TIPS FOR FOURTH-YEARS

What can you do if you don’t match?

If you don’t match, your chances of landing a residency position are still high. Here’s how to put together a contingency plan.

On March 16, the vast majority of osteopathic fourth-year medical students will learn if they matched into residency. Four days after that, they’ll learn where they matched. The weeks leading up to Match Week are often highly stressful, as students anxiously wait to learn where their training will continue and also consider the possibility of not matching.

Students who don’t match on March 16th will no doubt feel disappointed. But while watching your peers celebrate before you can certainly be unsettling, not matching is not the end of your career. Right after the Match, there are ample residency placement opportunities, like the NRMP’s Supplemental Offer and Acceptance Program (SOAP) and the AOA Post-Match.

Last year, 98.48% of spring 2019 DO graduates were placed into accredited GME programs, according to AACOM.

The first steps to executing a contingency plan for not matching start well before Match Day, says Kim Peck, the director of academic and career development at Michigan State University College of Osteopathic Medicine. Melva Landrum, the assistant director of advising and career development at University of North Texas Health Science Center/Texas College of Osteopathic Medicine, agrees.

Steps to take beforehand

If your risk of not matching is high, advisors like Peck and Landrum have likely conferred that information to you ahead of the Match. These risk factors are good indicators that not matching is a possibility:

  • Low board exam scores
  • A low number of residency interviews (usually fewer than four)
  • Interviews you may feel went unsuccessfully
  • A geographically limited rank order list
  • Targeting competitive specialties

“I don’t know too many people who can think clearly while on rotations, because it’s not only emotional for them to think about not matching, but logistically, it’s a lot to keep track of,” Peck says.

To cut down on moving parts on Match Day, both suggest that all students take the following steps beforehand, even if they feel they are likely to match:

  • Update your personal statement to reflect your views on any new specialties you may need to consider. You can speak to your advisor about which options may be available.
  • Go to your program director for the rotation you’re on and ask if you can have days off during the SOAP that follows the Match.
  • Consider getting letters of recommendation from your current rotation as well as an updated transcript from your school.
  • Make sure you have time set aside on Match day for working with your student affairs office to prepare your new applications.

“The biggest step to take is to assess where you are right now and be prepared,” Landrum says. “The reality is, the numbers tell a very clear story. It’s really just being receptive to knowing what generally happens, and reviewing that information and knowing what resources your school will provide for you.”

Keep calm, and spring into action

In the event that you don’t match, even if you’ve got the above plans in place, advisors are cognizant that it’s a difficult pill to swallow and that some processing time is necessary. That said, there’s only so much time before students need to get moving on new applications.

SOAP week begins directly after Match decisions are handed out, and students taking part should come to campus to prepare as soon as they can. Students are not allowed to contact programs, but advisors and counselors are available to provide emotional support and help them put up to 45 applications together to send out.

Of course, by this point, students need to have had honest discussions with both their advisors and their loved ones on what they’re willing to do to match. There are many factors to consider, including whether to change one’s desired specialty and/or geographic location.

“Right after it happens, we have a really in-depth conversation on why they didn’t match and if their application can be improved for SOAP,” Peck says. “It’s also important to get everybody involved, like family and significant others, in agreement on the steps that lie ahead before you’re in a high-pressure time crunch of having to accept an offer.”

While SOAP is very competitive, students tend to hear back from programs and match very quickly, Peck says.

You have options after SOAP

If SOAP doesn’t work out for you, there are still plenty of paths you can take to continue your medical career. The most immediate is the AOA Post-Match, which will operate a little differently under a single GME system.

Former AOA programs that have ACGME accreditation but aren’t filled after Match Week will be able to share their open positions on the AOA Post-Match, explains Maura Biszewski, the AOA’s Vice President of Graduate Medical Education.

“Osteopathic medical students still looking for a residency slot can look there for additional potential opportunities,” Biszewski said. “It’s emotionally difficult, but you have to plug along and be available for programs who are looking for DOs.”

The AOA Post-Match will also allow programs that are up for ACGME accreditation in April to post advertisements for positions. Once those programs are accredited, they are able to fill those spots. Programs can also post advanced-level positions, which may be an option for DOs currently in residency who don’t have a postgraduate year 2 (PGY2) position lined up, Biszewski says.

No matter which option you choose, continuing to move forward is the top priority.

“We recommend that if you can’t match at all, you still be part of something that will allow you to enhance or develop your education, like another degree,” Landrum says. “But targeting one-year rotating internships out there is going to be the next best thing to residency. I encourage you to look at programs that fit your interests.”

The most important thing to do as you continue on without a match is to maintain relationships with people you have auditioned with, interviewed with, or just met along the way, Peck says. Those who make the extra effort are generally rewarded for it, she says.

“If you stay engaged, let people know you’re still interested, and try to get as much positive relevant experience in that year [away from residency] as possible, you tend to have more success instead of those who go silent,” Peck says. “It’s really about communicating and staying in the game.”

Related reading

I didn’t Match. Here’s how I survived and created my best life yet.

5 things to know about the 2020 NRMP main residency match

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