Who Should I Ask to Review a Pre-Match Contract Before Signing?

Most residents ask the wrong person to review their pre-match contract—and it costs them.

You do not need more opinions. You need the right eyes on that contract before you sign something that controls your next 1–3 years (or more, if there’s a payback clause or non-compete).

Here’s the answer you’re looking for: you should ask a healthcare/physician employment attorney to review a pre‑match contract first, then selectively loop in others depending on what you’re worried about—money, visa, career trajectory, or red flags in the program’s behavior.

Let’s break that down so you know exactly who to ask, in what order, and what each person is actually useful for.

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1. Start with the only non‑negotiable: a healthcare/physician attorney

If you remember only one thing from this article, remember this: do not sign a pre‑match contract without an independent attorney reviewing it.

Not your uncle who “does real estate law.” Not your friend in corporate M&A. A healthcare/physician employment attorney. Ideally one who routinely reviews residency and fellow employment agreements.

Why? Because pre‑match contracts can include:

• Early commitment language that affects your NRMP participation
• Penalties for withdrawal (repayment of bonuses, relocation, stipends)
• Non-compete or geographic restriction clauses (yes, even some GME contracts try it)
• Work-hour expectations that quietly blow past ACGME norms in practice
• Moonlighting restrictions (important if you’re counting on extra income)
• Malpractice coverage details that affect you after you leave

A generalist lawyer may understand contract structure but miss how these pieces play out in GME and licensure.

Here’s what a good healthcare attorney will actually do for you:

1. Translate legalese into normal language:
   “This paragraph means if you back out, you owe them $15,000 plus relocation costs.”

2. Flag high‑risk clauses:

   • Automatic renewal without clear exit
   • One-sided termination (they can fire you easily, you can’t leave easily)
   • Liquidated damages that are essentially a financial trap

3. Check for conflicts with NRMP rules:
   Some pre‑match offers exist outside the Match (e.g., military, some prelims, certain specialties). Others can create NRMP violations if handled incorrectly. You want someone who knows that terrain.

4. Tell you what’s normal vs predatory:
   I’ve seen residents think a clause is “standard” because a PD said so. It wasn’t. It was just standard for that exploitative hospital system.

Cost: typically $250–$600 for a contract review, depending on region and complexity. That feels painful when you’re a student or intern. It’s cheap compared to:

• A year in a toxic program you can’t easily leave
• Paying back a “signing bonus” plus moving costs
• Being blocked from working in a region because of a non‑compete

Bottom line: First ask a healthcare/physician employment attorney. Everything else is optional; this is not.

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2. Who else is useful—and who isn’t

After you have legal eyes on it, you can selectively add other reviewers depending on what you need.

Reviewer Type	Primary Use
Healthcare/Physician Attorney	Legal risk, enforceability
Trusted Senior Resident/Fellow	Reality check on workflow
Specialty Mentor/Program Director	Career & training implications
Financial Professional (CPA/Planner)	Taxes, benefits, loan strategy
Immigration Attorney (if on visa)	Visa and status implications

A. Trusted senior resident or fellow (in that program or similar)

You’re not asking them to “review the contract” legally. You’re using them as a truth serum.

They can tell you:

• Whether the call schedule in the contract matches reality
• If “typical” clinical hours are actually 80+ every week
• If people get the promised OR time, clinic volume, or subspecialty exposure
• How the program handles pregnant residents, illness, remediation

How to use them effectively:

• Send them the schedule/call/rotation portions only
• Ask specific questions:
  • “Does this look realistic?”
  • “Anything here that doesn’t match what actually happens?”
  • “Would you sign this again knowing what you know now?”

What they cannot do: protect you legally. Do not let “the chief said it’s fine” substitute for an attorney.

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B. Specialty mentor or external program director

This is about career implications, not clauses.

Ask an attending or PD you trust, preferably not affiliated with the offering program, to look at:

• Duration and type of commitment (e.g., 1-year prelim vs 3-year categorical vs integrated program)
• Training structure: enough volume, case mix, supervision, research exposure
• Board eligibility and reputation: “If I train here, will this hurt or help me for [X] fellowship/job?”

Questions to ask them:

• “If I take this pre-match, does it close doors later?”
• “Would this be a red flag to fellowship directors?”
• “Compared to typical contracts in this specialty, anything concerning?”

They’re not lawyers, but they do know how certain arrangements look on a CV and in fellowship discussions.

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C. Financial professional: CPA or fee-only financial planner

Most residents underestimate the money side because they’re just grateful to have an offer. That’s how they get stuck in terrible deals.

A financial professional can help you:

• Analyze the real value of:

  • “Signing bonuses” (often with strings attached)
  • Loan repayment promises
  • Relocation money and clawback terms

• Understand tax impact:

  • Bonus all in one year vs distributed
  • State tax differences if you’re moving
  • Whether any benefits are actually taxable income

• Check cash flow reality:

  • Salary vs cost of living in that city
  • Whether moonlighting restrictions kill your backup plan

You do not need a long-term advisor just to review one offer, but a one-time consult can be useful if:

• You’re supporting a family
• You’re comparing multiple pre-match offers in different cities
• There are complex benefits or loan pieces attached

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D. Immigration attorney (if you’re on a visa)

If you’re on J‑1, H‑1B, or anything not straightforward, do not guess. Do not rely on the program’s “international office” only.

An immigration attorney should specifically check:

• Whether the position and employer can sponsor your specific visa type
• Timing issues: will there be gaps in status between med school and residency start?
• Two-year home residency implications (for J‑1) and future waiver options
• Whether geographic limitations in the contract could hurt a future waiver job

Immigration is one of those areas where residents routinely get burned because they trusted verbal assurances from HR.

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3. Who you should not rely on for actual contract review

Some people are good for emotional support, but not for binding commitments.

Be cautious relying on:

• Medical students or co‑interns
  They mean well but usually have no clue what’s enforceable or normal. Comparing notes with classmates is fine; using them as authority is not.

• Family or friends who are lawyers but not in healthcare/employment
  Corporate, real estate, criminal defense, patent—these are not the same as GME/employment law. They might miss key risk points unique to physician contracts.

• Hospital HR or GME office
  They work for the institution, not you. They’re useful for clarifying wording, but not for giving you objective advice on whether you should sign.

• The program director or coordinator
  You can ask questions, but don’t treat their answers as protection. If it’s not in writing in the contract (or an official addendum), it basically does not exist.

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4. How to sequence the review process (step-by-step)

You don’t need 12 people in the loop. You need the right 3–4, in the right order.

Pre-Match Contract Review Sequence

Step	Description
Step 1	Receive Pre-match Contract
Step 2	Initial Read Yourself
Step 3	Healthcare Attorney Review
Step 4	Immigration or Financial Review
Step 5	Trusted Resident/Fellow Input
Step 6	External Mentor or PD Input
Step 7	Clarify Terms with Program
Step 8	Decide to Sign or Decline
Step 9	Visa or Complex Money?

Here’s the practical timeline:

1. Day 0–1: Your own read-through
   Mark anything you don’t understand or that feels off (hours, penalties, vague language).

2. Day 1–5: Attorney review
   Send it to a healthcare/physician attorney. Many can turn it around in a few business days. Ask them for:

   • A summary in plain English
   • A list of suggested edits or questions to send back to the program

3. Day 4–7: Resident/fellow reality check
   While attorney work is in process or just after, send the call/rotation portions to a trusted resident or recent grad.

4. Day 5–10: Mentor/fellowship PD perspective
   Send the cleaned version (with your highlights) to a mentor: “Would you sign this if you were me?”

5. Any time in parallel: Immigration/financial if applicable

6. Before deadline: Clarify with program
   Go back to the program with specific questions or requested changes. Example:

   • “Can we remove or cap the repayment obligation to X months of salary?”
   • “Can we clarify that call will not exceed X per month except in emergencies?”

Document everything by email.

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5. What to prioritize if you can only involve 1–2 people

Reality: some of you will be short on time, money, or both. Here’s the triage:

• Absolute minimum:

  1. Healthcare/physician employment attorney.

• If you can add one more:

  2. Senior resident/fellow in that program (for ground truth).

• If visa-dependent:
  Swap the resident for immigration attorney if you absolutely must choose. Legal status > schedule annoyance.

If your situation is:

• First match attempt, normal USMD/DO, no visa issues:
  Attorney + resident/fellow is usually enough.

• Re-applicant, SOAP trauma in the past, desperate to secure a spot:
  You’re at higher risk of signing something bad out of fear. Attorney is non-negotiable; add a mentor who will be brutally honest with you.

• Early pre‑match from a less-than-stellar program while you’re still waiting for interviews:
  You especially need an external mentor/PD to tell you whether you’re selling yourself short.

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6. Red flags that should push you to get even more scrutiny

If you see any of these in your pre-match contract, stop and make sure a qualified attorney has eyes on it:

Common Red Flags in Pre-Match Contracts

Category	Value
Large Penalty	80
Non-compete	60
Long Commitment	70
Ambiguous Call	75
Moonlighting Ban	65

• Large penalty or “liquidated damages” if you withdraw or fail to start
• Non‑compete language, especially with specific mileage radiuses
• Commitment > 1 year with no clear resident-initiated termination clause
• Extremely vague language about hours, call, or rotation sites
• Moonlighting banned without reason in a setting where others can moonlight
• Anything that seems to pressure you not to participate in NRMP when you are supposed to

The more of these you see, the more you need someone experienced on your side.

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7. Quick comparison: who does what for you

Reviewer	Legal Protection	Reality Check	Career Impact	Money/Taxes	Visa Status
Healthcare Attorney	Strong	Moderate	Low	Moderate	Sometimes
Senior Resident/Fellow	None	Strong	Moderate	Low	None
Mentor/External PD	None	Moderate	Strong	Low	None
Financial Professional	None	Low	Low	Strong	None
Immigration Attorney	Some	Low	Moderate	Low	Strong

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FAQs

1. Is it really necessary to pay for an attorney for a residency pre-match contract?

Yes. You’re committing years of your life and potentially thousands in penalties if you back out. A few hundred dollars up front to avoid a bad deal is rational, not excessive. I’ve seen residents spend more on a single weekend trip than on someone protecting their entire training.

2. Can I ask the program for time to have the contract reviewed?

Absolutely. A reasonable program expects this. Say something like, “I’m very interested and would like to have this reviewed by an attorney. Could I have until [date] to get back to you?” If they pressure you to sign immediately, that’s a red flag in itself.

3. My friend who’s a lawyer offered to look at it for free. Is that enough?

If they’re not experienced in physician/employment/healthcare law, it’s risky to rely on them alone. Best case: they catch some generic contract issues. Worst case: they reassure you about something that’s standard in, say, corporate work but toxic in GME. You can combine their free review with a shorter paid consult from a specialist.

4. Should I let my parents or partner read the contract too?

Sure, but for values and lifestyle, not legal advice. They can help you think about hours, location, safety, and family planning. They can’t tell you if a clause is enforceable or whether it’s normal in your specialty.

5. What if the contract looks “standard” and similar to what friends got?

“Standard” doesn’t mean safe, and it definitely doesn’t mean optimal. Hospitals often reuse templates that are tilted in their favor. Friends may also not know what’s problematic. Treat “it looks standard” as a starting point, not a green light to skip professional review.

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Key points to leave with:

1. A healthcare/physician employment attorney is the one person you should always ask to review a pre‑match contract before signing.
2. Layer in a trusted resident/fellow and an external mentor/PD for reality and career impact, plus immigration/financial experts if relevant.
3. Do not confuse verbal reassurance or “standard language” with protection. If it matters, it needs to be in writing—and reviewed by someone whose job is to protect you, not the program.