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  1. #1
    doctormua is offline Permanently Banned 510 points
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    pre-match versus top choice programs

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    i'm a first year med student at mua-nevis and have a few questions on pre-match offers versus top-choice programs. i hear a lot of people saying that most people who pre-match are at bad programs and they usually leave after a little while. why is that? i'm guessing that the training must be not as good.........but are there any other disadvantages to a pre-match program? i mean, will the job offers after residency be not as good?? please somebody shine some light on this subject..........

    i know i'm looking way into the future, but i'm set to graduate on august 2009, which means i'd have to pretty much wait out a year in order to start residency. and if i get a pre-match offer, i might want to start ASAP and not wait out that year................so what are the disadvantages of the pre-match programs? ??

  2. #2
    wcb22 is offline Elite Member
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    no, it's good to think ahead.

    this is my opinion. take pre-match offers from programs as a compliment. the more, the better. if you get 4 or 5, basically i think you're hot to trot. the best programs usually aren't prematching, why would they need to? only IMGs can prematch. US seniors cannot. if a program is competitive, all these US students will be competing to fill the spots. they wouldn't need to resort to a prematch offer.

    now take a less competitive program. (side note, a general rule of thumb is that university programs are more competitive than community programs, but there are exceptions. also, USUALLY once again, the more IMGs in a program, the less competitive. if you're the only IMG in your program, take that as a compliment as well). they might offer prematches to fill these spots. some programs have several unfilled spots each year.

    they can resort to a prematch for your benefit and theirs. they have a guaranteed spot (b/c you sign a contract), and so do you. you don't have to worry about spending thousands of dollars on ERAS and interviews, hotels, etc. drawbacks here are this... say you are offered something much better only 3 weeks after you signed your prematch contract. sorry, too late. you're stuck.

    my advice is that if you are offered a prematch at a place you would have already ranked very highly (top 1 or 2, maybe 3), then take it. you have a guarantee. make sure the residents are happy, make sure there is low attrition rate, make sure you really know that the program is good.

    you want a good university program if you want to go into a fellowship after residency. i.e., not all internal medicine programs are created equal. some of them won't even look at you unless you have 230/93+ board scores, and even then you have to make them feel all warm and fuzzy about you at the interview to land a spot. once you land a solid IM program, cardiology, or GI might be open for you. but pretty much forget it if you go to a community program, you will be stuck in general practice (not that this is bad either), unless you have something special to offer, then you MIGHT get a fellowship.
    M.D., PGY-3 Internal Medicine

  3. #3
    TheOne_1 is offline Junior Member 510 points
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    Quote Originally Posted by wcb22
    no, it's good to think ahead.

    this is my opinion. take pre-match offers from programs as a compliment. the more, the better. if you get 4 or 5, basically i think you're hot to trot. the best programs usually aren't prematching, why would they need to? only IMGs can prematch. US seniors cannot. if a program is competitive, all these US students will be competing to fill the spots. they wouldn't need to resort to a prematch offer.

    now take a less competitive program. (side note, a general rule of thumb is that university programs are more competitive than community programs, but there are exceptions. also, USUALLY once again, the more IMGs in a program, the less competitive. if you're the only IMG in your program, take that as a compliment as well). they might offer prematches to fill these spots. some programs have several unfilled spots each year.

    they can resort to a prematch for your benefit and theirs. they have a guaranteed spot (b/c you sign a contract), and so do you. you don't have to worry about spending thousands of dollars on ERAS and interviews, hotels, etc. drawbacks here are this... say you are offered something much better only 3 weeks after you signed your prematch contract. sorry, too late. you're stuck.

    my advice is that if you are offered a prematch at a place you would have already ranked very highly (top 1 or 2, maybe 3), then take it. you have a guarantee. make sure the residents are happy, make sure there is low attrition rate, make sure you really know that the program is good.

    you want a good university program if you want to go into a fellowship after residency. i.e., not all internal medicine programs are created equal. some of them won't even look at you unless you have 230/93+ board scores, and even then you have to make them feel all warm and fuzzy about you at the interview to land a spot. once you land a solid IM program, cardiology, or GI might be open for you. but pretty much forget it if you go to a community program, you will be stuck in general practice (not that this is bad either), unless you have something special to offer, then you MIGHT get a fellowship.
    I liked the way you explained the issue, thank you. A good, university program that offers fellowships is a dream of all applicants. It needs some time to sit and review your strong and weak points like USMLE scores, USCE (US Clinical Experience), US LOR's, the kind of Visa that you're looking for (as an IMG) and the programs that you will going to apply for.

    It's a common question "Where shall I apply?"
    And the answer requires your knowledge of the requirements of each medical program (Not Impossible but really difficult) and to compare it with what you've got in your pocket...

    TheOne.
    Last edited by TheOne_1; 08-11-2006 at 05:03 PM.
    TheOne

  4. #4
    wcb22 is offline Elite Member
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    exactly, and what you should do also is apply BROADLY. apply to 10 programs that should be easy to get into. apply to 30-40 programs that are in your "range", depending on the factors just described. (i.e., don't apply to top programs if your step 1 score is a 188/77. just save the $$$), and apply to 10 programs that are a reach for you. so depending on the year (which you don't know how competitive it was until it's over), you'll be well covered. if it so happened that your particular specialty wasn't as competitive as before, maybe you'll land up there in your top 10.
    M.D., PGY-3 Internal Medicine

  5. #5
    AUCMD2006's Avatar
    AUCMD2006 is offline Ultimate Member 6129 points
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    side note: many community programs also offer fellowships, they will likely only have 2 or 3 programs vs the gambit at a university but being in a good community program is not the end of the world..specially if you know your stuff. i've met AUC cardio/GI/Nephro/MFM fellows and someone in surgery being 'offered' plastics so just know you stuff and know a community program is not the end to a fellowship...very close but not the end. if you are interested in a fellowship definitely go to a hopspital that has it, even if they don't take you, over your 3 years you will be in social situations with high ranking people, meet the program director and have a good LOR done.
    AUCMD2006
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  6. #6
    doctormua is offline Permanently Banned 510 points
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    so would....

    so would taking a pre-match or a community program hurt your job opportunities after residency? or is the benefit of university-based programs just that they offer fellowships????

    like, if say, somebody just wanted to do IM, and no fellowship, would it hurt to go to a pre-match community program?

  7. #7
    AUCMD2006's Avatar
    AUCMD2006 is offline Ultimate Member 6129 points
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    tracts

    Quote Originally Posted by doctormua
    so would taking a pre-match or a community program hurt your job opportunities after residency? or is the benefit of university-based programs just that they offer fellowships????

    like, if say, somebody just wanted to do IM, and no fellowship, would it hurt to go to a pre-match community program?
    short answer, NO. the system is pretty complex and hard to describe in short because there is so much overlap in what you are able to do. the basic law of the land is the more prestigious the program the better job you will get, the easier it is to get a fellowship however there are ways around everything because there is such a demand for us. here is some fun things i learned to confuse you:

    you gotta make up your mind with semi long term goals in mind. a community program will in no way hamper your ability to work anywhere except maybe ivy league. i have done most rotations at two community programs and two huge university programs, the residents get head hunter letters stuffed in their mailboxes from all over the place, they get flyers from university programs, the programs also get letters from private practicioners throughout the country looking to expand their practice that they post in the lounge, locum tenens positions, rural loan paybacks, military, offers for doctor car leases, house loans, it really is mind numbing the potential of where top go and what to do.

    the university tract will help if you have any interest in academic medicine, ie if you want to be faculty at a university or of you want a fellowship. it really does not do much for work prospectus at our "level"
    i say our level because we will be looked at and lumped with most US grads for most positions. the people at the ivy league will get the great gigs, those who don;t hire img;s seem to be few and far between so the rest of us are on pretty level ground work wise.

    even then, working as an attending at a community hospital with acgme residencies you are able to be teaching faculty affiliated with that medical school and can move to academia from there.

    real world observations: out of the 2 community programs i've been at a large chuck of the graduating class this year went to work at university hospitals like university of wisconsin, minnesota, UCSF, UF and another 4 went to fellowships in plastics, high risk ob, cardio, gi. a few that i know wanted fellowships but were turned down in GI and nephro so they got a job at a local university for a year and will re apply..meanwhile one got a bmw m3, the other an audi a6s, new clothes and are enjoying actually getting paid..hehe
    AUCMD2006
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  8. #8
    AUCMD2006's Avatar
    AUCMD2006 is offline Ultimate Member 6129 points
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    one more thing: to show you that ability overshadows anything else, a group at wayne state spoke to a resident before graduation about coming back as an attending after he finished fellowship. they offered him an additional stipend of $2,000 per month, on top of fellowship salary, while in fellowship in exchange for at least 4 years as a partner in the group. of course with equal pay, profit sharing, etc.

    potential really si there for almost anything
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  9. #9
    wcb22 is offline Elite Member
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    Mmmmmmmmmmmm... M3
    M.D., PGY-3 Internal Medicine

  10. #10
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    microphage is offline Useless Member 512 points
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    this is even too early for me to consider... and I'm about to apply for programs!


    I'll consider it once someone offers me a prematch...(<=== not bloody likely )
    Finally beat Super Mario Bros within 7 mins.

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