I Didn’t Match, Now What?

You didn’t match. When it comes to finding a residency program for the next step in your education, nothing is more frustrating than receiving the message of unmatched MD. What does it mean? More importantly, what do you do next?

What Does It Mean to Be “Unmatched MD”?

If you received the unfortunate news that you do not match with a residency program, you may be unsure what that really means. Being unmatched means that, although you may be ready educationally for a residency position, you did not qualify for one or match with one right off the bat. This means you were unsuccessful in obtaining a position through Supplemental Offer and Acceptance Program (SOAP). Can you still become a practicing physician?

It is possible to move forward, but it often takes making the most out of the year that is ahead. That way, you may be able to increase your chances of securing a position in the next opportunity. Improving your odds is possible, but it’s critical to take this path seriously.

How Common Is It to Not Matched?

It is rather common for some people not to match into a residency right away, especially the first time around. If you ask some of the doctors you know, you surprise yourself by how many of them had this happen to them before they enter into a residency program in the coming years.

Match Day, as it is often called, is a day when medical students (thousands of them across the country) wait to find out what they will do next and how they will train in residency. As noted, it is not that uncommon to not match.

Read this: Residency Salary Guide for New Physicians

How Many Medical Students Don’t Match Initially?

Here’s a look at some statistics from 2019 data. That year, 38,376 people applied for residential matching. About half of these people were medical students in their fourth year that were working towards earning their MDs. Of those applications, 79.6% of all applicants, or 93.9% of the fourth-year medical students, matched. That means they made it into a first-year residency program.

Now, that means that as much as 20% of all applicants, or 1 in 5, or 1 in 16 of all medical students in their fourth year, learn that they did not match. No matter how common it may feel, it’s simply not an easy thing to hear – you want to get into a program to start building your skills, and you don’t want to be an unmatched MD.

Keep in mind that it is harder than ever to be matched – and that’s not necessarily your fault. The number of medical school positions are increasing quickly, and the number of residency positions are not moving as fast. That means that while you may find yourself as an unmatched MD right now, it may be a numbers game. As you work towards finding your next step, do not take being unmatched as a negative or any sign that you cannot be a medical provider. It simply means your path may be a bit different.

How many of those go on to get matched eventually?

It is somewhat common for people to eventually get matched. The key is to know that the process is not just a one time thing. If you do not match during the Main Residency Match, you are then able to apply for SOAP. There are three rounds during that initial matching week. During that time, an unmatched MD can apply and connect to residency programs. In most cases, residency programs will place students during this process.

The most common reasons why a student may match initially are important to understand. Often, they are not related directly to the student’s background. They could be a result of the following:

  • The program did not rank the student
  • Another applicant (or applicants) already filled the program
  • The program withdrew from the Match

No matter when this happens or who it happens to, the stress is very real and can be overwhelming. Knowing that you are not the only one can give you a bit of peace of mind. The good news is that your educational program within your medical school will have a clinical education department that is tasked with working closely with you throughout this entire process. You are not left on your own to manage it.

Here’s a bit more about what happens to those who do not match. In 2021, the matching program offered 38,106 positions. The initial Match led to 36,179 connections – those positions were filled initially. That is about 94.9% of an initial fill rate.

That also means 1,892 positions were not filled. These entered the SOAP round process. After that three round process occurred, there were 119 positions that were still unfilled. That means that 99.6% were filled at that point.

That year, 99 percent of fourth-year students who were seeking GME were placed into a residential program. Considering these factors, there’s a very good chance that you will find a position in the process.

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How to Use SOAP

As noted, SOAP is a type of lifeline designed to provide students with the support they need throughout the Matching process. It is a uniform system for programs that has a range of unfilled positions that are available to MDs who are unmatched but eligible to work or those who partially matched.

To use SOAP, you must first register for the Main Residency Match process. You do not register separately for SOAP. Rather, you must register for the initial Match, and if you do not make it in that initial round, you are automatically a component of the SOAP process. You must be eligible to move forward with the process.

During this week of rounds of matching, you can expect there to be telephone or email interviews completed by programs. It is not uncommon for applicants to need to dedicate a significant amount of time to interviewing and working through this process. Video interviews and short phone calls are not uncommon. In some situations, there may be local, in-person interviews available depending on the program itself.

You do not have to do much of anything else during this process. The programs that you applied to have access to your application through all of the rounds. That means you do not have to reapply to them. If you do have any unused applications from the first 45 that you were originally able to use, you can still complete them. You can do that for any unfilled programs currently available that you are interested in being a part of, even if you did not apply to them prior to this point.

Read this: Pros and Cons of a DO vs MD

What Other Options Are There If You Decide Not to Pursue Matching?

There are some situations in which you may be thinking about doing something other than a residency program through this process. If you are an unmatched MD – and you want to get started on your educational path – you may have a few other avenues to consider, especially if you plan to wait until next year to reapply for matching. Here are some considerations.

Work in a clinical setting

The key is to work in a field that you are able to that allows you to keep and maintain your clinical skills. That way, you are practicing your skills and remaining sharp while also getting more of the training and experience that you need. It is very common for programs to look the other way if you try to apply again later if you have not done anything in the previous year.

What can you do? You do not have to work in direct patient care to make this time matter. You may want to work in electronic health record training in a clinic. Another option is to work as a scribe for a doctor, which can open the door to new opportunities and help you get some of the experience in the clinical field you need. Check out our article on Moonlighting Medical Residents: Side Gigs to Make More Money for even more ideas.

Work with your medical school

It is also very important to maintain contact with your medical school. They have the resources and tools to help you get into a program, or if that does not happen, they can help you improve your odds for the next year.

It is not uncommon for MDs who are unmatched to feel as though they are inferior, and they may not want to tell anyone. However, that is the opposite of what you should do. Rather, work with your dean and others at the medical school to find a program to get your foot in the door. Asking for help can open doors for you. It may mean getting involved in a research project or turning to mentors for additional guidance.

Consider taking the U.S. Medical Licensing Exam

Also known as USMLE Step 3 test, you can and should consider taking this exam now even if you have not done a residency program. The key reason for this is because the test is very in-depth in clinical knowledge. It is a deep dive into decision making, and because of how detailed it is in the core disciplines of medicine, you certainly want to take it when you are most prepared to do so, such as when your education is fresh in your mind.

You can also benefit in a number of ways by taking this test now before you head into your residency. For example, if you pass the test now, that helps you to look like an impressive choice for the next Matching round. It allows you to showcase your skills and knowledge in this field, helping you to stand out from other applicants. This is perhaps the best way for you to get more interviews and into the program.

What Can a Medical Student Do to Increase the Likelihood of Matching?

When you do not match into a residency program, you may need to step up the work you do between now and the next round to give yourself the best possibility of getting into a program. Here’s a look at what you should do now:

  • Start with SOAP if you are eligible.
  • Meet with the medical school to find out about any paid research positions available to you.
  • Talk to senior residents and fellows as a resource. They may have information and opportunities for research programs or openings at other programs that you may qualify for – network.
  • Start using LinkedIn and other resources like this to connect with people who are likely to have opportunities. The more well-connected you are online, the more likely you are to find an opportunity. Remember that when you are interviewing in the next rounds, it is likely that the person doing the interviewing is going to look at your LinkedIn and other networks – do the work now to build up those connections and ensure your pages showcase the benefits you bring to the table.
  • Cold call residency programs. If you really want in, get on the phone and call some of the programs you know about to learn what options may be available.

The key to your future is for you to engage it. Working hard to improve your interpersonal skills and boosting your interviewing abilities can help you as well. Work to refine any areas where you know you stumbled so you can make a better impression next time.

Related: Top 12 questions to ask during your residency interview

Unmatched MD: Getting on Track Is an Option

It is always a good idea to use compensation providers to help you evaluate an employment opportunity. Even if you are not in a residency program just yet, this is an opportunity for you to dive into new opportunities in the field. Physicians Thrive is an expert in Contract Review. We can help you with all aspects of your contract for that employment position. Take a few minutes to learn more about our contract review services.

Read this: Saving & Investing In Your Family’s Growing Years

Take Your Future in Your Own Hands

If you are ready to start achieving your goals, download our Physicians Thrive Compensation Report. We have scoured all of the available compensation reports and summarized the information into one easily digestible report. Use it to help you plan your next move.


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