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A question from a colleague

This an easy question if you are offered a prematch from you favorite program, or you only have 1 or 2 interviews.

But if you have several interviews, and this program is in the middle or lower down in your list of preferences then you face the dilemma of prematching into a less favorable program, and missing the chance of doing better in the match with the risk of going into match and not matching at all and losing a whole year.

This advice might help:

1. The Program that offered you the prematch If you don't mind working in that program for 3 long years, AND the other factors such as location, fellowship chances etc. are acceptable then you should probably accept it.
2. The other programs that invited you for interview, Ideally, you would have seen all the programs before you get offered the prematch but that doesn't usually happens, when offered a prematch the program gives you a short period of time before they withdraw the offer and give it someone else who will take it in a heartbeat. So what you should do when offered a prematch is assess your chances of matching in the other programs even if you haven't gone there yet, if you are positive that your chances are excellent then you might consider taking the risk of going into the match. 
3. Personalized Advice Talk to people who have gone through the prematch, and even better those who are currently working in the program that offered you a prematch, that will be helpful in your decision making. Obviously, everyone gives their own prespective which may or may not be applicable to you. 
4. Caveats:

• IMG Match rates are low in the 50%, so the risk of not matching is real, however this greatly varies from one person to another
• If you want to do fellowships in GI/Cardiology, your chances of getting them depend on where you did your residency. So prematching into a small community program will make you struggle A LOT to find a cardiology/GI fellowship, while foregoing that and matching (in the match) into a big university program will make your subsequent fellowship application much easier.