If you’re a fourth-year medical student, March marks the beginning of the next chapter of your medical journey. You’ve been anxiously awaiting the Match results. Even if Match Day ended up not being what you expected and you did not match this cycle, keep your head up! There are other paths forward.
NRMP Match By the Numbers
A successful match year is measured not only by a high percentage of applicants matching into programs, but also by how the applicants’ preferences were met. Medical students are ambitious, so not matching the first time around naturally causes initial shock and disappointment.
If you fall within this category, remember that you’re not alone. Data from the National Residency Matching Program (NRMP) reveals that thousands of students don’t match on their first cycle and either take a year off or go into the Supplemental Offer and Acceptance Program (SOAP). During the 2024 Match, 44,853 active applicants applied to 38,494 PGY-1 positions.
Keep in mind that over 90 percent of U.S. medical school graduates continue to practice medicine within four years of graduating from med school—so keep your head up and keep going!
(This data bodes well for U.S. grads, while IMG grads should check out this IMG post dedicated to you!)
An Action Plan After Not Matching
The great news is that if you’re considering SOAP, the odds may still be in your favor! In 2024, the SOAP had 2,575 positions listed, after which only 176 residency positions remained unfilled—yielding a total match rate of over 99%!
Whether you’re preparing for the SOAP or planning to reapply next Match cycle, here’s our step-by-step guide for revisiting your application.
1. Reflect on your application
Once you’re past the initial disappointment phase, try your best to pinpoint the reason(s) you didn’t match.
Did you…
…have a limited or unbalanced rank list?
If you ranked too few programs or selected mostly highly competitive urban or academic centers, this may have decreased your chances.
…lack sufficient U.S. clinical experience (USCE)?
Many programs, especially in certain specialties, prioritize applicants with hands-on experience in the U.S. healthcare system (if you are an IMG).
…have gaps or red flags in your application?
A lower than specialty-average USMLE score, failed attempt, or unexplained gap in training could have affected your ranking by programs.
…receive less-than-stellar letters of recommendation?
Strong and personalized, specialty-specific letters are crucial. Lukewarm recommendations may weaken your application. If your letter writers were hesitant or provided generic letters, perhaps finding new writers will be of benefit.
…struggle during residency interviews?
Poor communication skills, inability to articulate why you’re a good fit for the program, or improper follow up may have played a role in poor match results.
…apply to a highly competitive specialty?
Some specialties, such as dermatology or orthopedic surgery, have far more applicants than available spots, making it difficult to match, especially against other stellar candidates.
…not meet visa requirements for certain programs?
If you’re an IMG requiring visa sponsorship, some programs may have ranked you lower or excluded you altogether.
2. Diagnose the problem
Reflecting on these factors can help you adjust your strategy for the next application cycle or effectively navigate the Supplemental Offer and Acceptance Program (SOAP). Make sure to have an experienced set of eyes—preferably your medical school’s student affairs dean, specialty mentor or program director—review your ERAS application and personal statement.
Perhaps your exam scores were on the lower side, or your application would have benefitted from additional med school extracurriculars. Once you have help pinpointing the problem, you can work to strengthen your application.
3. Be proactive!
Once you’ve figured out the cause(s), put in the work to address it and bolster your ERAS application!
Take Step 3
If you’re planning on taking a gap year, study and take USMLE Step 3 to prove you can crush standardized national exams.
Since USMLE Step 1 is pass/fail only and you cannot retake a passing USMLE Step 2, scoring well on Step 3 may compensate in case your scores on the previous tests were lower than you wished.
Participate in Research
If you’re aiming for a particularly competitive residency, use the year to seek out research opportunities. Options include laboratory research, a public health or health policy role, or clinical research. First authorship publications are important as are publications in reputable journals.
Talk to residents or fellows who have already matched in the field to find out which is best for your specialty. Then find the right mentor or PI, because a publication in your field can help your cause—especially if you are the primary author or if you or your co-authors present at a national conference.
Volunteer
If research is not for you, think of getting a year of medical experience such as by working in a volunteer clinic. Show your commitment to medicine to program directors, improve upon your exam skills, care for patients and stay up to date on medical knowledge. Alternatively, consider pursuing an advanced degree such as an MBA or MPH with your year off. Doing so will set you apart from traditional applicants. It will indicate to PDs that you will bring a unique perspective and expertise to the residency.
Explore Other Options
Taking a year off is out of the question? Some rural areas in the Midwest allow you to practice straight out of medical school. Most of your work will be primary care in medically undeveloped/underserved areas, and this option is quite new, so constant changes can make it challenging.
Meet With Experts
No matter which part of your application needs improvement, consider meeting with one of our residency consultants!
Our residents and attendings have successfully guided hundreds of students through the Match with personal statement writing help, ERAS application review, interview prep, and more. Get started with a FREE consultation! 💙
Rethink your specialty
Another option is to apply for a less competitive specialty. The NRMP has useful data on specialty matches including average step scores, research publications, students’ standings such as AOA, etc.
Ideally, you can use this information before you submit your application, but you also can check it out afterward to gauge how competitive you are for any given position. Sometimes, the difficult truth is that changing specialties is the right path. If practicing medicine is your true passion, think of multiple specialties you could enjoy, perhaps less competitive ones, to aim for.
Final Thoughts
If you don’t match, you are likely to feel disappointed but don’t give up. Reach out to your support system, whether it’s your mentors, your school deans, or friends and family in the medical field. Press on, and work towards your next steps. Strengthen your skills, knowledge, and application, and you’ll make it through!
