You Didn’t Match into Residency – Now What?

Every year, 4th year medical students wait anxiously for Match Week to find out if they matched into a residency program. This special week is a significant  milestone in every medical students’ career in medicine. During Match Week, social media feeds are filled with students celebrating their own successes. For some, however, Match Week may not turn out the way they had hoped it would. If you received the news that you didn’t match into any residency programs, it is not the end of your journey to becoming a physician. Here are some steps you can take to reach your goals.

Looking for more advice on surviving your time before, during, and after residency? Download our free eBook, A Complete Guide to Medical Residency.

Remember You are Not Alone

While it is easy to feel like you are the only medical student who didn’t match into residency, the truth is that you are far from alone. According to the National Resident Matching Program numbers, each year thousands of medical students do not match. During the 2023 Main Residency Match, there were 42,952 applicants with only 37,425 positions available. There are simply not enough open positions to meet the growing demand among medical students. Remember that you are not the first, and you will definitely not be the last, medical student to not match.

Participate in the SOAP Program

If you didn’t match anywhere and are eligible to participate in the Supplemental Offer and Acceptance Program (SOAP), you must act fast to take advantage of this option. Through the SOAP system, eligible unmatched applicants in the Main Residency Match may apply for up to 45 programs to try to obtain unfilled residency positions that were not filled when the matching algorithm was initially processed. 

The SOAP window opens at 12:00 PM EST the Monday of Match Week and closes at 3:00 PM EST on the Thursday of Match Week. Programs may begin contacting applicants and setting up interviews as early as Monday at 3:00 PM EST so remain alert for any calls or emails.

Offers are made in a series of four rounds starting on Wednesday through Thursday, each lasting two hours, during which applicants can accept or reject offers they receive.

If You Don’t Match During SOAP

Struck out in SOAP? You can still be a doctor. Keep that in mind, but your road is going to be unpaved and requires a lot of legwork. Once SOAP concludes on Thursday at 3pm, the final list of unfilled positions including programs that didn’t participate in SOAP will be made available in R3. During this time, you may contact programs on the list directly about their unfilled positions.

Contact Your Medical School

Another option is to go back to your medical school and ask for a transitional slot. This will give you the opportunity to mimic an additional fourth year of school and you can re-apply for the Match in the next year.

You can also talk to your school about a potential research fellowship for a year. During this time, you can do research in the specialty that you are interested in so you become a more competitive candidate in the next year’s match.

Thinking about earning an additional degree? It may seem extreme, but if you go for a second degree you become very valuable all of a sudden to a Resident Program.

Address Your Weaknesses

Don’t be afraid to ask your network for help. Reach out to your academic advisor or program director to go through your application and personal statement and see where you can strengthen it, either with extracurricular activities or additional research experience. Your mentors can also help you optimize your program list for the next round. 

Take the USMLE Step 3

Most students choose to take the USMLE Step 3 during their residency. However, if you didn’t match into residency, passing Step 3 early can help your next applications, especially if you underperformed on Step 1 or 2

Take Care of Yourself

When you have spent your life dreaming of becoming a doctor, not matching into residency can be devastating. While you may feel embarrassed or disappointed, you may not feel like telling anyone the bad news, but make sure to reach out to your support system. Your friends and family can offer the love and support you need. 

Taking a little time for self care is important right now. Don’t be afraid to sit back and breathe for a moment while you figure out your next steps.

Not matching into a residency can be heartbreaking. But if a career in medicine is truly something you want, this is just another bump on the road to success. Take advantage of this time to grow into a stronger applicant. Your future self, and future patients, will thank you.

Want more insight about the road to medical residency? Download our free eBook, A Complete Guide to Medical Residency.

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