Hi aditi2000-ga, and thanks for your question.
The post-match scramble is one of the most stressful experiences there
is. You basically have 2 days to determine not just where you'll do
your residency, but in some cases, what field you'll end up in and if
you'll get into a program at all. I've actually been through this
process a couple of times (as a US grad) and can say that it has very
much turned me off from the Match process itself. I can give you some
For the reasons above, many medical school Deans recommend having
someone (such as a medical school Dean) on your side ready to make
phone calls for you as soon as the scramble list is out. You'll know
on March 13, 2006 at noon whether or not you matched. If you get an
e-mail that you didn't match, then you'll need to get the list of
unfilled positions on March 14, 2006 at noon (Eastern Standard Time).
You can find list at the NRMP Match site:
Let me take your third question first... First, I highly recommend
putting together a packet of information that you will need to submit
to programs during the scramble. I would have both a printed and
electronic (PDF) form. Request copies of your letters of
recommendation NOW. People tend to delay writing them and might delay
getting you a copy. I've had this problem many times at various
points in my academic career. This can be one of the most important
parts of your application.
The fmgamerica.com site has a good list of things to get together:
Scan a copy of the various documents into PDF format. If you don't
have your own scanner, use one at a copy center or buy a cheap one.
Put all of these files in one labeled directory on your desktop that
you can get at quickly. A photo is helpful, since some programs ask
for one. You can include a CV (Curriculum Vitae) if you have one.
Next, I recommend making one large PDF file that contains all of these
documents. There are various windows and Mac programs out there that
can do this. This way you don't have to send 12 files to each program
and they can just hit "print" and get a complete printout of your
Here's a listing of PDF utilities to do merges:
Many of these have limited trials (see, for example, PDF Split-Merge 1.1):
Next, print out the merged PDF document on standard 8.5" x 11" paper
and place this in a folder where you can find it.
Lastly, put together a standard FAX cover letter that you can modify
for each program. Don't rely on the FAX, since just about every fax
machine out there will be busy for the entire day as people madly fax
their info in. You won't have this problem with e-mail, which is why
you want to have a PDF file to send. Make sure that the size is not
larger than around 5MB, or the mail may bounce. If the file is too
big, you may have to send several e-mails with the various parts of
the applications. Put together a draft e-mail that you can modify and
send to each program after the scramble starts. Attach your PDF file
to the draft so you don't forget to send it. Make a backup CD of all
your files and put it in a safe place.
Ok, now you have a PDF with all your application info, a printed copy
for faxing, and a draft e-mail. The programs that will have unfilled
spots during scramble is fairly unpredictable, but you can search
online for lists from previous years to look for trends in your field.
For example, maybe every year 2 or 3 programs don't fill.
Unfortunately, this is often for good reason - they're malignant, they
are bad programs, they're in bad places, etc. You'll have to decide
if the risk is worth it. In any case, there's a good chance that some
of these repeat programs will be on the list again this year. You
should learn a little about those programs.
Being an FMG is a bit of a special situation. As you know, many
programs dismiss FMG's out of hand. Of course, these same programs
might consider you if you have strong credentials and they have
openings. That being said, it pays to find some programs that are FMG
friendly in your field. There are lots of Internal Medicine programs
with significant numbers of FMG's, mostly in rural areas. There are
exceptions, such as St. Vincent's hospital in Worcester,
Massachusetts. These programs often have openings in the scramble as
well, primarily because they seem to be located in places shunned by
Another factor that plays a major role in the scramble are phone
calls. The ideal situation is something like... someone you've worked
with for years happened to have trained the chairman at a program you
want to go to and makes a call for you. This rarely happens. You
should, however, look carefully at the people who wrote you letters of
recommendation to see if any of them would be good candidates for
making calls - respected, known by or have some ties with programs in
the US, and reliable. You can have more than one person obviously.
For example, there are several Harvard Medical grads who now have
returned to their home countries and train FMG's, which helps those
FMG's get positions back in the US. You might look through your
school's faculty now and identify some people who could potentially
help you. Chairpersons, Department Chiefs, Deans, etc., are generally
good at this sort of thing.
Another meter of programs is where people from your own school have
ended up. If there are a few schools that have taken lots of grads
from your school, give them a call, even if they state that they have
no openings. Places can sometimes make a position for you,
particularly if they're large and people have left. You also stand a
better chance at programs where you might have done externships as a
Once you know the people who will be making phone calls for you, make
a sheet or file with all of their names, phone numbers, titles,
e-mails, and addresses. You don't want to waste time looking for your
advisors office phone number. Ask people where they will be early in
the afternoon on scramble day.
Make sure that anyone who is going to be making calls on your behalf
has your application file in hand the day of the scramble. People
will misplace it. People will forget what day the scramble is.
People will forget who you are. It's amazing given how important to
you it is, but it all happens. You need to keep on them and check in
with them the day before the scramble. Sometimes people go out of
town for last minute meetings and conferences. Have at least one
backup ready to go.
Another thing to keep in mind is that for the NRMP match, more so than
for the early SF Match, time is important. Most programs will make a
decision quickly since the Match is only two days after the scramble.
Programs want to get the best scramble candidate they can get their
hands on, so it's also in their interest to make offers to people that
they like. They also have the option of just not picking anyone and
leaving the spot unfilled. In this case, positions can be posted at
the AAMC Find a Resident site:
This is a reliable resource for finding positions at all levels. It's
not a free service, and I recommend checking that there are some open
programs in your field at your level prior to paying. You can get a
summary listing here:
Here are some other sites that list open positions:
Ok... Now you have paper and electronic versions of all your documents
and your advisors are cued up and ready to call for you. You can
check to NRMP site a little before noon for the scramble list, but
they are pretty strict about not releasing it until at least noon.
Download the file (usually a PDF) and save it. Print a copy. The
list will usually list at least a phone number for each program. If
they list an e-mail, send your application with a cover letter. You
should also look up the e-mail of the chairman of the department, the
director of the residency program, and their assistants and send
copies to them. Confirm with their assistants that a copy was
received (call or e-mail). Remember that they are being barraged with
applications, so it can take a while to get a reply or get through by
phone. When you confirm receipt, also ask who's making the final
decision, how the process will work (will they be interviewing, etc.),
and when a final decision will be made.
Programs get so many applications that they may not tell you that they
didn't pick you until after the Match. Painful. Some will just
assume that you'll figure it out when you haven't heard from them by
Match day. More painful. Finding a helpful assistant at a program
can really help you figure out what's going on.
You can also try faxing your application, but it takes a while to fax
a 25 page application and the fax lines will be continuously busy.
There's little that's more frustrating than redialing 50 times,
finally getting through, then watching the fax machine jam or
disconnect before the entire application is through. One program one
year had a fax that was out of paper for most of the day, so it would
answer but nothing would get through. I highly recommend the e-mail
Put some money aside. Some programs will decide to interview scramble
applicants, sometimes in part to filter out people, but also because
they have to work with you for some years and don't want to get
someone who's going to make everyone (more) miserable. That means
getting a flight for the next day, which will be very expensive,
particularly from a foreign country. I don't recommend this,
particularly since it means you'll be away from the phone if one of
your programs calls. You may not even have enough time to get to an
interview if you are traveling from very far away. You may even
consider being in the US on the day of the scramble, possibly at a
friend's, where you have good phone and computer access. Some good
hotels can also provide this type of service, but they probably won't
let you sit and redial on the fax all day. It's a very expensive
process, as you can see. In any case, you won't be severely hampered
by working from home. An advantage to this is that you will be closer
to the folks who are making phone calls for you.
Lastly in this regard, don't forget to let people know if you actually
match and don't need their help during the scramble. They'll be happy
and relieved for you and themselves.
Regarding fmgamerica.com, even if they were the most reliable service
on the planet, I wouldn't soley rely on them. Too much is at stake.
They can't do anything about busy fax machines or busy phones. They
can't get your advisors to make phone calls for you, which can be one
of the most important factors. You're also putting things into their
hands, which could be disastrous, no matter how good they are. I've
had experiences with the SF Match where they didn't send out letter of
recommendation, etc., and also didn't let me know. I didn't find out
until interviews. Errors and problems will happen, and if you're
relying on them entirely, you won't be in control to fix them or
overcome them as they happy.
That being said fmgamerica.com does9o
They also provide some useful resources. See, for example, their
program listing, which are free:
I recommend having a copy of the list for your field on hand when you
look through the scramble programs to compare your credentials with
the snippets on the list for FMG's.
One advantage of fmgamerica is that they act as a server for your
application. This means that you upload your letters, transcripts,
etc., and you just have to e-mail a link to the programs. This
obviates the need to send big PDF files to everyone, which I think is
an advantage. Of course, you could also just make your own website
and pay much less to have someone act as a server (e.g., cedant.com).
Here is are some example pages from applicants:
I do find it a little suspicious that they don't clearly state their
fees for various services on their website. They do ask you for a
credit card number before they tell you how much they might charge.
They offer $100 off if you send them a bank check. They claim that
this discount is due to fees that they pay for credit card processing
(typically 2-3%). This only makes sense if their service costs in the
range of $2,000-$3,000. This doesn't sound like a high volume,
well-oiled machine for FMG's, particularly since very few applicants
are likely to pay such high fees. You could contact them for exact
There are very mixed opinions about FMG America out there. People
have also raised the concern that FMG has been flooding the various
medical student forums with "testimonials," making it more difficult
to find reliable information and making their claims all the more
dubious. Here are some examples, some of which are likely planted
(which ones no one can say with certainty of course):
Here's an interesting story that sounds believable:
"zoe - 01/05/05 12:33
Currently working in the hospital as a Lab (Tech Aid), and work in
some attorney office as accounting controller, I have very strong
personal statement, and resume too however I have list it the
non-experience in USA on my PS, I think the non-experience generate
the problem for me!!! Any way I do believe in the LUCK Now, my major
problems (I can?t find any externship or observer ship) I have contact
some web- site like FMG America they needs $3,000.00 and I have to go
to another state + Expense like hotel or apartment and etc, Thanks
for you nice feeling"
It doesn't sound like the individual above has actually joined FMG
America, but does state their fee.
I haven't been able to find any substantial number of reliable stories
detailing success with FMG America. Any such stories are particularly
suspect given the accusations that FMG America has been seeding forums
with positive stories.
Multiple Lexis-Nexis and InfoTrack searches turned up nothing on them.
While there are other programs for FMG's trying to get residency
positions in the US, I don't think that any of them are any more
reliable than FMG America in my opinion. I think that for $3,000 you
can do what they do for yourself and more. You can dial a busy fax
machine just as well as FMG America can. They don't have any magic
that can get through the obstacles any better than you can. I also
doubt that they will be sending personalized letters to programs.
Phone calls from people who know you probably go the furthest in
helping you both before the Match and during the Scramble, which are
not part of the FMG America schema.
Have some sort of a backup plan. For example, if you're applying in
Internal Medicine, think about Family Practice. Right now, a large
percentage of positions go unfilled, even in good programs. Other
more competitive fields are very tough. I've come across dozens of
(US) fellowship trained FMG's practicing in other countries who are
starting over as interns in the US so they can practice here. One of
them was a skull base fellowship trained neurosurgeon with 15 years of
practice under his belt, applying for beginner positions in the US.
I hope this information is helpful. I wish you the best at this
difficult time. Hang in there... you will find a position. You may
even surprise yourself and match! Please feel free to request any
clarification prior to rating.