength AND the OBJECTIVE evaluation of the PD and faculty.

Just some notes from a fellow USIMG who went through the scramble last year...The scramble is HORRIBLE AND PAINFUL, and not as useful for the average IMG.

What is average?...well that depends on the IMG applicant pool for this year. However each year the "average bar" is getting higher and higher with the increasing number of applicants.

Finally I leave you with an advice from our wise ancestors....Something to do with "A BIRD", "THE HAND", and "THE BUSH"

Good Luck.

 

[katarina]

Thanks Leukocyte, I appreciate your insight. I am scared as hell of scrambling and I don't doubt that it's as painful as you say. But well, like I said, all bets are in and I've chosen the uncertain path. Nothing left to do but wait... and pray.

 

[gng930]

The scramble was incredibly difficult starting last year...something like 1,000 unfilled positions for 7,000 unmatched applicants. The year before it was more like 2000-to-5000.

My ROL is maxed out at 20...yeah I'm that paranoid. Would I "love" to be at all 20 of these places? Probably not, but I think I'd be much happier at any of these places than to be unmatched.

 

[Doowai]

2) What are the chances I won't match at all? I'm planning on ranking 11 places, and yes I've read in the NRMP reports that ranking 7 to 9 programs is enough to match with a 99% probability, but geez, it's still scary as hell.

Please take into account that the NRMP report includes AMGs, NOT just FMGs. Also in that report the NRMP states that "U.S. seniors consistently have the highest match rate and the longest average ROLs". Please take a look at the study again. As far as your chances of not matching, well that depends on your stats and application strength AND the OBJECTIVE evaluation of the PD and faculty.

NRMP actually breaks the stats doen for USMGs and IMGs, and also into competitive and less competitive residencies. An IMG going into a less competitive residency who does 10 interviews has roughly a 75% chance of matching.

 

[Doowai]

Also a friend of mine last year (also a USIMG) was offered a prematch, but he declined it because the PD at his number one choice TOLD him he is going to rank him at the top of his list. Well, March 12 came and he was unmatched. .

How many programs did he interview at?

I have decided to take one of the prematches. My #1 choice is in a much warmer and sunnier place. They have told me I am in their top 6. I tend to believe them as I get email from them weekly telling me something about the community, I got a Christmas gift from them, as well as another gift last week. But the thought of not matching is just too much - I will just have to get use to the idea of crappy weather for 3 years. I picked medical school based on the best beaches... looks like I am not going to have that luxury for residency.

 

[Leukocyte]

How many programs did he interview at?

I have decided to take one of the prematches. My #1 choice is in a much warmer and sunnier place. They have told me I am in their top 6. I tend to believe them as I get email from them weekly telling me something about the community, I got a Christmas gift from them, as well as another gift last week. But the thought of not matching is just too much - I will just have to get use to the idea of crappy weather for 3 years. I picked medical school based on the best beaches... looks like I am not going to have that luxury for residency.

He interviewed at, and ranked 14 FM programs. He got an offer from a university based program in the mid west, but thought that since the PD at his #1 choice "promised" him a position at his program, he felt confident that he was going to match there. Also, the program that offered him the pre-match did not fill, and had 2 positions in the scramble. He called them up at 12:01pm on scramble day, but their phone and fax were busy (like almost ALL of the programs on the scramble list). Finally he was able to reach them at around 12:45pm (45 minutes into the scarmble), but was told that the 2 positions have already been FILLED!

These are some personal concusions:

1-Calls, gifts, and promises from PDs mean NOTHING. IF IT IS NOT IN WRITING IN A FORM OF A FORMAL CONTRACT DO NOT TAKE THE PD SERIOUSLY. There are many many many many applicants, and he has the freedom to choose from a HUGE applicant pool. This came to me as a SHOCK, since the PD is still a M.D., a doctor who is supposed to be ethical and all....but it seems that in the match they take off the M.D. hat and put on the tactful businessman hat and "play" the game of letting the applicants believe that they are "special". However this is just a recruiting tactic to ensure that all of their applicants rank them high so that the PD does not have to suffer during the first few hours of the scramble.🙄

2-In the scramble it is almost IMPOSSIBLE to get hold of programs. Their phones and fax machines are ALWAYS busy or the Program Coordinator never picks up the phone. If you are LUCKY to talk to her, she will be very short and tell you 5 words..."send your application through ERAS"...and will hang up.😡

3-Do not take those statistics or "chances of matching" seriously. My friend ranked 14 programs in FM and did not match, while one of the residents who took me out to dinner at one of my interviews (also a USIMG) ranked only ONE program (he only got one interview)...and he matched! Those numbers mean nothing especially to IMGs.

Doowai, my number one choice was also at a sunny place...Vegas! But after the horror of going through the scramble last year I decided not to take any chances. I galdly accepted the offer from my #7 choice. I have no regrets.

Good Luck to all of you.

 

[Doowai]

He interviewed at, and ranked 14 FM programs.
😱

Good Luck to all of you.
Thank you my friend

🙂

 

[Top Gun]

I am a USIMG. I scrambled last year...no luck. In my opinion, the scramble is useless for IMGs. It is VERY tough to get anything, unless you are a IMG with top credentials. I applied to EVERY POSSIBLE open spot in the scramble, and paid nearly $4,000 to enlist the services of the so called "scarmble companies"...but nothing came out of it. Also a friend of mine last year (also a USIMG) was offered a prematch, but he declined it because the PD at his number one choice TOLD him he is going to rank him at the top of his list. Well, March 12 came and he was unmatched. He tried to scramble also, but like me, he got nothing. So when I applied this year, I promised my self that if I get offered a pre-match ANYWHERE, I will take it with no questions asked.

Halfway through my interview trail I received a pre-match offer at my #7 choice on my potential ROL. Guess what, I accepted it that instant. Sure it would have been nice to be at my #1, or #4, hell of even my #6, but the PAIN that I went through last year in the scramble sealed the deal for me. I have NO regrets. After 2 years in the match, I have reached some personal conclusions:

-The "match" is getting tougher EVERY year. The number of applicants (espesially FMGs) is INCREASING year by year.

-The "match" is REALLY designed for AMGs, and top notch FMGs.

-After the UK "closed" its doors to FMGs. Many of FMGs from the Near and Far East are now coming to the US for residency. Many of these FMGs have been practicing medicine for many years in their home country. Many are very smart with excellent stats.

-My personal opinion/advice is: If you are an AVERAGE IMG, and got a pre-match offer, TAKE IT NOW.

That being said...

1) Will the program that offered me a prematch (the one I like) still rank me even if I turned them down?

Generally yes, but it really depends on the PDs personality. He might take your refusal as a sign of un-interest, and rank someone else instead in your position. Also keep in mind that programs that offer pre-match have LESS POSITIONS OPEN FOR THE MATCH....So you do the math.

2) What are the chances I won't match at all? I'm planning on ranking 11 places, and yes I've read in the NRMP reports that ranking 7 to 9 programs is enough to match with a 99% probability, but geez, it's still scary as hell.

Please take into account that the NRMP report includes AMGs, NOT just FMGs. Also in that report the NRMP states that "U.S. seniors consistently have the highest match rate and the longest average ROLs". Please take a look at the study again. As far as your chances of not matching, well that depends on your stats and application strength AND the OBJECTIVE evaluation of the PD and faculty.

3) Will I actually match to my dream program?

Again, that depends on your stats and application strength AND the OBJECTIVE evaluation of the PD and faculty.

Just some notes from a fellow USIMG who went through the scramble last year...The scramble is HORRIBLE AND PAINFUL, and not as useful for the average IMG.

What is average?...well that depends on the IMG applicant pool for this year. However each year the "average bar" is getting higher and higher with the increasing number of applicants.

Finally I leave you with an advice from our wise ancestors....Something to do with "A BIRD", "THE HAND", and "THE BUSH"

Good Luck.

Great advice, Leukocyte. I had to go through the scramble last year too. It is the most soul-sucking experience any residency applicant could have. I would not wish it upon my worst enemy.

 

[Top Gun]

The scramble was incredibly difficult starting last year...something like 1,000 unfilled positions for 7,000 unmatched applicants. The year before it was more like 2000-to-5000.

My ROL is maxed out at 20...yeah I'm that paranoid. Would I "love" to be at all 20 of these places? Probably not, but I think I'd be much happier at any of these places than to be unmatched.

Dude, I hear you. My ROL will be maxed out as well. I'd rather match somewhere, even at a suckish program, than be unmatched.

 

[Top Gun]

How many programs did he interview at?

I have decided to take one of the prematches. My #1 choice is in a much warmer and sunnier place. They have told me I am in their top 6. I tend to believe them as I get email from them weekly telling me something about the community, I got a Christmas gift from them, as well as another gift last week. But the thought of not matching is just too much - I will just have to get use to the idea of crappy weather for 3 years. I picked medical school based on the best beaches... looks like I am not going to have that luxury for residency.

Congrats on your decision. Good luck with your residency.

 

[katarina]

Ok, so I turned down two prematch offers already since I am a fool carrying a huge torch for my dream program (who will never nor need ever prematch anyone). Like I said before, one of those programs I turned down I didn't like at all, so that was easy. But the other one I actually liked, so it was a bit harder letting go of that one. But I did (gee, if my dream program only knew all I've given up just for the chance to match there - just to be clear, they've never given any indication that they'd rank me highly or even just rank me period.) So anyway, I placed all my money on going through the match, and I thought all there is left to do is to hunker down 'til match day.

But here's the rub - a few days ago, my number 2 program called and offered me a prematch spot! Programs have to submit to the NRMP the final number of spots they have up for grabs in the match (original spots minus prematched ones) by Thursday, so they gave me only until tomorrow to decide.

Jesusmaryandjoseph! So what the heck do I do now? I mean, this is my number 2! If I still go through the match, it will only solely be for the chance to match at my dream program. My number 2's been very nice, telling me that even if I don't take their offer, they will still rank me. But still! They're number 2! So what now? Do I stick to the plan and still do the match? Or do I buckle under the enormous pressure of making sure I get matched?

Help!!!

 

[mlw03]

katarina, if you're happy with #2 i'd seriously consider accepting it. i feel your pain, really. it's a tough call, giving up the "dream" for safety, but think about this. which would you regret more: the chance at going to your #1 or the risk of having to scramble?

 

[Winged Scapula]

I dunno...I think a prematch at a program you would rank number 2 is a pretty good deal.

There are no guarantees in the match...which would disappoint you more:

1) not matching at all
2) not matching at your number 1
3) taking the prematch and never knowing if you would have matched to your number 1 (which you've described as pretty competitive)?

 

[Doowai]

Katarina I feel your pain

I just can't seem to put the pen to the paper on the prematch contract. The second program that offered me a prematch has withdrawn that.

This one program that still offers me a prematch I really dislike several things about. Its the one program that I immediately disliked the town (less than 12,000 people). At the interview I had to daydream of chocolate and things like that to keep a smile on my face. From the age of 29 to 36 I lived in a small midwestern farm town like this and hated every minute of it. Plus the main thing I want out of a program is the opportunity to learn procedures - this program teaches almost no procedures - but they say I can always go to seminars during my education week and learn those things - but its just not right to learn something like vasectomies at a seminar, without the opportunity to do 15 or more of them actually.

The thought of living there 3 years is dreadful to me. And it seems like a waste to spend 3 years working hard and not learning what I wanted.

There really are only 6 programs of the 10 interviews I kept that I feel I would enjoy living at and that would provide the education I want.

1) Can I learn procedures after I graduate?
2) How easy is it to transfer programs PGY2?

The 3 questions you postulate , Winged Scapula, are right on the money. I am thinking I would rather not match and get on with my former professional life than spend 3 years in a small midwestern town again, and work that hard to not really learn what I wanted to learn.

 

[Leukocyte]

There are no guarantees in the match...which would disappoint you more:

1) not matching at all
2) not matching at your number 1
3) taking the prematch and never knowing if you would have matched to your number 1?

I agree with Dr. Cox. As an IMG who applied to 250 programs (in mid October) and received "only" 18 interviews my options when I accepted my pre-match offer were more like this:

1) Accept the pre-match offer, put my $250,000 degree into use, and get board certified in a medical specaility....THEN persure my dream career of being a SURGEON.

2) Decline the pre-match. Rank my 18 programs, and accept the REAL possibility that I might not match anywhere. In that case, I have to be prepared to risk forgeting medicine as a career while still stuck with a hefty $250,000 in medical school loans.

The option (if I really had one) was very OBVIOUS in my case.

And scarmbling, yeah right. I was STUPID, and actually scrambled last year. What a waste of time and money. If I did not accept the pre-match, and did not match this year...I would have NOT scrambled again.

As "Top Gun" said earlier...."I would rather take an enima filled with 10 rabid rodents than go through the scramble again".

A wise man once said..."a bird in the hand is better than 10 in the bush"

Eminem (yes, also a wise man😎) said in one of his song "...Opportunity comes once in a lifetime, live it up..." hoo,hoo

Enough said.

 

[tkim]

I am thinking I would rather not match and get on with my former professional life than spend 3 years in a small midwestern town again, and work that hard to not really learn what I wanted to learn.

Considering you failed to match last year and also failed to scramble, I'd think hard about not taking a prematch offer. However, it seems that you were doing alright before med school, so perhaps you can afford to roll the dice and enter the match with a ROL only 6 deep. In any event, I wish you luck!

 

[Doowai]

Yeah I can't believe I turned it down. I sent them a text and an email telling them I would not be taking it. Unbelievable. It gives them a couple of days to change their qouta. If I don't match I am sure there will days of teaching or my former career where I wonder how I could have been so stupid - but at least I will be living where I love to live and with my family. I just could not trade 3 years of my life in hard labor, to not even learn what I really wanted to learn - and I just don't feel comfortable learning procedures with quickie weekend courses instead of under supervision in a residency. Time is one of the things I can never get back. Twice I have lost large sums of money and somehow made it back - but time flies and is gone.

We will see if the other PDs lied to me - if I don't match I will let you guys know and give those of you a chance to say "I told you so, haw haw".

 

[katarina]

We're in the same boat, Doowai. I turned down the prematch offer from my number 2. Saying it was very hard to do so is an understatement. My family has been very supportive, but at the same time, a lot of my med school classmates, fellow IMGs, shook their heads and looked at me like I was crazy.

But the chance to match at my number 1 comes only once, so I swallowed hard, screamed f*** it and prayed really really hard at the same time, and clicked send on the dear john email I sent to the PD of my number 2. I've been brave enough to pursue training here, brave enough to fork over the thousands of dollars in fees for exams, applications, not to mention plane tickets and lodging expenses, brave enough to go far away from home. I thought now is not the time to suddenly play it safe, as I've risked too much already. Might as well go all the way.

Thanks for everyone's two cents, I appreciate the ample warning. But now that I've made a (fully-informed) choice, it's time to sit back and wait...

Doowai, I'm rooting for you, and for everyone who've made the same hard choices in this match season. Cross your fingers for all of us!