HopefulDoc1984

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How does prematching work? It sounds like the director tells you that you are going to match but that seems to go against the whole match process. Can anyone explain how it works.
 

aProgDirector

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First, you can only prematch if you are not a 4th year allopathic medical student. This would include all IMG's, all DO's, and all graduated MD's.

Here's how it works:

1. You apply for programs just like everyone else.

2. Programs review applications and offer interviews.

3. Sometime after the interview, if you qualify for a prematch, a program may offer you a contract outside the match. You can accept and sign it, or not.

4. If you accept the spot, you are supposed to stop looking for another one. Chances are, the contract you will sign will state this explicitly. Some people do continue looking for another spot, hoping to find something better, and planning on resigning from their 1st spot. Whether this is legal, enforcible, or ethical is a matter of some debate.

5. The benefits of a prematch are pretty obvious. You know earlier where you are going, so you get to make plans. If you need a visa, this gives you and the program more time to arrange your visa. If you prematch into an early interview spot, you might save a bunch of $$. Prematching is very handy when you get an offer from your #1 or if you are very geographically or otherwise limited.

6. The downsides of prematch offers are rather straightforward also. You take a "sure thing" but will never know if you might get something better. If a program early on your interview trail offers you a spot, you might never get a chance to see other programs (as most of these offers have a very short timeframe for making up your mind).

7. Programs can prematch all of their spots, none of their spots, or any number in between. However, programs must finalize the number of spots in their match by Jan 31, so most prematch offers stop then (except in programs that prematch all of their spots). Programs that offer all prematches tend to interview earlier. Also, they tend to offer spots on a rolling basis -- once they have filled all their spots, they simply contact candidates and tell them that all future interviews are cancelled.

8. In general, more competitive programs / fields fill via the match, and less competitive ones via prematches.

9. If you accept a prematch, you must withdraw from the match. Not doing so is a match violation, and puts your entire future at risk.

10. The match is binding legally. Verbal prematches are not. If a program offers you a prematch, it should be in writing or you really have nothing.
 

RussianJoo

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APD, have you ever heard of people prematching after their elective? i.e. way before interviews at the begining of their 4th year.
 

Law2Doc

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... Whether this is legal, enforcible, or ethical is a matter of some debate.
...
No real debate here. It is a contract and you are breaching it. It is an enforceable contract. And not standing behind your signature is by definition unethical. You are reneging on an agreement and absent some acceptable reason based on actions by the other party this is considered unethical in most circles. The only thing subject to debate is whether anyone would ever bother enforcing such a contract in court, when there is a ready supply of would-be residents. No PD would want to spend a lot of time or money litigating this kind of breach of agreement -- the damages will be negligible. So you can probably breach and get away with it. That is the only thing perhaps subject to debate. The legality, enforceability and ethics of signing and reneging on a contract, however, are NOT a matter of debate in any way or form. If you are an ethical person or want to stay on firm legal ground, you simply cannot sign and then ignore contracts.
 

jiy76

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No real debate here. It is a contract and you are breaching it. It is an enforceable contract. And not standing behind your signature is by definition unethical. You are reneging on an agreement and absent some acceptable reason based on actions by the other party this is considered unethical in most circles. The only thing subject to debate is whether anyone would ever bother enforcing such a contract in court, when there is a ready supply of would-be residents. No PD would want to spend a lot of time or money litigating this kind of breach of agreement -- the damages will be negligible. So you can probably breach and get away with it. That is the only thing perhaps subject to debate. The legality, enforceability and ethics of signing and reneging on a contract, however, are NOT a matter of debate in any way or form. If you are an ethical person or want to stay on firm legal ground, you simply cannot sign and then ignore contracts.
Thats true, I know someone who accepted a prematch verbally but did not sign the contract he then found a better position elsewhere and took the other spot.He made the initial program wait months and then took another position. Thats unethical but technically not illegal since he didnt sign anything.I'm sure the program wasn't happy but as mentioned it wasn't worth pursuing particularly since he didnt sign a commitment.
 

Law2Doc

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Thats true, I know someone who accepted a prematch verbally but did not sign the contract he then found a better position elsewhere and took the other spot.He made the initial program wait months and then took another position. Thats unethical but technically not illegal since he didnt sign anything.I'm sure the program wasn't happy but as mentioned it wasn't worth pursuing particularly since he didnt sign a commitment.
Well, you can sometimes have a verbal agreement, so it may still technically be a breach of contract. The signing doesn't make it enforceable, just provable.
 

bbpiano1

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So is any school that participates in NRMP also allowed to recruit by pre-match.....it sort of scares me that I might rank a program that has already filled its slots by pre-matchers.
 

Law2Doc

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So is any school that participates in NRMP also allowed to recruit by pre-match.....it sort of scares me that I might rank a program that has already filled its slots by pre-matchers.
You have to realize that places generally only use prematch if they feel they can't do better in the match and/or scramble. Meaning it's usually the less desirable programs that never fill in the match that use this option the most. The ones that historically do well in the match, and get someone of their choosing from the competitive applicants, will use the match and not "waste" their slots with prematch folks. So no, you won't be ranking programs already filled up by prematchers. You may end up scrambling into a program that has a lot of prematchers if you don't fare well in the match, though.
 

aProgDirector

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No real debate here. It is a contract and you are breaching it. It is an enforceable contract. And not standing behind your signature is by definition unethical. You are reneging on an agreement and absent some acceptable reason based on actions by the other party this is considered unethical in most circles. The only thing subject to debate is whether anyone would ever bother enforcing such a contract in court, when there is a ready supply of would-be residents. No PD would want to spend a lot of time or money litigating this kind of breach of agreement -- the damages will be negligible. So you can probably breach and get away with it. That is the only thing perhaps subject to debate. The legality, enforceability and ethics of signing and reneging on a contract, however, are NOT a matter of debate in any way or form. If you are an ethical person or want to stay on firm legal ground, you simply cannot sign and then ignore contracts.
Just like a lawyer to point out when I have worded things badly...:cool:

But, yes, I agree with L2D's assessment. With some additional questions / thoughts:

1. Legal -- Let's say the contract says it is terminatable with 90 days notice. If the contract starts on July 1st, if you informed the program >90 days before July 1st could you cancel it? I assume the 90 day clock starts with July 1, but I've always wondered.

2. Enforcible -- poorly worded by me. Agree with L2D, what I meant was that programs were unlikely to pursue it for all the reasons he mentions, and more.

3. Ethical -- this is a more difficult situation. Let's say I prematch into an IM program. Then, 2 weeks later, I get a dream-of-a-lifetime offer, a radiology spot. It's now or never, this offer is unlikely to recur and I can't start late. I see this as a tough situation. We're talking about my entire career here, it's not like I can just try again next year. Whether it's "ethical" to hold students to their contracts in this sort of situation is unclear.

Of course, this is a slippery slope. What about if I get an offer from a "better" IM program... same problem, but to a lesser degree.

I expect the correct answer is: "This student is an adult, they made a decision, and they should stand by it." And I think I agree.

So is any school that participates in NRMP also allowed to recruit by pre-match.....it sort of scares me that I might rank a program that has already filled its slots by pre-matchers.
I would also point out that if you actually rank a program that has no slots, or a program that didn't rank you at all, it does not hurt you in the match at all. You will simply match at the next program down on your list. You might have wasted time / effort / money in interviewing there, but that's it. I guess you could be disappointed that you matched one lower on your match list, but presumably if you knew this program actually had no slots, you simply would have moved everything below them up one more spot, so the result is the same.

And, as a final note, if the program really removed all of their slots from the match, the NRMP would (probably) remove them from the match, and you wouldn't be able to rank them at all.