So You Did not MATCH: A Guide to the USMLE Residency Re-applicants

The USMLE Residency MATCH is highly competitive. There is a high financial burden that the applicants face, including thousands of dollars spent towards the USMLE exams, securing and completing clinical rotations, multiple visits to the US, and the exorbitant application fee. However, 38.6% of US citizen IMGs and 41.9% of non-US citizen IMGs fail to match into any specialty yearly. If you did not match into residency, it is natural to find yourself stranded, not knowing what to do next.

So Did not MATCH: Where Do I Begin?

Failing to match into a residency program can be a painful experience for USMLE aspirants. However, it is essential to remember that this is not the end of the road. If you find yourself in this challenging spot of deciding to apply next year, there are many steps that you can take to increase your chances of matching in the next cycle. In this article, we will explore what to do if you did not match into a residency program, and how to improve your chances of matching into the residency program of your choice.

Evaluate Your ERAS Application

The first step in preparing for reapplication is thoroughly evaluating your application, CV, and personal statement. This includes looking for areas that could be improved and seeking feedback from mentors, colleagues, or even people who interviewed you during this season. During this process, it is essential to be honest with yourself and identify any gaps in your clinical experience or areas that need more focus.

For example, if your personal statement lacks clarity or direction, it may not effectively communicate your strengths and goals to program directors. Residency program directors look for well-rounded applicants and a CV that tell a story about a person. If certain parts of your application are lacking, such as leadership experiences, etc., then focus on improving those aspects for the next match cycle.

Re-evaluate Your Choice of Specialty for Residency

When I started, I was dead set on Emergency Medicine as my specialty of choice. I thought being an emergency physician is the only way to find happiness and satisfaction in a career. It turns out I was wrong. After I went unmatched for one cycle, I reapplied and was matched to Internal Medicine, where I am extremely happy. I just matched into a competitive subspecialty fellowship that fits my passion and dreams. Hence, it is worth reconsidering the competitiveness of your chosen specialty and the programs to which you are applying.

There are things in your application that you can change, such as research experiences and publications. However, other things, such as where you went to medical school or your step scores, are not changeable. Hence, reassess your competitiveness for the specialty you are planning to reapply. Trust me, happiness can be found in any specialty, and it is merely a matter of having the right mindset and open attitude to learn.

Network with Residents and Attendings

Networking is an essential aspect of the residency application process, and it can be especially valuable for USMLE aspirants who have failed to match. Reach out to residents and attendings in the fields you are interested in and ask for informational interviews or advice. Attend residency fairs, open houses, and other events to meet program directors and learn more about their programs. Doing this can help you build relationships and better understand what each program is looking for in applicants.

In addition to attending events and meeting with residents and attendings, consider reaching out to alumni from your medical school or former classmates who have successfully matched into residency programs. They may be able to offer advice and insights into the process and can also be a valuable resource for information on specific residency programs or specialties. They may also help you put your foot in the door and get you interviews, come the next cycle.

Consider Alternative Pathways

Alternate career paths can include research positions or subspecialty fellowships. These opportunities can provide valuable experience and help you stand out in the next residency application cycle. After I went unmatched for one cycle, I worked as a research trainee for one year, which was immensely valuable and strengthened my CV for the next application cycle. Research positions can offer hands-on experience in a specific area of interest and can help demonstrate your commitment to the field. This experience can also be valuable for your personal and professional growth, providing additional networking opportunities and exposure to different career paths. The training from your research year can also be invaluable during residency. The publications will help your residency application and also your fellowship application if you choose to apply for one years down the line. Besides, you also develop lifelong relationships with research mentors that can be invaluable.

Subspecialty fellowships can provide a focused and intensive learning experience in a specific area of interest. For example, suppose you are an international applicant and have completed a residency in your home country. In that case, you may be eligible to apply to certain less competitive subspecialty fellowships (such as Nephrology) in the United States. After completing your subspecialty fellowship, you can apply again for a residency, but this time with a more competitive application. This can be especially valuable if you want to specialize in a particular field and will help you stand out in the next residency application cycle.

Gain Additional Clinical Experience

Consider volunteering at a clinic or doing observerships to increase your hands-on experience and boost your CV. This will demonstrate your commitment to the field and make you a more competitive candidate in the next residency application cycle. It is crucial to prove that you spent this gap year in your CV wisely, and findings ways to work in a clinical setting will convey to the program director that you haven’t lost touch with the clinical aspects of medicine. If you can find ways to obtain clinical experience (externships, observerships, etc) in a hospital with a residency program, by working hard during that time, you can make a stronger case for your application when the next interview cycle arrives.

Participate in Continuing Medical Education (CME) Courses and Conferences

Continuing medical education (CME) courses can help you stay current with the latest developments in your field and demonstrate your commitment to professional growth. Consider enrolling in online courses or attending conferences in your area of interest. These opportunities can help you expand your knowledge and skills and can also provide opportunities for networking and building relationships with other healthcare professionals.

Publish Peer-Reviewed Research

Conducting research and publishing articles can also help improve your CV as a USMLE residency reapplicant. Engaging in research projects can demonstrate your dedication to advancing your knowledge and skills, and can also help you develop a deeper understanding of the issues and challenges facing your field. Additionally, publishing articles in peer-reviewed journals can increase your visibility and credibility as a healthcare professional, and can also demonstrate your ability to work independently and contribute to the academic community. When conducting research, it is important to choose projects that align with your interests and career goals, and to collaborate with experienced mentors who can provide guidance and support.

Stay Positive and Maintain a Growth Mindset

It can be discouraging to fail to match, but staying positive and maintaining a growth mindset is important. Seek out support from family, friends, and colleagues, and focus on the steps you can take to improve your chances of matching in the next cycle. Remember, the residency application process can be competitive, and it is not uncommon for applicants to fail to match on their first try. However, where there is a will, there is a way. This minor setback does not define you as a person, and having faced this roadblock, you will consider yourself much more equipped to face challenges in other facets of life as well. Please refer to our USMLE applicant guide for the IMG and the residency interview preparation guide if you found this article helpful.