"Deadline" for Prematch offers from Residency Programs?

This unique query came from a reader and warrants a post on it's own, as it aids understanding of the system.

A "Deadline" for getting / accepting prematch offers, meaning the last date for getting any prematch offers from residency programs would technically be the same as the deadline for a program to change the quota of positions they submit to the NRMP match program. This quoata-change deadline is usually the 31st January of a given Match Year.

Previously, I had said that the technical deadline would be the same as that of submission of Rank Order Lists. The ROL submission date, which is the same for participating candidates and the residency programs, typically would be the 2nd or 3rd week of February of the match year, but I need to take that back.

Here's NRMP's message to Program Directors about Match quota position change deadlines:

"You can add a program and change program quotas up until the program quota deadline, January 31. After that date, quotas can only be changed in cases of extreme emergency, i.e., loss of funding, loss of accreditation, closing of institution, or to accommodate the results of an earlier match. In such cases, programs must request in writing an exception to the quota change deadline."

It's not uncommon to see the FREIDA database show reduced match quotas during January as compared to what it shows at the beginning of the match season - that happens due to the giving out of prematch positions. Once the quota for match is finalized and submitted by the residency program, no more prematches can be offered.

On the candidates side, the prematch offer MUST come he or she submits his Rank Order Submission - coz once the submission deadline has passed and the e candidates fails to withdraw from the match - he is legally bound to accept the Match results.

As posted on the NRMP website:

'Applicants who have submitted certified rank order lists and do not withdraw by that deadline will be included in the Match and will be obligated to accept an appointment if matched, provided all program prerequisites are satisfied. An applicant who accepts a position outside the Match and does not withdraw is in violation of the Match Participation Agreement and may be subject to penalties under Section 7.0 of that Agreement"

Besides, offering a prematch takes it own time - the offer, the response from the candidate and then a timeframe to finalize the contract and then the need withdraw from the NRMP match.

Hence....functionally speaking, lets put the "deadline" for prematch offers at around the last week of January of the Match year or the first week of February at the maximum.


Also read:

- How to Withdraw from the NRMP Residency Match ?

How to find if a Residency Program Offers Prematch Positions ?

Thanks to 'Mandy', we have a reasonably accurate way of determining whether a Program has a habit of offering pre-matches (i.e. Out of match positions) or not. I await his real name for better crediting :-)

Step 1:

Look up the Number of Positions for a Program On FREIDA.

Let this be 'x'


Step 2:

Look up the Quota that was released for the previous Match on the NRMP ProgramsMatch Results Data Sheet. - Download it here [PDF]

Let this be 'y'


Step 3:

x - y should give us the number of positions that were NOT available for Match - i.e. residency positions that were withdrawn from the match.

Generally speaking, the a withdrawn position would mean it was given away as an out-of-match position.

Mandy likes to call it the Mandy Prematch Algorithm - So be it !! :-)

Example:

Now, let's clarify this with a real example. We look at one of the 'Mother of Prematches' - the St. Barnabas Internal Medicine program at Bronx, New York :-)


Step 1:

We look up the FREIDA Entry for St. Barnabas: There are a total of 30 positions in the First Year. (When I looked, Information is updated for Year 2007)

Thus, x = 30

Step 2:


As Per the NRMP Program Match Results Data File, there were only two postions on the Match Quota for the 2007 Match at St. Barnabas

Thus, y = 2


Step 3:

x - y = 30 - 2 = 28

Hence 28 Positions were Withdrawn Before the Match

As I said before, withdrawn positions are generally Out-Of-Match Positions, though the other reason could be an actual decrease in the number of residency positions that were closed due to lack of funding. However we could potentially cross-check against that by looking at other years' data. The Number of positions for second and third year internal Medicine stays is consistent at 30 on FREIDA, while the match quota for both years 2006 and 2005 was 4, implying 26 prematches were given away in both those years and there was no actual decrease in positions

:-)


For the visually-inclined amongst you - Here goes again :




More Notes:

1. Program policies change - a program that offered a Pre-match the earlier year may not do so this year and vice-versa

2. Program coordinators are more likely to tell you over the phone about pre-match policies rather than over email - coz' thats always been a sensitive issue

3. Some programs may include even Prelim years on their Total positions mentioned on FREIDA - but the Program data file will do a better job of splitting the position types


Also read:

- Prematch Basics

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