Unmatched After Match Day -- What's Next?

Beth Skwarecki

Disclosures

February 10, 2017

Ending Match Day without a residency doesn't signal the end of your career, even if it may feel that way at first.

"To get to that point and want to match, and not match, can be a moment of deep disappointment and a lot of soul searching," says Rael Mazansky, MD, who cofounded the Drop Out Club, a website for students who leave medicine. "It can be a moment of deep despair as well; you spent the past 7 or 8 years preparing for this moment and it doesn't arrive."

According to the National Resident Matching Program (NRMP), more than 26,000 students matched in 2016, including 1022 during the Supplemental Offer and Acceptance Program, which occurs in the days following Match Day. Those students together filled 99.5% of the available positions. But nearly a quarter of students ended Match week without a residency—8640, to be exact. The most competitive specialties were reported to be dermatology, orthopedic surgery, radiation oncology, and vascular surgery.

While the future is set for those who match, some students who don't match decide to leave medicine altogether; others regroup and reapply a year or two later. "I took probably 1 to 2 weeks to myself, just accepting the fact that I didn't match," says Wilnise Jasmin, who later reapplied and had success. Jasmin is now a chief resident in family medicine at Loyola University Medical Center.

What comes next for those who finished Match Day matchless?

Making the Next Move

"Do some soul searching to see what you really want to do," says Chandler Park, MD, who advises students at the University of Louisville School of Medicine. "It really boils down to prioritizing what's most important."

If a student has his or her heart set on a certain specialty but didn't get into that specialty during the initial match, Park recommends casting a broader net by looking for unfilled PGY1 internships in a program that also has a residency in the desired specialty. From there, the student can try to make a good impression on the program director. "During the internship, you have to impress the attendings by coming in early and staying late. It is an audition for a strong letter of support and also an audition to stay at that program." He cautions that you have to make your impression quickly because you will be applying again by fall.

Most students must reapply later if they still want to do a residency, and they should consider either a less competitive specialty or a broader geographic range. Jasmin originally listed about a dozen family medicine residencies in and around New York City, where she is from. When she applied again the following year, she expanded her list to about 50 from all over the country. According to the National Resident Matching Program, the average applicant who matched listed 10.6 programs. The average unmatched applicant had only 4.7.

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