Difficult Ranking Question-please advice!

[Iluvpassingas]

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Hey guys,

So I interviewed this season for anesthesia and categorical internal medicine as back-up.

I was offered a pre-match at a program for medicine, and decided to take it. They asked me to withdraw from the NRMP match, which I haven't done yet. The contract is for one year, and then renewed come the following year pending satisfactory evals, yada yada, and of course, if I agree to sign for the subsequest year.

Now my question:

I interviewed at my number 1 anesthesia program, which offers advanced positions. This is the only program that always makes me wonder if I could have matched, or if they ranked me. Could I possibly just rank them for an advanced position as my number 1 rank. I wouldn't rank any program, but that advanced anesthesia position. No prelims or nothing, because I technically have a first year position (even though it is categorical).

If I matched in the advanced position, I would start in 2011 and it wouldn't really break the original contract, right? I mean people change fields after a year from medicine to anesthesia and vice versa if they get a spot.

Is this risky? Is this unethical? Or would you say I have nothing to lose? Do I run the risk of losing the guaranteed medicine spot?

I tried to search all the forums, but I think this is a unique question and I'm hoping someone who has been or knows someone who has been in a similar situation can just give me some insight.

Thanks and best of luck to all!

 

[howelljolly]

Hey guys,

So I interviewed this season for anesthesia and categorical internal medicine as back-up.

I was offered a pre-match at a program for medicine, and decided to take it. They asked me to withdraw from the NRMP match, which I haven't done yet. The contract is for one year, and then renewed come the following year pending satisfactory evals, yada yada, and of course, if I agree to sign for the subsequest year.

Now my question:

I interviewed at my number 1 anesthesia program, which offers advanced positions. This is the only program that always makes me wonder if I could have matched, or if they ranked me. Could I possibly just rank them for an advanced position as my number 1 rank. I wouldn't rank any program, but that advanced anesthesia position. No prelims or nothing, because I technically have a first year position (even though it is categorical).

If I matched in the advanced position, I would start in 2011 and it wouldn't really break the original contract, right? I mean people change fields after a year from medicine to anesthesia and vice versa if they get a spot.

Is this risky? Is this unethical? Or would you say I have nothing to lose? Do I run the risk of losing the guaranteed medicine spot?

I tried to search all the forums, but I think this is a unique question and I'm hoping someone who has been or knows someone who has been in a similar situation can just give me some insight.

Thanks and best of luck to all!

I have a friend in this situation.

If and only if the IM spot is registered as a preliminary, you can stay in the match.

If it is a categorical spot, you must withdraw from the match... even if the contract is for only one year. To my understanding, categorical residencies are one-year contracts everywhere. Thats just how they get around employment technicalities.

 

[RussianJoo]

yep this is unethical, immoral and illegal. you should have thought about this before accepting the prematch. if you get caught there's a good chance you won't be able to participate in the match ever again.

like it was said above, all categorical spots are technically one year contracts but in reality they're three year contracts, that im program is expecting you to go all three years and that's why they offered you a prematch, and think you will graduate from there. Did you tell them that you were also applying to anesthesia and would much rather be an anesthesiologist and will try to transfer into an open anesthesia spot? i would assume u didn't because that's just asking for trouble you probably told these people that they were your number one and that you'd love to be there and thus accepted the prematch.

yeah it's tough but you can't have your cake and eat it too. if you wanted to do anesthesia so badly you should have been prepared go a year unmatched if need be.

it seems like you made your choice though and you have to withdraw from the match if you ever want to go through the match again.

What you can do is withdraw now and then reapply next year and in the mean time tell your program director that you're not happy with IM and you thought it would be different. you don't want to burn any bridges in medicine, it's a very small world everyone knows eachother and talks. you don't want to be the guy who screws over one residency to better his position, cause that will screw you over big time in the end.

I guess all that's left to say is Congradulations on Pre-Matching, best of luck to you.

 

[ResidentMD]

yep this is unethical, immoral and illegal. you should have thought about this before accepting the prematch. if you get caught there's a good chance you won't be able to participate in the match ever again.

like it was said above, all categorical spots are technically one year contracts but in reality they're three year contracts, that im program is expecting you to go all three years and that's why they offered you a prematch, and think you will graduate from there. Did you tell them that you were also applying to anesthesia and would much rather be an anesthesiologist and will try to transfer into an open anesthesia spot? i would assume u didn't because that's just asking for trouble you probably told these people that they were your number one and that you'd love to be there and thus accepted the prematch.

yeah it's tough but you can't have your cake and eat it too. if you wanted to do anesthesia so badly you should have been prepared go a year unmatched if need be.

it seems like you made your choice though and you have to withdraw from the match if you ever want to go through the match again.

What you can do is withdraw now and then reapply next year and in the mean time tell your program director that you're not happy with IM and you thought it would be different. you don't want to burn any bridges in medicine, it's a very small world everyone knows eachother and talks. you don't want to be the guy who screws over one residency to better his position, cause that will screw you over big time in the end.

I guess all that's left to say is Congradulations on Pre-Matching, best of luck to you.

This is the single biggest reason why you shouldnt do this - even if you dont get caught by NRMP (because the match is a binding agreement, so the IM PD will HAVE to let you go), the reason above can basically jeopardize most of your career ahead, unless you do something so significant in your career so that people can look past it.

 

[Mental Gymnast]

Hey guys,

So I interviewed this season for anesthesia and categorical internal medicine as back-up.

I was offered a pre-match at a program for medicine, and decided to take it. They asked me to withdraw from the NRMP match, which I haven't done yet. The contract is for one year, and then renewed come the following year pending satisfactory evals, yada yada, and of course, if I agree to sign for the subsequest year.

Now my question:

I interviewed at my number 1 anesthesia program, which offers advanced positions. This is the only program that always makes me wonder if I could have matched, or if they ranked me. Could I possibly just rank them for an advanced position as my number 1 rank. I wouldn't rank any program, but that advanced anesthesia position. No prelims or nothing, because I technically have a first year position (even though it is categorical).

If I matched in the advanced position, I would start in 2011 and it wouldn't really break the original contract, right? I mean people change fields after a year from medicine to anesthesia and vice versa if they get a spot.

Is this risky? Is this unethical? Or would you say I have nothing to lose? Do I run the risk of losing the guaranteed medicine spot?

I tried to search all the forums, but I think this is a unique question and I'm hoping someone who has been or knows someone who has been in a similar situation can just give me some insight.

Thanks and best of luck to all!

wow. i agree with you that this is truly a tough issue. i would contact my number one gas program, tell them tht you were offered a pre-match position (no need to mention where or what), but that their program is number one and you loved it for X,Y,and Z reasons. if their feeling is mutual and you get enough reassurance from them that they will rank you then withdraw from your prematch contract (that PD would rather have you back out now while he can still fill the position as opposed to one year into it). On the other hand, if you don't get enough good feedback then I agree that you should withdraw from the match as was said above.

good luck! 👍

 

[MacchinaDaCaffe]

Hey guys,

So I interviewed this season for anesthesia and categorical internal medicine as back-up.

I was offered a pre-match at a program for medicine, and decided to take it. They asked me to withdraw from the NRMP match, which I haven't done yet. The contract is for one year, and then renewed come the following year pending satisfactory evals, yada yada, and of course, if I agree to sign for the subsequest year.

Now my question:

I interviewed at my number 1 anesthesia program, which offers advanced positions. This is the only program that always makes me wonder if I could have matched, or if they ranked me. Could I possibly just rank them for an advanced position as my number 1 rank. I wouldn't rank any program, but that advanced anesthesia position. No prelims or nothing, because I technically have a first year position (even though it is categorical).

If I matched in the advanced position, I would start in 2011 and it wouldn't really break the original contract, right? I mean people change fields after a year from medicine to anesthesia and vice versa if they get a spot.

Is this risky? Is this unethical? Or would you say I have nothing to lose? Do I run the risk of losing the guaranteed medicine spot?

I tried to search all the forums, but I think this is a unique question and I'm hoping someone who has been or knows someone who has been in a similar situation can just give me some insight.

Thanks and best of luck to all!

Wow dude, all I can say is I hope I don't end up at the same Internal Medicine program (as a REAL categorical) that you pre-matched at. It sounds like you have no qualms about screwing someone over to achieve your aims. Did you even realize that if you are able to go through with this plan that your PD at the IM program is going to have to fill the vacancy you left? Not even to mention the basic reality that you completely misrepresented yourself to this PD who thinks he just secured a 3 year resident for his program. It's unethical across the board.

 

[LadyWolverine]

Wow, dumb move. Seriously, if anesthesia was your first choice, why on earth would you accept a pre-match at anything other than an anes program? It doesn't matter if it's the greatest IM program in the entire universe - it's not what you wanted. Were you that certain that you weren't going to land a spot in Anes, anywhere that you applied, that you felt like this was your best option? Or did you just like this IM program more than some of the anes programs that you interviewed at?

Assuming you've already signed the contract, then the day you accepted the offer you should've read the fine print and realized what it meant, and withdrawn from the match. Or, once you realized your mistake, you should've contacted the PD asap, told him/her "JUST KIDDING!," and been labelled an a**hole for the rest of your life by everyone affiliated with that program, but at least been able to continue in the match.

Looks like you made your bed, but don't want to lie in it. This must be part of the whole reason that we have a match in the first place.

 

[RussianJoo]

Wow dude, all I can say is I hope I don't end up at the same Internal Medicine program (as a REAL categorical) that you pre-matched at. It sounds like you have no qualms about screwing someone over to achieve your aims. Did you even realize that if you are able to go through with this plan that your PD at the IM program is going to have to fill the vacancy you left? Not even to mention the basic reality that you completely misrepresented yourself to this PD who thinks he just secured a 3 year resident for his program. It's unethical across the board.

not to mention screwing over your fellow residents because they will have to pick up your extra calls and clinic hours and all the other stuff.

even though contracts are renewed every year they still pretty much count on you to be there all three years.

 

[howelljolly]

Wow dude, all I can say is I hope I don't end up at the same Internal Medicine program (as a REAL categorical) that you pre-matched at. It sounds like you have no qualms about screwing someone over to achieve your aims. Did you even realize that if you are able to go through with this plan that your PD at the IM program is going to have to fill the vacancy you left? Not even to mention the basic reality that you completely misrepresented yourself to this PD who thinks he just secured a 3 year resident for his program. It's unethical across the board.

Wow, dumb move. Seriously, if anesthesia was your first choice, why on earth would you accept a pre-match at anything other than an anes program? It doesn't matter if it's the greatest IM program in the entire universe - it's not what you wanted. Were you that certain that you weren't going to land a spot in Anes, anywhere that you applied, that you felt like this was your best option? Or did you just like this IM program more than some of the anes programs that you interviewed at?

Assuming you've already signed the contract, then the day you accepted the offer you should've read the fine print and realized what it meant, and withdrawn from the match. Or, once you realized your mistake, you should've contacted the PD asap, told him/her "JUST KIDDING!," and been labelled an a**hole for the rest of your life by everyone affiliated with that program, but at least been able to continue in the match.

Looks like you made your bed, but don't want to lie in it. This must be part of the whole reason that we have a match in the first place.

not to mention screwing over your fellow residents because they will have to pick up your extra calls and clinic hours and all the other stuff.

even though contracts are renewed every year they still pretty much count on you to be there all three years.

I was going to be nice, saying that my friend had this issue... but ive decided to be nasty, because it seems like the right thing to do. My friend made sure to pre-match at a PRELIM program. You signed a categorical offier, knowing that you were screwing over the PD, the program, the other residents, and some other applicant who wanted the categorical spot.

You have no choice but to withdraw from the match. The minute you signed the prematch offer you should have done that.

You should probably go play in traffic too.

 

[gutonc]

jdh71 in 3...2...1...

If you take your prematch AND stay in the Match, you will have violated the Match contract (and the Pre-Match contract which, I will bet the $500 it just cost me to get the rear window replaced in my crappy car, states that you will withdraw from the Match as well). As such, you will be removed from both programs and be labelled a Match violator which will prevent you from participating in the Match for several years (2, 3, 5, I don't remember and it doesn't really matter).

Basically, if you do what you are proposing, and you get "lucky" and match to that gas program, you are guaranteed to be out of a job for 3 - forever years. Good luck with that.

 

[ResidentMD]

Hopefully the OP has been woken up (though he could take some more beating for what he has done/is about to do), and so I am going to post some constructive advice, that was on a double post of his in the Anesthesia forum -

The program you accepted is expecting a categorical resident that will be there for 3 years regardless of the institution offering a one year contract (almost all programs do this). If word of this type of behavior then got to your #1 anesthesia program, I wouldn't be surprised that they rescind the acceptance because you violated the match rules.

If your REALLY want to do anesthesia, like others suggested already --> Go through the regular match and decline the categorical medicine spot.

Please do yourself, your career and others a favor. If you want anesthesia, go for it, and decline this spot, and frankly, come clean with the PD of the Internal Medicine program. Or else you will damage your reputation vastly.

Meanwhile, FOR GODS SAKE, if you are wanting to backout of the prematch, do it ASAP. The NRMP quota needs to be submitted by Jan 31st, which is barely 10 days away. If you cancel your prematch, your program can offer a spot to another candidate who really deserves (and WANTS) to be in the 3 year categorical program, and will be able to fill it.

Now, if they cant find a reasonable candidate, they can at least submit that spot for the match.

I hope you arent an IMG, because this is one of the reasons why programs stop inviting/offering prematches to IMGs, because of a few who have burned them in the past. Imagine the damage this will do to your medical school, and the graduates that come out of it hoping for a residency at this particular program. And frankly, you have no right to do that to anyone who has worked so hard, and truly wants to devote his/her life to sincerely training and eventually practicing medicine.

 

[Rogue Synapse]

I hope you arent an IMG, because this is one of the reasons why programs stop inviting/offering prematches to IMGs, because of a few who have burned them in the past.

I thought only IMGs could prematch? I'm a USMG and didn't even know there was such a thing as a prematch until recently.

 

[Iluvpassingas]

Thanks guys for all the answers. I withdrew, and content with medicine...was just a burning thought.

I'm a DO, from what I know, DO and IMG's can prematch only.

Best of luck!

 

[howelljolly]

I thought only IMGs could prematch? I'm a USMG and didn't even know there was such a thing as a prematch until recently.

IMGs. DOs and American allopaths who are not seniors (? switching residencies/specialites) can prematch.

 

[diosa428]

IMGs. DOs and American allopaths who are not seniors (? switching residencies/specialites) can prematch.

DOs can prematch. The only people who cannot prematch are US seniors in an allopathic medical school.

 

[RussianJoo]

DOs can prematch. The only people who cannot prematch are US seniors in an allopathic medical school.

that's exactly what HJ said.