Matching into a residency program is often an incredibly exciting event. You’re learning where the next chapter of your career will take you. But the journey to get there can be challenging, confusing and stressful—especially when you consider the possibility of not matching.
Taking stock of your strengths and interests, looking realistically at your options and preparing a solid backup plan are all steps you can take to help ensure a successful match. Read on to learn more.
1. Seek professional help
Connect with a student affairs professional or dean at your school who can give you greater insight into the matching process, suggests Harold Lausen, DO, chair of the AOA’s Bureau of Education.
“You need to know the profile of the candidates who’ve matched into the programs that you’re interested in to better understand where you fit,” says Dr. Lausen, who is also associate dean for clinical affairs and population health at Southern Illinois University School of Medicine. “Someone who deals with student affairs will have this data.”
The meeting should also give you a clearer understanding of the matching timeline and requirements such as personal statements and recommendation letters.
2. Honestly assess your competitiveness
Asking yourself these six questions can help you identify what you’d like to do and how competitive a candidate you are:
- Do you enjoy surgery or non-surgery?
- Do you want to work in a hospital or non-hospital setting?
- Which specialties would allow you to do work you enjoy?
- How competitive are you within those specialties?
- How competitive are the programs you’re interested in pursuing?
- Are you being honest with yourself about where you’re going to be able to match?
3. Visit residency sites
Audition rotations are not supposed to be required, but it’s a good idea to find two or three sites that you’re really interested in and rotate with them to better understand the programs, Dr. Lausen says.
“Rotating with a program can tell you if you’re a good fit and if the program fits your needs. If you do a great job, the program leaders will remember that when they’re going through applications,” he says.
If you can’t audition and the program is near you, try to spend a day visiting it instead. Many programs will allow interested students to do this. Dr. Lausen also recommends checking programs’ websites and social media feeds for opportunities to connect with current residents and ask questions.
4. Have a backup plan
Putting all of your eggs in one basket can leave you without a spot. “It’s a good idea for every student to have a backup plan,” says Dr. Lausen, who advises students to consider pursuing two different specialties rather than trying to fall back on a traditional rotating internship (TRI).
“Internship years, or traditional rotating years, are becoming fewer and fewer,” he says. “It’s not a good backup plan, and those spots are generally linked to another program.”
Instead, think creatively about your interests and how they might align with different specialties, Dr. Lausen suggests. “Internal medicine-pediatrics could overlap with internal medicine or with pediatrics, or family medicine could overlap with pediatrics or obstetrics or emergency medicine,” he notes. “But there are also limits to this approach. For instance, if you’re a non-ER boarded doctor, you can’t work in a level-one emergency room as a family physician.”
On the other hand, scrambling into a TRI position worked out for Jordan Hitchens, DO, who failed to match into an emergency medicine residency last year. “I am now in a TRI at a very well-respected program, where I am working towards my end goal of becoming an emergency physician,” Dr. Hitchens told The DO in 2017. Last year, Dr. Hitchens joined the emergency medicine residency program at University Hospitals in Cleveland.
5. Stay informed about the single GME transition
As the profession transitions to a single system of graduate medical education accreditation, the world of the match will be changing. The final AOA Match took place Feb. 4, 2019. In 2020 and beyond, most fourth-years will participate in the NRMP Match.
Pay close attention to single GME announcements from the AOA, the ACGME, and the American Association of Colleges of Osteopathic Medicine. You can find the latest single GME updates here.
But in the end, if you don’t match: Don’t panic
“Understand that if you fail to match, you still have options,” Dr. Lausen says. “But to get a spot, you may have to let go of some of the things you wanted. And you want to get into the soap process as soon as possible. Don’t be picky. At this time, your focus should be on getting a position.”
Although some DOs choose to take a year off if they fail to match, Dr. Lausen doesn’t recommend doing this. “If you sit out for a year, the competition doesn’t get smaller. It gets bigger,” he says. Students considering this option should think long and hard about what they could do during a year off that would make them a more competitive candidate, he notes.
In addition to facing greater competition the second time around, those who sit out a year may also find themselves in a financial bind when it comes to student debt.
“If you’re in residency, you can defer your student loan payments,” Dr. Lausen says. “But if you don’t match and you decide to take a year off, you may be required to begin paying your loans back sooner than you’re ready to.”
Waiting a year also delays the day when a DO ultimately becomes a fully trained physician earning a salary that makes paying down debt more feasible.
Dr. Hitchens’ debt is over $400,000, and $2,000 accrues in interest each month.
“Scrambling into a TRI position guaranteed me a job, further training and a way to continue on my path toward becoming the physician I want to be,” she said.
Every year, there are many family medicine residency programs that go unfilled. Most unmatched students have the option of entering one of them.