What if you don’t match? 3 things you should do

On Monday, March 11, medical students participating in the 2019 Main Residency Match will find out whether they matched with a program. Those who get the unfortunate news that they did not match and who are then unsuccessful in obtaining a position through SOAP, the Supplemental Offer and Acceptance Program, might wonder what their options are for keeping their dreams of a career as a practicing physician alive. A physician who has worked with unmatched applicants explains how to make the most of the coming year and improve the odds of matching the next time around. 

Margarita Loeza, MD, is a family medicine physician and chief medical information officer at Venice Family Clinic, a community health center in Los Angeles. For several years, she has hired unmatched graduates to work with her in clinic. She has seen firsthand, in both those graduates and her peers, the steps applicants can take to make themselves more attractive to residency programs. 

Dr. Loeza offers this advice. 

Stay in touch with your medical school. “Some [unmatched applicants] will be embarrassed, hide out and not tell anyone, but they ought to do just the opposite,” Dr. Loeza said. “Stay in touch with your dean and others at your medical school and ask them for help. 

“Also, get involved in a research project. Look for mentors at your medical school who are working in the field of medicine you want to work in and volunteer to help.” 

Find a job in a clinical setting. “You have to get a job that helps you keep your clinical skills so you don’t forget medicine,” Dr. Loeza said. “Programs are going to want to know how you kept your clinical skills current, because you sat out a year. 

“As a rule, you aren’t allowed to care for patients unless you’re in a residency, but you can, say, scribe for a doctor. Some states, though—Missouri is one of them—now allow unmatched graduates to work as assistant physicians in underserved areas.” 

But the work does not have to be in direct patient care. Dr. Loeza hires unmatched applicants to work as electronic health record trainers for the clinic’s hundreds of volunteer physicians, residents and medical students. 

Take the USMLE Step 3 exam. “Passing it will make you a more competitive applicant the next time around,” Dr. Loeza said. “Some residents have started intern year and then didn’t pass Step 3, so their program was short a doctor. Passing it will make program directors feel they don’t have to worry about you. 

“A couple years ago, I had two unmatched graduates working for me. One took Step 3 and passed it, and he got 14 interviews. The second student didn’t take Step 3 like I asked him to—he got only one interview invitation and didn’t match. The next year, he took Step 3 and passed, and then he matched.” 

More help is available 

Dr. Loeza also suggests, when the time comes, taking a different approach to applying and interviewing. 

“The Match process and the interview process are expensive, but the second time around, you’ll probably have to apply to even more programs,” she said. “You might also have to apply to more than one specialty.” 


FREIDA™, the AMA Residency & Fellowship Database® (registration required), enables unmatched students to research residencies from more than 11,000 programs both during and following SOAP. Access is free, but extra benefits—such as 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.