Will refusing a prematch affect my chances matching?

Today I was posed a very interesting question on the Facebook page. The question was Will refusing a prematch affect my chances of being ranked high in that program? if you decline a prematch would the program still consider you? This was a great question that required some thinking and here is what I came up with.

Out of the match offers are an abbreviated, compact quick-fix version of the NRMP match where results are almost instantaneous. Prematch offer is a combination of three things -

1. The program in effect has already ranked you at the top (program ranks applicant)

2. they are disclosing that fact to you.

3. Your acceptance of a prematch offer means you ranked the program at the top (applicant ranks program)

Getting a prematch offer begins the dice roll of decisions

If you decline the prematch offer (which means you did not place the program at the top, for what ever reason), it may be (mis)read as not being interested in joining the program/institution/city etc.

Since the program ranked you at the top once and you declined, I would think it would go ahead an open up the spot to someone who may be interested in coming to that program. This may work as such in some cases

However, I have also read about 2 instances on (online forums) where the candidate refused a pre-match offer but ended up at the program anyways. This may be a coincidence or an exception to the norm.

Bird in the hand worth two in a bush conundrum:

This is the problem with out of match offers (prematch), especially so if you are good candidate. You may be offered a prematch from a very low tier program and this leaves you in a dilemma, "Should you settle for something thats less because its certain or should you wait for the good thing but there is no certainty." This is a question that does not have an easy answer and each candidate should weigh in all the pros and cons. The key is to arrive at a decision that you are satisfied with and feel is the best decision.

Final thoughts

Going back to the original question of does refusing a prematch affect your chances of being ranked high by the program? I am of the opinion that yes, it will negatively affect your chances. I am more than happy to welcome other opinions on this matter! please leave comments, thanks!

You can also read up on how to rank programs in the ROL and aspects of an interview that affect ranking of applicants.