Receiving the news that you did not match into a residency program is a challenging experience. The feelings of disappointment and uncertainty are understandable. This outcome, however, is not a final verdict on your medical career. It represents a hurdle that can be navigated with a clear plan, beginning with the processes during Match Week.
Understand the SOAP Process
The first step is to engage with the Supplemental Offer and Acceptance Program (SOAP), which provides an opportunity for unmatched applicants to secure a position. SOAP is a fast-paced process managed by the National Resident Matching Program (NRMP) during Match Week. It allows eligible applicants to apply for residency spots not filled during the main Match. Eligibility is extended to applicants who registered for the Main Residency Match, are certified to start graduate medical education on July 1, and were unmatched on the Monday of Match Week.
The SOAP process begins on Monday of Match Week when applicants learn if they have matched. At 10 a.m. Eastern Time, unmatched applicants can see the list of unfilled programs through the NRMP’s R3 system. Application submission through the Electronic Residency Application Service (ERAS) opens an hour later, at 11 a.m. ET. Have your ERAS application materials, including personal statements and letters of recommendation, updated and ready before this week.
Programs begin reviewing new applications on Tuesday morning, with four offer rounds taking place from Wednesday through Thursday. During each two-hour round, programs extend offers, and applicants must decide whether to accept or reject them. A rule of SOAP is that applicants cannot initiate contact with a program until the program has contacted them first; doing so is a Match violation. Acting quickly and staying organized are parts of a successful SOAP strategy.
Assess Your Application and Situation
Once Match Week concludes, the next step is a structured analysis of your application to understand what contributed to the outcome. This phase is about identifying areas for improvement to build a stronger candidacy for the future.
Schedule a meeting with your medical school’s Dean of Student Affairs or a faculty advisor. They can provide an objective review of your ERAS application, personal statement, MSPE, and letters of recommendation to help pinpoint weaknesses. Also, reflect on your interview skills and application strategy, considering if you applied to a balanced list of programs.
Strengthen Your Candidacy for the Next Match
Pursue a Research Year
For those planning to reapply, the interim year is an opportunity to strengthen your application. One strategy, especially for competitive specialties, is a dedicated research year. This can result in publications and presentations, which add weight to your ERAS application. Finding a productive lab with a supportive mentor is a large part of this path’s success.
A research year also develops your ability to analyze scientific literature and contributes to your clinical knowledge. The connections you build can be valuable, as a research mentor can become a strong advocate. They can provide a detailed letter of recommendation that speaks to your work ethic and growth. However, the year must be productive, as a lack of output could be viewed negatively.
Earn an Additional Degree
Another avenue to enhance your profile is earning an additional degree. Programs like a Master of Public Health (MPH), Master of Health Administration (MHA), or Master of Business Administration (MBA) can broaden your perspective. An MPH provides a deeper understanding of health systems and policy. An MHA or MBA can equip you with leadership skills attractive to residency programs.
Pursuing a graduate degree demonstrates resilience and can make you a more unique applicant. While professors in these programs may not write clinically focused letters, the experience can be part of your narrative. This is especially true if you connect the degree to your long-term career goals within your chosen specialty.
Gain More Clinical Experience
If your application review suggested a need for more hands-on patient care, seeking clinical roles is a good use of your time. This is important if there are gaps in your clinical activities or if experiences were not in your desired specialty. Options include working as a medical assistant, a clinical research coordinator, or finding externship or observership positions. These roles keep your clinical skills sharp and demonstrate a commitment to medicine.
The goal is to gain recent experience that can lead to strong, updated letters of recommendation from U.S. clinical supervisors. An ideal experience would be within a hospital that has a residency program. This can provide insight into the daily life of residents and opportunities to interact with faculty, which can lead to an interview in the next cycle.
Network and Build Connections
The time between Match cycles should be used to network and build professional connections by seeking advice and mentorship. Reach out to faculty from your medical school, current residents, and program directors at institutions you are interested in. Ask for informational interviews to discuss your application and seek guidance on becoming a more competitive candidate.
Maintaining these connections is important. Send periodic updates on your progress, such as a new publication or a skill developed in a clinical role. This keeps you on their radar in a professional manner. Networking can provide you with advocates for your application and insights into what specific programs are looking for.
Consider Non-Residency Career Paths
While many unmatched graduates focus on reapplying, it is practical to be aware of career paths for individuals with a medical degree who do not complete a residency. An MD is an educational achievement that opens doors to non-clinical fields where medical expertise is sought after. Exploring these options can provide security and reveal fulfilling alternative careers.
These roles allow you to contribute to the healthcare industry without engaging in direct patient care. Opportunities exist in fields such as:
- Healthcare consulting, advising hospitals and pharmaceutical companies on strategy.
- Medical Science Liaison (MSL), acting as a bridge between a company and physicians.
- Medical writing.
- Health informatics.
- Public health policy.
- Medical education.
Manage Your Mental and Emotional Wellbeing
Navigating the period after not matching is emotionally taxing. It is common to experience a range of emotions, including shock, grief, and anger. Acknowledging these feelings is a necessary first step, but it is important not to face them in isolation. This period requires a focus on mental health to plan your next steps.
Reach out to your support system, including friends, family, and mentors. Your medical school likely has mental health and wellness services available, and professional counselors can provide coping strategies. Taking care of your well-being is a part of building the resilience needed to move forward, whether you reapply for the Match or pursue a different path.