FP positions outside of match

[Pilot]

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I was suprised this week when the FP residency I am rotating through this month inquired about my thoughts on accepting a 1st year position outside of ERAS. The chief resident stated that with 99% certainty I could get me a spot outside of the Match if I was interested.

I spoke with one of the attending, who advised me that last year they signed 4 residents to contracts prior to the Match, and matched their remaining top 2 choices in the Match. I was also told this is last year for this ability to sign contracts prior to the Match.

Has anyone else been blindsided with this? I thought no contracts were allowed outside of the Match anymore. My delemma is that I have another program which I would like better for family reasons, and the program with the potential offer is my second choice.

 

[CambieMD]

Student interest in Family Practice is way down. The program that offered you a position outside of the match wants to make sure that all of their positions are filled. If another program meets your needs better then the program that made the offer, stay in the match. Make sure that your number one choice knows that you really want to go there. This may cause them to rank you high.

Positions will no longer be offered outside of the match after the up coming match. The NRMP met with stiff opposition from from groups that feel that the elimination of the pre- match will make it impossible to fill their programs. The impact of the pre-match will be studied carefully.

All the best.

 

[Pilot]

I should have asked in my original post, but I thought of it too late. Are all FP programs able to offer positions outside of the Match, or only certain programs meeting preset requirements? Thanks for your responses.

 

[BellKicker]

I'm no expert but.....

It's perfectly legal for programs to offer prematches if the candidate is "independent", ie. an IMG, DO-student or graduated before last september. It looks like the plans to outlaw the prematch have been delayed indefinitely.

I hate the concept of prematches; it's too much pressure on the applicant and too easy for the programs.

 

[CambieMD]

The pre-match can be very helpful in some instances. Programs in less desirable locations can fill with qualified applicants. A friend of mine who needed a prelim int. med. position matched in a rural
Northeastern program. She was happy for the position and the program was happy to have a highly motivated intern. Small programs in "bad" locations would have to wait for the scramble to attempt to fill if the pre-matche was abolished.

 

[BellKicker]

Yeah, but from the point of view of the applicant, I reallt don't see the advantage.

I know I'll be one of those chicken****s. I'll sign the first pre-match offered to me (if any). One bird in the hand, you know, but it still robs me of the chance of matching into my top ranked program.

 

[nychick]

Don't let anyone pressure you into signing something you feel uncomfortable with. Seeing as you think you like the program that made the offer second best, however, I think it would also be ill-advised to totally diss them, you may want to fall back on their offer...

Have you visited or received an interview at your first choice? B/c if you do and it turns out you don't like it as much or even if an interview offer is not extended to you, the point essentially becomes moot, right?

I would tell the PD that you are very flattered by the offer but that you are still ealry in the process, that you like his program very much and can see yourself there but would like to check out some others to get a frame of reference. Ask him how long he is willing to "hold" the spot for you, if at all. Most pre-match offers are not extended until later in the interview season (pretty much right up to the ROL day, at which point you would have to withdraw from the Match if you had signed a pre-match offer), therefore if the PD really likes you he is probably willing to give you some time unless he is very insecure about his program which would be warning sign in and of itself, in my opinion.

Anyway, once you interview with the other program, if you decide that you still like it better than this one, you would have the option of letting that program's PD know that you find yourself in a difficult position as you have a pre-match offer outstanding. At that point, you'll find out if the program also uses pre-match or not. If it doesn't then you'll actually have to roll the dice.

I have a friend who was in this situation; she had gotten a number of pre-match offers at so-so places but also interviewed at very competitive places (they usually don't offer pre-matches b/c their residents are mainly AMG). You can't ask a place like that whether they will match you cause that's against the rules; but you can tell them that you have pre-matches outstanding that you would have to decline if you went through the match and do they think you should take the chance? I think they would be truly mean if they told you yes but actually aren't even ranking you, if you get my point. Anyway, my friend ended up going through the match and matched at her no. 1 choice.

By the way, I pre-matched in peds last year, at what would have been my first choice had I submitted a ROL. So pre-match can be win-win.

 

[BellKicker]

nychick, good to hear from you again.

That's good advice. I guess I didn't take into account that the PD can give you a few weeks to think it over. I have heard accounts of applicants getting less than 24 hours to think it over, though.

I do remember your story about your pre-match and that's certainly at the happy end of the spectrum. However, I do believe there are many applicants who are too scared to turn down a sure thing and end up thinking "what if...?" come match time.

I'm not applying till next year, anyway, and the pre-match could be history by then (although I don't think so).

Take care.

 

[Apollyon]

Originally posted by BellKicker
That's good advice. I guess I didn't take into account that the PD can give you a few weeks to think it over. I have heard accounts of applicants getting less than 24 hours to think it over, though.

Just like the high-pressure car salesman, if they don't give you adequate time, don't take it. Period. If they need an answer NOW, the answer is NO.