Part 1: How I Went from an Unmatched Medical Student to Matched Medical Graduate

“We are sorry, you did not match to any position.”

I read these words after just completing a 24-hour shift on the internal medicine service at the hospital. I was exhausted but it was Match Day; the day I found out whether all my efforts - the 10+ years of schooling and countless late nights - had been worth it. The night before, I was a nervous wreck. Something in me was preparing for the worst to happen and I just couldn’t shake it off. As I sat in the hospital parking lot early that morning and read those words, I felt…numb. Almost as if it wasn’t real.

I immediately called my partner and broke the news. He was devastated. I got off the phone with him and proceeded to call my mom. She was shocked. I tried to comfort both her and myself by saying that it would be OK, that I still had a chance to match somewhere that same week.

For those of you who don’t know how the MATCH process works, I will briefly explain. During the fourth and final year of medical school, students apply to residency programs to complete their training in their chosen specialty. They go through a grueling process of trying to prepare an impeccable application and personal statement, as well as gather letters of recommendation from physicians to prove to the programs that they are indeed ready for the rigors of residency. Once they submit their application, they receive multiple interview offers from the programs they applied to. At the end of the interview season they rank their favorite programs in order of preference. The programs also rank the applicants. Both the student and the program submit a rank list and let an algorithm match the student to a program and vice versa. Statistically speaking, students who receive 12+ interviews have a higher likelihood of matching into a program than those with less. 

When I first applied to residency during my fourth year of medical school, it was the very beginning of the COVID-19 pandemic. Almost all programs had converted their interviews to be conducted virtually. This act changed the playing field drastically. Students could now use the money that was traditionally allocated for flights and hotel stays instead on applying to more residency programs. I spoke with many students that year who said their schools advised them to apply to 200 programs and that is what they did! Pre-pandemic students would apply to anywhere from 20 to 45 programs. Even despite the interviews being virtual, I still did not have the money to apply to 200 programs. I was only able to apply to about 50. 

Students who had no “red flags” on their application had no issues getting interviews. But students, like myself, who were non-traditional medical students and/or who had “red flags” on their application struggled to get noticed by programs. What people consider as a “red flag” can range. Some programs view failed boards, leave of absences from school, disciplinary actions, failed courses, bad evaluations, lackluster letters of recommendations, attending an osteopathic, Caribbean, or international medical school as “red flags.” I fit into some of these categories and I believe it brought my application down. 

Unfortunately, these “red flags” fail to show the true picture of a student. They do not take into account systemic racism and inequities in health education especially for Black, Indigenous, and/or POC and LGBTQIA+ students. Moreover, students from these backgrounds typically face more financial and social hardships in education and generally do not have the same educational opportunities. Despite students persevering against all odds, enduing four years of medical school, and applying to residency, the shortcomings in their application due to structural violence keep them from matching. This is why Black and Latinx medical students are less likely to match. The education system, and in this instance, the medical education system is broken, and it fails us over and over again. Although I had 4 interviews to amazing residency programs and ranked them all, it was not enough to land me a spot in a residency program the first time around. 

Upon getting home from my shift, I immediately ran to the computer to answer emails from my school administrators who were trying to prep me for the SOAP (Supplemental Offer and Acceptance Program). I had to get all my paperwork ready in a neat package, apply to all the programs that still had spots available all across the country, and be ready for any and all interviews to come through. Because everything was conducted on east coast time and I was located in California, I had to be up and professionally dressed every day that week by 5 AM pacific coast time and wait for an interview to come through. The SOAP had different rounds it conducted each day and concluded them by extending offers to students. During the first round I was offered an interview to a program in my hometown. I was so happy because I had applied to that program during the regular season but had not received an interview.

“Why do you think you didn’t match?” 

That was the first question I was asked during my interview. It was a difficult question to answer given that I did not have any time whatsoever to process what had happened. Nonetheless, I was prepped by my school on what to say: be honest about your “red flags” and own up to them. I did just that. The program director then asked me, “Why our program? Why our specialty? Why should we choose you?” After interviewing me for about 10-15 minutes, I waited 24 hours to hear whether I’d be extended an offer. When I unfortunately was not given a PGY1 spot after this interview, I was crushed.

I did not receive any other interview offers during the next 3 rounds, thus going completely unmatched. I was completely heartbroken.

What was to ensue after that week was a series of leads to positions in programs that had received accreditation after the MATCH and whom wanted to fill their spots before June. I was invited to interview to multiple programs between the month of April and May, all ultimately ending in rejections. It was an emotional rollercoaster and I wanted off!

After speaking with my family and closest friends, I decided to stop pursing these dead ends and focus on putting forth a better application for the next MATCH season.  What I did during that year after graduation really change my trajectory in ways that I did not anticipate nor know were possible. This is why I choose to share my story in hopes that others can learn from my mistakes.

Stay tuned to read what I did differently the second time I applied to the MATCH and how I was successful in securing a position in a residency program!