PREMATCHES - SHOULD YOU SAY YES OR NO?

A very debatable topic since a long time - I won't make any commitments on this one coz, it works differently with different people, but I shall analyze the different perspectives of a prematch offer and leave decision making to you guys :-) The purpose of this blog is to keep you pre-informed and prepared !

What is a Prematch ? For those who do not know, a 'Prematch' or an 'Out of Match Position' is a an offer to accept a residency position out of the formal 'Match' Process. i.e. when you interview at a program and you are really liked, the program director could offer you a residency position without having you to participate in the match.

Q. Are Prematches Legal ?

A. Only Independent Candidates can be offered Prematches Legally - this includes the IMGs, the American Osteopathic school candidates and the regular MD track American Medical Students who have already graduated out of their medical schools. The final years American Medical senior students (which make up the bulk of Residency Applicants), who are still enrolled in the medical schools, are not eligible. The latter are not considered independent candidates since their applications are sponsored by the Dean of their medical schools


The pre-match offer is typically made either on-the-spot, right after the Interview or over a week or two after the interview. Usually the program gives 48 hours to a week deadline for the candidate to reply with a yes or no. Once a prematch is accepted, the candidate is required to withdraw from the formal NRMP Match.

Let us now look at the logic behind a prematch. Why would a program rush to accept a candidate out of the formal Match process ? Two reasons:

1. The program cannot attract enough American Medical Graduates (AMGs) through the match and is scared to further lose its interviewed IMG / FMG candidates to other competing programs . Like I already mentioned, AMGs cannot be granted Prematch positions. ( If you are not already reading between the lines - this means that the Program is not rated good by AMG applicants - like some community programs )

2. The candidate ( you !) is so darn good that the program MUST have the person in it's program.

While, an inarguable benefit of a Prematch is that it takes away the uncertainty of getting a Residency position instantly while others are still fiddling their thumbs and waiting for the D-Day, it could be a double-edged weapon ! Because, accepting a prematch could also mean that you lose out getting that cool residency you would have preferred and would have secured with patience. There have been plenty cases where candidates receive a better pre-match offer right after they sign that "letter of intent" with another program - Arrrrrgh ! Besides, the really nice programs are confident they will be ranked high by candidates and do not bother about pre-matches - like most University programs.

Moral of the Story : A Prematch is worth the risk if the program offering is amongst the top of your choice of all the places you have interview offers from. However even this statement comes with a caveat - A good interview offer may even come to you as late as the end of January !

However, on the other hand, many residents I spoke to believe that : those who have less than 5-6 interviews, those who did not match in the earlier attempt, Old IMGs, those with low scores, without US-Clinical experience and the others who get that undeniable gut-feeling that they don't have a chance at in the match, maybe be actually better off accepting a Pre-match.

Very soon you will be needing to brush up your Interviewing strategies - these are being compiled and updated regularly at MDinterviews.blogspot.com.


Secondly, I am attempting to enlist places that are known to offer prematches at IMGfriendly.blogspot.com. Hopefully the list will get longer in time and will benefit those strategizing their applications based on prematch-offering Programs !

On the lighter side, I am sure many of you who are used to American Television must be watching the program "Deal - No Deal" on NBC, where participants often come to a point when they gotta decide whether to walk home with the amount that the Banker offers as against deciding to take a chance and open another suitcase which MIGHT win him a better amount or loose all. Wise men would like to accept a sizeable amount and go home rather than take that unknown chance of a bigger amount - rings a similar bell with prematches ? ;-)



Also Read:

- List: Prematch Offering Residency Programs Database
- How to refuse to a Prematch Offer