If you are a fourth-year medical student, March marks the beginning of the next chapter of your medical journey. You have 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 plenty of options to consider. 

Take a breather!

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 are not alone. Data from the National Residency Matching Program (NRMP) reveals that thousands of students do not match on their first cycle and either take a year off or go into the Supplemental Offer and Acceptance Program (SOAP). During the 2020 Match, 44,959 applicants applied to 37,256 positions, and with the substantial increase in medical schools across the US, more students will naturally go unmatched.

Remember that about 95 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!

Diagnose the problem

Once you’re past the initial disappointment phase, pinpoint the reason(s) you didn’t match:

1. 1. Have an experienced set of eyes—preferably your medical school’s dean or local program director—review your ERAS application and personal statement.
2. 2. Perhaps your exam scores were on the lower side, or your application would have benefitted from additional extracurriculars.
3. 3. Maybe your academic standing was lower in comparison with peers applying to the same competitive specialty.
4. 4. Or, you may have needed additional assistance with your residency interview skills.

Be proactive!

Once you’ve figured out the cause, work to address it. Take an extra year to bolster your ERAS application. Study and retake USMLE if your initial scores were not competitive enough. Gain experience to improve your personal statement. Meet with one of our residency consultants to hone your interview skills. Overall, don’t be afraid to ask for help.

Furthermore, consider checking USMLE Step 3 off your to-do list. Program directors favor applicants who have passed Step 3 as it’s a hurdle you’ll have to conquer during residency otherwise. Also, scoring well on Step 3 may compensate in case your scores on the previous tests were lower than you wished. 

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.

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. 

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.  

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.  

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. Sometimes, the difficult truth is that you are not competitive enough and need to change specialties. If practicing medicine is your true passion, think of multiple specialties you could enjoy, maybe less competitive ones, to aim for.

Lastly, if you happened not to match and are eligible, you should consider participating in SOAP.

If you don’t match, you are likely to feel disappointed but don’t give up. Reach out to your support system. Press on, and work towards your next steps. Strengthen your skills, knowledge, and application, and you’ll make it through.