To a PD - is this a common response?

[Is It Lupus?]

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Hi all, so my fiance and I are USIMGs who are trying to match together in the same general area. PRE-matching together in the same area would be an even bigger plus, naturally. So imagine my joy when I got a call from one of my top programs, a university-affiliated program close to where his family is, offering me a prematch. After reminding them about my fiance, they suggested that we email HIS program nearby to see if they will prematch him as well. His program happens to be his absolute TOP TOP choice; he was received very warmly and was told on his interview day, "If you want a spot here, you can pretty much have one." We also knew that prematching was possible as the residents at his program say they usually prematch a DO every year or so.

SO, today he gets an e-mail back from his PD, which I'm basically paraphrasing like this...

"Sorry, all our positions are thru the match. I cannot violate match regulations and tell you where you are on our rank list. (Which, of course we DIDN'T even ask) I suggest you contact her program again to let them know my response and see what they say. Have them call me with any questions..."

OK so now we're assuming that A) prematching in this city together is probably not going to happen and B) his program doesn't even sound like they want to rank him high at all, so even matching here doesn't look too likely. What do you guys think? 🙁

 

[southerndoc]

Pre-matching is against match regulations for both you and the program. The program cannot offer you a spot that was previously in the match (they can offer you a spot that they didn't advertise in the match; however, this must be done prior to you applying to their program through the match).

You agreed not to accept any position outside the match when you applied through ERAS/NRMP.

I would strongly advise you to be very careful about what is occurring. You and the program could be in jeopardy.

 

[Hard24Get]

I'm no expert, but feel compelled to offer my 2 cents:

seems like the safe thing is to say you are flattered and very interested in the program, but cannot withdraw from the match without a guaranteed prematch for the both of you. Tell them you will be ranking them highly. And don't change your ROL based on this. It is still good news for you because the program really likes you and will probably take you through the match if you make your interest clear, and if you are that attractive to others, you guys may get exactly what you want. I'm sure that his program is still interested in him and hopefully not offended by him asking for a pre-match. It seems understandable.

Edit: I didn't realize a pre-match wasn't a violation for IMGs - at least I admitted previously I am no expert! =)

 

[bigapple34]

She and her finace are IMG's. They are both eligible for pre-match, and it is not a violation as they are considered "independent applicants". Wish I had an answer for you as far as what you should do, it's a tough call, but if you want to stay together and his program is unwilling to offer him a pre-match I would say you have to go through the match and hope for the best! My husband and I are couples matching as well, I know how miserable it can be! Good luck!

 

[Leukocyte]

Pre-matching is against match regulations for both you and the program.....I would strongly advise you to be very careful about what is occurring. You and the program could be in jeopardy.

For FMGs/IMGs and Independant Applicants, a pre-match is LEGAL. NO VIOLATION will occur. However the Independant applicant must withdraw from the match before the ROL deadline.

The program cannot offer you a spot that was previously in the match (they can offer you a spot that they didn't advertise in the match; however, this must be done prior to you applying to their program through the match).

This is how it works my friend:

-A residency program has a pre-determined set number of positions.

-To participate in the match, the PD has to provide a certain number of these "set number of positions" in the match. This is usually a very small number of the total "set number of positions".

-BEFORE the end of January of each match year, these "set number of positions" (MINUS the minimum seats that must be provided in the match) are open to any Independant applicant for pre-match, if the program offers a pre-match.

-BEFORE the end of January of each match year, the PD has to submit his program's "QUOTA" or number of seats he wants to offer in the match.

-It is this seat "quota" that is provided to the NRMP by the PD that is locked in the match.

 

[NotAProgDirector]

For FMGs/IMGs and Independant Applicants, a pre-match is LEGAL. NO VIOLATION will occur. However the Independant applicant must withdraw from the match before the ROL deadline.



This is how it works my friend:

-A residency program has a pre-determined set number of positions.

-To participate in the match, the PD has to provide a certain number of these "set number of positions" in the match. This is usually a very small number of the total "set number of positions".

-BEFORE the end of January of each match year, these "set number of positions" (MINUS the minimum seats that must be provided in the match) are open to any Independant applicant for pre-match, if the program offers a pre-match.

-BEFORE the end of January of each match year, the PD has to submit his program's "QUOTA" or number of seats he wants to offer in the match.

-It is this seat "quota" that is provided to the NRMP by the PD that is locked in the match.

You're doing my work for me 😀 Totally agree

To the OP: It depends on how important being together is. If being together is non-negotiable, then you need to stay in the match if you both can't obtain prematch spots. Don't read too much into what the other PD wrote, that's standard response to a pre-match request.

If being apart is acceptable, then you'll need to decide whether you want to accept your prematch and hope for the best, or stay in the match and potentially risk not matching.

You'll need to make up your mind quickly. The quota change deadline leukocyte referred to is Jan 31 this year -- your prematch offer will likely expire then.

 

[Is It Lupus?]

Thank you, everyone, for the responses! We do have about 22 possible permutations of programs that will keep us together in the same area thru the match, so I will try to keep the anxiety under wraps and hope for the best. For us, being together is definitely non-negotiable, but obviously we both want jobs. So we will put down all of the "together" permutations first, followed by all other permutations that would keep us apart but at least we might still match, followed by one person selecting "no match."

Another complicating factor is that he is applying to an advanced program and therefore is trying to secure a prelim year in medicine in the same area as well. However, we know it would be fairly difficult to get my categorical program, his advanced program, and his prelim program all in the same geographical area, so we were planning on him scrambling to a surgery prelim in the area we end up if need be.

Sorry if this is confusing... thanks again, and I'd also appreciate your 2 cents regarding the aforementioned strategy. Are we doing this the smart way?

 

[Doowai]

You'll need to make up your mind quickly. The quota change deadline leukocyte referred to is Jan 31 this year -- your prematch offer will likely expire then.

So prematches have to be accepted by Jan 31?

 

[Leukocyte]

so we were planning on him scrambling to a surgery prelim in the area we end up if need be.

Just a note from a guy (USIMG) who SCRAMBLED for EVERY preliminary surgery spot that was left after the match in 2007.

-DO NOT under-estimate the scramble.

-DO NOT under-estimate the competetiveness of scrambling into a Preliminary Surgery year.

Please keep scrambling ONLY as a very very very last desperate option. Scrambling (into anything) should NEVER EVER be "a plan".

Just my 2 cents.

Signed,

Leukocyte, who was violated (in every orifice) by the scramble.

 

[Leukocyte]

So prematches have to be accepted by Jan 31?

For the love of everything that is Holy, PLEASE do not wait too long before accepting a pre-match offer. You never know when the PD will just say,"screw it", and move along to the other person in line for that pre-match offer.

REMEMBER - NOTHING is final until you AND the hospital's CEO sign the contract. Until then...Nothing has occured.

Good Luck.

 

[NotAProgDirector]

Thank you, everyone, for the responses! We do have about 22 possible permutations of programs that will keep us together in the same area thru the match, so I will try to keep the anxiety under wraps and hope for the best. For us, being together is definitely non-negotiable, but obviously we both want jobs. So we will put down all of the "together" permutations first, followed by all other permutations that would keep us apart but at least we might still match, followed by one person selecting "no match."

Another complicating factor is that he is applying to an advanced program and therefore is trying to secure a prelim year in medicine in the same area as well. However, we know it would be fairly difficult to get my categorical program, his advanced program, and his prelim program all in the same geographical area, so we were planning on him scrambling to a surgery prelim in the area we end up if need be.

Sorry if this is confusing... thanks again, and I'd also appreciate your 2 cents regarding the aforementioned strategy. Are we doing this the smart way?

This sounds like a fine plan. The chance of getting three prematches (one for you and two for your partner) seems low. Hence, you're probably best off in the match. However, as leukocyte has clearly stated, there is a risk that you will not match and scrambling is awful. Should both you and your partner not match, the chance of scrambling into the same program / same city is very low.

Even in the couples match, the prelim PGY-1 is not linked, so it is a risk that you will be separated for a year. You can minimize this risk by trying to match in a big city where there are likely to be prelim scramble spots.

So prematches have to be accepted by Jan 31?

Not exactly. On Jan 31 all programs have to finalize their spots in the match. Let's say I have 20 spots, 10 I plan to prematch and 10 I plan to match. Let's say I have 8 people signed already and 2 offers out but not accepted. On Jan 31 I will need to decide whether to put those two un-prematched slots in the match (i.e. match for 12), or put 10 slots in and continue to try to pre-match for two. After Jan 31, I can't ask for those two slots to be in the match any further.

Since I don't actually pre-match people, I don't know what the usual process is. People can continue to be offered and accept prematches right up until the ROL deadline legally, but once programs commit their spots to the match (on Jan 31) those spots are no longer available for pre-match.

Longwinded explanation, sorry.

 

[Is It Lupus?]

Thanks again, aProg. So I just want to get it straight... my fiance's prelim list will NOT be linked to our categorical/advanced lists, right? So in the following scenario...

1. Me - Categorical Program A; Him - Advanced Program B, Prelims 1, 2, 3

Assuming we are high enough on the categorical/advanced programs' rank lists, this would be a match for both of us, EVEN if he was not high enough on the prelim programs' rank lists? So he would then go unmatched for his PGY-1 year? Or would this be considered a "no match" completely and would it go on to our second set of programs? I just want to make sure I have it correctly, b/c this might change things... we don't really want to end up in NY but it might be wise to rank our programs there higher so he has a better chance of getting a prelim year, should he need to scramble. Any input is greatly appreciated!

 

[Doowai]

Permutations. Per-Mu-Ta-Tions. Thats a cool word.

 

[NotAProgDirector]

Thanks again, aProg. So I just want to get it straight... my fiance's prelim list will NOT be linked to our categorical/advanced lists, right? So in the following scenario...

1. Me - Categorical Program A; Him - Advanced Program B, Prelims 1, 2, 3

Assuming we are high enough on the categorical/advanced programs' rank lists, this would be a match for both of us, EVEN if he was not high enough on the prelim programs' rank lists? So he would then go unmatched for his PGY-1 year? Or would this be considered a "no match" completely and would it go on to our second set of programs? I just want to make sure I have it correctly, b/c this might change things... we don't really want to end up in NY but it might be wise to rank our programs there higher so he has a better chance of getting a prelim year, should he need to scramble. Any input is greatly appreciated!

Correct.

The couples match links your Categorical match with his Advanced match. Once that's set, it's done. Then the prelim match happens afterwards. If he fails to match as a prelim, his advanced match stays put.

If you're matching to NYC, shouldn't be much of a problem given the number of prelims there. If you're matching to a smaller area or a place that only has a limited number of prelim spots, you should touch base with that PD. I will usually tell those people exactly where they are on my prelim list, as I think it's only fair. Remember that you can't ask -- you simply say that you are very interested in matching there but are worried about the prelim spot issue.