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The Scramble

Preface

"The Scramble" takes place in the days just before Match Day, when students learn they have not matched into any residencies and must then seek out new opportunities among the unmatched residency slots that are still available.

Learning that you have not matched into your chosen specialty is one of the most stressful events of medical school. Students sometimes feel angry, frustrated, or that they are a failure. These are all normal feelings. However, there are multiple reasons for not matching: Some specialties are so competitive that even good students are routinely unable to obtain spots; students may have been limited by geographic or family reasons; students may not have applied to a sufficient number of programs or gone on enough interviews; and some students simply have unrealistic expectations given their academic history. The good news is that the majority of students who scramble are able to obtain a spot for the next year. This may not always be in their chosen specialty: it may be necessary to perform a preliminary or transitional year, then reapply. Some students will choose to take a year off to do research and strengthen their application.

On Monday morning of Match Week, the Office of Student Affairs will be notified of the names of their unmatched students. Monday at noon, applicants will be able to find out if they are matched or unmatched via the web or via the NRMP Voice Response System (with NRMP code and PIN numbers). If you are unmatched, contact the OSA immediately.

The Office of Student Affairs is here to help guide you through this stressful time. We can assist in sorting out why you did not match, estimate your chances of scrambling into a spot in that residency, or assist you in making alternative plans. What follows is a rough roadmap of the process. We will be with you to help, and wish you all of the best.

Monday of Match Week

  • Review your MSPE - you may be able to add in new evaluations.
  • E-mail your ERAS application to OSA: this will be converted to a PDF file along with your letters of recommendation, MSPE, and personal statement. This can then be e-mailed by OSA to programs that do not accept ERAS during the scramble.
  • Some program directors will want to meet with you this afternoon rather than Tuesday morning.
  • Discuss your scramble strategy with one of the deans in OSA: you should have a main strategy (which could be attempting to scramble into your initial specialty) and a back-up strategy (which may be a preliminary year, a different specialty, or a year off to do research, etc).
  • Review the "Regional Statistics by Specialty." You won't know the actual programs with unfilled spots until Tuesday, but this list gives the total number of unfilled spots in each specialty in each region (Western, Central, Southern, Northeastern) of the country. This gives you an idea of how difficult it will be to obtain a residency position in the specialty of your choice.
  • If you have an advisor in your specialty, or are friendly with the chair or program director, let them know that you did not match, ask for their advice, and confirm their availability for scramble day.

Tuesday of Match Week - "Scramble Day"

  • Meet with OSA staff at 10:30 AM in OSA's conference room. You may bring your significant other, or anyone else that could offer advice or support.
  • At 11:30 AM, the "List of Unfilled Programs" is released. OSA will Xerox this list and provide each student with a copy. The list shows what programs in each residency are unfilled, how many spots they have available, and how they wish to be contacted (ERAS, e-mail, fax, phone). This list is updated hourly on the NRMP website, though it is up to the individual program to notify NRMP when they have filled a spot.
  • Take your list to the person that your chosen specialty has designated to help you. This may be the chair, program director, other faculty member, or administrative assistant. OSA will have a list of contacts. If the program is not providing anyone to assist you, OSA will be your contact person.
  • You may not contact programs before 12 noon - THIS IS A MATCH VIOLATION AND CARRIES SIGNIFICANT CONSEQUENCES. 
  • At noon, contact the programs you are interested in, by the manner they have designated. If they want applications faxed or e-mailed, OSA will send the PDF file that was created on Monday. You cannot e-mail these packets yourself because they contain letters of recommendation which you have waived your rights to review.
  • Most of the faculty contacts here will prefer the student to initiate the contact with programs. Then, if the program wishes to speak with a faculty member, they will take the phone. Some faculty may choose to actually make the calls themselves.
  • Each program you contact will be different: some will only tell you to send your application for their review, while other program directors will actually get on the phone and conduct a "mini-interview" which may or may not be followed by a verbal offer. More often than not in this day of electronic applications, programs will take some time to review the applications and make offers to the person that they perceive is the best candidate. This is especially true for a competitive specialty with only 1 spot to fill. A less competitive specialty with numerous spots to fill will be more likely to offer positions over the phone to the first people that show interest.
  • If an offer is made over the phone, it is OK to ask the program if they are willing to hold that spot for you for a short time. If they are NOT willing to do that, you may need to make a decision immediately or risk losing the spot. Verbal offers will be followed by faxed contracts that must be signed and returned. THIS IS A LEGAL DOCUMENT AND REPRESENTS A ONE-YEAR COMMITMENT TO THAT PROGRAM. RENEGING ON THIS CONSTITUTES A MATCH VIOLATION. It is also immoral to verbally accept an offer and then continue to pursue other offers, even if you haven't yet signed the contract.
  • If you accept a position, let OSA know so that they can make up an envelope for Match Day.

Wednesday of Match Week

  • Scramble continues as necessary.

Thursday of Match Week - Match Day!

  • If you have successfully scrambled into a spot, an envelope will be ready for you just like the rest of your classmates. Please note, this entire process is confidential - your classmates need not know that you scrambled unless you choose to tell them.
  • Relax, and enjoy the day - you've earned it!