Monday, April 25, 2011

I didn't match! What should I do now?

Unfortunately, not every applicant matches into a residency program. As bad as this year's situation was with the delayed list of open programs on Scramble Day, you can't just blame the NRMP. And maybe some program directors gave you false hope during your interviews, but they never actually promised you a residency position. Think back. Did you get as many residency interviews as you had hoped for? Now is the time to assess your application and determine how to make it stronger to get those interviews you want:

  1. What specialties did you apply in last time? Did you pin all of your hopes on a competitive specialty like orthopedic surgery? Or did you remember to apply in primary care fields like family and internal medicine, which often have more vacancies and are looking for qualified applicants?
  2. Where did you apply last time? Did you focus your search on states like California and New York, perhaps because that's where you and your family live? Or did you apply to places like Idaho and Nebraska to increase your chances of getting interviewed, since programs there don't always fill during the Match?
  3. What have you done since graduating? Have you been relying on the knowledge base and procedural skills you learned in medical school? Or have you continued to grow as a doctor through externships, medical volunteering, and relevant research?
If you're planning to apply to residency programs again in the fall, you must seriously consider what you can do over the next few months to become a stronger applicant:

  1. A hands-on externship is much more impressive than a simple observership. Admittedly, these opportunities can be hard to find. But if you're serious about improving your application, talk to the doctors in your community to find out about available externship opportunities. There are even companies you can pay to place you into an externship. While it's an expensive option, the knowledge you acquire and skills you practice during that externship will be extremely valuable, should lead to a strong letter of recommendation, and will be prized by the residency directors.
  2. If you graduated from a foreign medical school, and you performed poorly on USMLE Step 1 or Step 2, you should consider taking Step 3 now. Remember that taking the exam is not enough; you need to have your passing score available before you submit your applications to residency programs. Applying with the phrase "awaiting results" in your ERAS Common Application Form is not going to help you; there are plenty of people who have already passed Step 3, and why should a program director look at your incomplete application? Of course, you want to do better than simply passing Step 3; you want to get a great score, so you should strongly consider paying a professional test prep organization to help you study. Additionally, your externship will be a great way to prepare, since there's nothing like real-life experience.
  3. Did you have someone help you with your residency application? A well-written personal statement and detailed Common Application Form can make a huge difference when residency directors are deciding who to invite for an interview. I am happy to provide a free consultation, assessing your old residency application and suggesting some things you can do to improve it. I have over ten years' experience advising and supporting residency applicants like you.