10+ Year Member
5+ Year Member
Sep 30, 2005
I was lucky enough to match this year, but have several friends in competitive specialties who did not. I just helped them scramble, and they both successfully scrambled into very good prelim surgery spots. However, both also earlier submitted their apps to categorical programs which went unfilled, and were told by our home PDs to wait to hear back after they got good feedback when they called on the applicants behalf.

The categoricals obviously aren't prepared to offer spots on a dime like the prelim places and likely will not respond until tomorrow, so our deans told my friends to just accept the prelims.

But, what if they get a call later tonight, or tomorrow morning, saying congrats, you're in, after they've already accepted prelim spots? My initial inkling is to just go ahead and take the new spot. It wouldn't be a match violation, and in at least one case, there is only a verbal agreement. It's clearly not very ethical, but this system is designed to bend applicants over a barrel.

All theoretical at this stage, but I'm wondering, and I haven't found any good information on this subject.


Pastafarians Unite!
10+ Year Member
Oct 11, 2006
Attending Physician
I think you've summed it up yourself quite well, indeed. Except most categorical programs in the scramble will offer spots quickly, to avoid losing good people.

If they get further offers, they will need to decide whether to renege on their prior acceptance. Some would consider this an ethical problem. Others would counter that the whole scramble is ethically suspect.

Theoretically, they could be sued for breach of contract. Never heard of that happening, but I guess it could.
Sep 11, 2009
Medical Student
Remember, once you sign the employment contract then its binding. So, if you are able to get a categorical spot before you need to sign the prelim year contract, then you are well set. However, if you already signed and sent them your contract for prelim year, you cannot go somewhere else.