Participating in the Post-Match Scramble

1. Beginning at noon Tuesday EST of Match week (check the www.nrmp.org Web site for specific dates for this year), unmatched applicants can contact unfilled programs to secure a position. This is commonly called the "Scramble" and is somewhat like a game of musical chairs.
2. Unmatched applicants can enter the NRMP web site [or NRMP Voice Response System at (202) 828-0566] after noon on Tuesday of Match week to get a list of programs which did not fill. This is the basic information you need to participate in the "Scramble." The interactive systems allow you to narrow your search by locations or specialties. Check the AMA-FREIDA system accessed through the www.nrmp.org Web site for specific program information.
3. If you want to participate in the Scramble, you must be prepared! Immediately visit the www.ecfmg.org Web site and subscribe to their free ECFMG newsletter, which will provide very specific directions for how to prepare your ERAS application packet so that ERAS can quickly send it out to unfilled programs that you will be calling. They guarantee to have the application materials to programs within 2-3 hours, so this is the easiest and the fastest way to get your application to programs during the scramble period. Faxing takes too long and should only be used as a last resort!
4. When calling a program, ask how you should proceed to submit an application for the position. Follow the instructions you receive exactly. Repeat the instructions back to the program person whom you are speaking with to make sure that you have written down the correct information and numbers.
5. Ask for a telephone interview. Avoid personal interviews unless the program seems really promising because the time spent there will use up many valuable hours you could be using to contact other programs with positions still open. In the Scramble, the luxury of an in-person interview is most frequently abandoned and each side takes the other sight unseen (except for the application).
6. Do not assume that you have a position and quit calling just because a program has shown some interest. In the scramble game, no position is secure until you have a commitment (contract offer) in writing.
7. During the scramble process, look for both categorical and preliminary unfilled positions. Often preliminary positions (available in both internal medicine and surgery) are the last ones to fill, or do not get filled. These one-year positions are a way to establish yourself at that institution and position yourself to match in your desired specialty at the same site next year. At minimum, you may get strong letters of recommendation, strengthening your chances of matching next year.
8. Hospital contracts / letters of appointment will be sent by the program or hospitals after a position is offered to you. This can sometimes take a few weeks so do not become anxious. If you are concerned, you can call the program secretary for further information. Be sure to return a copy of the contract/letter of appointment to the hospital within the required time frame. The hospital will also send you other documents which you must review, sign and return in a timely manner. This is also the time to take care of any final issues concerning your visa. The program/hospital can help you with getting the necessary forms completed or direct you to a competent attorney.
9. Usually all positions are filled within 2 weeks after the match. After that, there may be some movement in the number and availability of positions, but it is minimal. If a hospital has several unfilled programs and the phone number given is the hospital's education office number, do not continue calling that number after being told that all positions are filled. This wastes your valuable time and that of the hospital personnel. After the second call, secretaries are unlikely to help you, even if they could. Once you are beyond that two to three week period after the Match, the scramble is effectively over.
10. If you did not enroll in the most recent match, this presents a problem for you in the scramble process, because you need an NRMP access code and PIN number to quickly access the online posting of programs with unfilled positions. Obtaining unfilled position information online is much faster than waiting for delivery of the paper version of the unfilled list, which can be ordered directly from the NRMP Web site.