Over the last few weeks, I’ve spoken to applicants who did not match in the 2024 NRMP match. They are just a few of the thousands of highly qualified students and physicians who did not match this cycle. This is a wrenching experience, and it can be hard to pick yourself up and move on to the next steps. However, the actions you take over the next few months can be instrumental in setting you up for later success. I recommend that you start with these five steps.
1. Process your emotions. It takes an immense amount of time and energy to apply for residency, from preparing for licensing exams and excelling in rotations to writing applications and interviewing. If you didn’t match, it’s understandably a significant disappointment and can even undermine your sense of self-worth or accomplishment. This is why it’s so important to take the time to process your emotions and care for yourself. Self-care can sometimes become a buzzword, but it is an important aspect of recovery. Identify the coping strategies that have helped you in the past, and start implementing them now.
2. Evaluate your application. I have a saying: treatment before diagnosis. In other words, take the time to analyze your application and identify the factors that affected your success. Are there areas of your application that could be strengthened? I recommend that you study the NRMP annual report and compare your statistics to those of applicants who successfully matched into your field. For example, in the 2022 residency match, matched applicants in dermatology had an average of 21 publications, presentations, and abstracts, while unmatched applicants had an average of 16. While some applicants fail to match due to the randomness of the process (and I’ve seen this many, many times), others are able to identify some important contributing factors.
3. Inform everyone who helped you on your journey. Sometimes applicants would prefer to retreat into silence because it can feel embarrassing and difficult to reach out to faculty, advisors, and mentors to inform them that you were unsuccessful. However, this is absolutely the time to reach out widely. If these individuals have supported you in your career journey in the past, they’re likely to help you during your next attempt. One student has already reached out to the program director (PD) at her home program. While her goal was simply to seek feedback on her application, the PD offered to reach out to several programs on her behalf. Specifically, the PD wanted to inform these programs that although this student did not match, she was an exceptional candidate and one they might want to consider for next year’s match.
As you set up meetings with your advisors, what do you say? First, ask for feedback. Were there any areas of your application that could be strengthened?
Next, seek advice. What are their thoughts on your chances of successfully matching into this field? What advice do they have for you in terms of next steps?
Many people helped you reach this point in your career, and you should always end your meeting by thanking them for their help. It’s also important to leave up-to-date contact information and request that they let you know if they hear of any new openings. Positions may open up outside of the match for various reasons (for example, the program may have obtained additional funding). Some of these positions are publicized only through announcements sent to faculty. Some programs may also offer PGY2 positions through next year’s match. The pool of eligible applicants for these positions (in other words, students or graduates who will have completed a transitional or preliminary year by the expected start date) is much smaller.
4. Ask for feedback on your interview skills. As you’re meeting with advisors, it’s also important to solicit specific feedback on your interview performance (especially if you had multiple interviews and did not match).
In my experience, some applicants are very comfortable in social settings and assume that this will translate to a solid interview performance. That’s not always the case, however. The most important factor in a solid interview performance is the ability to demonstrate your fit with a particular program, and demonstrating fit requires significant prep work. It requires a deep analysis of your own strengths, goals, and activities, as well as a deep dive into the strengths and goals of the residency program. I find that many applicants don’t do a deep enough analysis. Because of this, they sometimes end up sounding very similar to other applicants during the interview. Although it can be hard to stand out in a group of highly accomplished applicants, the right interview strategies can absolutely help.
5. Develop your strategy. Will you reapply in this field, switch to a different field, or reapply to two different fields? Importantly, what strategies can you employ to strengthen your application? One of my students has already been in touch with the PD of her preliminary year to see if she can use elective time to gain more experience in her chosen field. Some U.S. medical students may consider completing more rotations before graduation or even extending medical school. IMGs (international medical graduates) may consider additional U.S. clinical rotations. Some of my students have begun to inquire about research fellowships or other opportunities to complete research. I also recommend that all applicants review every component of their application materials to see where improvements may be possible.
There are so many variables, and it can be hard to determine the next steps. That’s why it’s so important to take the time to strategize and to meet with advisors. They can help you visualize potential actions and help you determine which ones might work best for your situation.
Although it can deeply shake your confidence to experience an unsuccessful match, I want to emphasize that I have seen many, many students over the years go on to a successful match. Some of these students have become colleagues to whom I refer patients or faculty members who speak at national conferences. It reminds me of how much the medical profession needs the skills, energies, and compassion of our highly dedicated students, graduates, and IMGs.
Rajani Katta is a dermatologist and author of Conquer the Medical School Interview and The Successful Match.
