As a medical student, there is no guarantee that things will work out according to your plan come Match Day. And when they do not, you may feel as though you’re alone in your disappointment.
In speaking with recent medical school graduates, it is clear that there is a good number of students feeling some form of disappointment after the Match.
“If something feels off or feels wrong, it’s really common, a lot of unexpected things can happen and no one really has control over the algorithm,” said AMA member Laura Halpin, MD, a psychiatry resident at the University of California, Los Angeles, Semel Institute for Neuroscience and Behavior. “The disappointment is a real challenge because most people find out about their match in a formal ceremony and the room is full of people screaming with excitement. It’s easy to feel you failed or did something wrong if you don’t get your top choice.”
According to data on the 2019 Match compiled by the National Resident Matching Program (NRMP), 47% of seniors from U.S. allopathic medical schools got the top choice on their rank-order list—the lowest figure on record—while 72.5% wound up in their top three on Match Day.
Based on that math—which is typical of the breakdown on an annual basis—students are often advised to envision living and training at any of their top five choices prior to Match Day. But for some, it is difficult not to get fixated on No. 1.
As a medical student at Texas Tech University Health Sciences Center School of Medicine, Myphuong Phan, MD, MPH, had her heart set on returning to Houston, her hometown, for residency. But things did not go as planned.
Upon reading her Match letter, she “literally froze for 30 seconds, it was like I was not reading what I was reading,” she said. “I didn’t see ‘Houston’ and I was shocked. I found myself crying and it took a few minutes to calm down and be OK.”
Dr. Phan, an AMA member, ended up at her No. 3 choice, the Family Medicine program at Dell Medical School at the University of Texas at Austin (UT). Instead of being a few minutes from family as she hoped, she’s a few hours away.
Yet, she has found several positives with the structure of her current program. For instance, the program at UT was smaller than her top choices—taking about seven residents per year. She discovered that working with a smaller team of residents creates a solid support system.
“I’m challenged and I’m growing in ways that I’m happy with,” said Dr. Phan. “I do think that the opportunities I have here are different from what I would’ve had at my No. 1 program. I’m part of this brand-new medical school that is establishing itself as innovative, there [are] so many added bonuses with that.”
Dr. Halpin ended up in a program she wanted to go to for general surgery, her preferred specialty in her Match rankings. From the start, however, it just did not feel right.
“On Match Day, I looked around and saw happy people and didn’t feel that happy,” she said. “I didn’t understand what was off at the time. A few months into the program, I realized that (general surgery) wasn’t the specialty choice that I wanted.”
She began to explore the possibility of leaving the specialty. For residents who take this step, Dr. Halpin cautions, you must read your employment contract at your program and with the NRMP. Anyone who matches through the NRMP is required to remain in the training program for 45 days after their contract takes effect. Failure to do so could prevent an applicant from being able to re-enter the Match.
Eventually, with help from her medical school advisers, Dr. Halpin identified psychiatry as her preferred specialty. She left her first residency program and re-entered the Match. The following spring, she wound up matching with her current program.
“My Match Day the second time around was me at work opening an e-mail,” she said. “I was super excited, but it wasn’t the same.… In the end, the place I’m at now is a perfect fit for what I want to do as far as specialty and career.”
Typically, around 5% percent of U.S. allopathic medical school graduates experience the disappointment of not matching—in 2019 the number was 6%. The Supplemental Offer and Acceptance Program (SOAP) is a vehicle through which eligible unmatched applicants in the Main Residency Match apply for and are offered positions that were not filled when the matching algorithm was initially processed. The Friday before Match Week all Main Residency Match applicants receive an email notification of their SOAP eligibility. SOAP is a service of the NRMP.
FREIDA™, the AMA Residency & Fellowship Database® (registration required), enables unmatched students to research residencies from more than 12,000 programs both during and following SOAP. Access is free, but extra benefits—such as a dashboard that helps users save, rank and keep notes on each program—are available to AMA members.
In addition, the AMA provides resources to help recent medical graduates obtain their medical licenses, study for licensure exams and support legislation to increase the number of graduate medical education positions.