I Didn’t Match…Now What?

Amiethab Aiyer, MD | Jonathan Kaplan, MD | Matt Varacallo, MD

March 12, 2020


While a hearty congratulations is in order for all those who matched, we wanted to offer our voice of support to those who, unfortunately, didn’t. This is a tough time and, no matter what, we have your back! Remember that although things may seem bleak right now, you are going to be a physician and help those around you, no matter which field you decide to pursue.

Every year, our hearts race around the time of the NRMP notification, hoping that no one has to go through not matching. Amiethab knows, having gone un-matched the first time around; unfortunately, it was a mentally torturous time for him. There are a multitude of options available for students who don’t match; you can change careers all together, you can do a prelim year (an internship without a guaranteed residency position), take a research year (or two), or you can bail on medicine all together (we hope you do not choose that option). Here is some more information on some of those options:

1Prelim Year

This is a guaranteed paid internship position at a hospital that may have the specialty that you are interested in. It allows you to demonstrate your clinical acumen, your ability to work with teams and obtain new letters or recommendation (LORs). It may be challenging to do your research during this year, as you are being spread over various clinical services. A prelim year may be more ideal for those who have done a fair amount of research during medical school. Additionally, it’ a good idea to identify what the track record of matching prelims into your specialty of interest is and whether there is dedicated time allowed for rotating through the specialty of interest. Lastly, a prelim year may help you match into that specialty (i.e. a general surgery prelim year may increase your chance of matching into general surgery).

2Research Year

These are not always readily available and are often found by word of mouth. This is what Amiethab did and it was an amazing experience. There are formal fellowships available, but they get picked up fast! A research year is the right move when research is the biggest deficiency on one’s application. Doing only one year makes it difficult to stack your CV with abstracts, presentations and manuscripts, so it may behoove you to do a two-year research stint. These are not always paid and that is something to keep in mind. Additionally, your ability to spend time in the clinic/OR may be limited (and dependent on the institution). Last but not least, you can develop multiple connections via the research you get involved with.

3Changing Specialties

This is not an easy thing to do, especially if you had your heard and mind set on a particular field. Take a deep breathe and realize that no matter what, you will be a physician at the end of the day. Looking at other fields that may have overlap with that you were aspiring for is the best way to go, especially if the academic prowess of your application is challenging (i.e. low board scores on steps 1 or 2).

Keep your head up! You will get through this and it will make you a stronger physician!


DISCLOSURES: Dr. Aiyer American Foot and Ankle Society: Board or committee member, Delee & Drez Orthopaedic Spots Medicine (Elsevier): Publishing royalties, financial or material support, Medline: paid consultant, Medshape: Paid consultant, Miller’s Review of Orthopaedics (Elsevier): Publishing royalties, financial or material support. Dr. Kaplan Medline: Paid consultant, Wright Medical Technology, Inc.: Paid consultant. Dr. Varacallo This individual reported nothing to disclose.

Read the AAOS Discussion Group Terms, Conditions and Disclaimers HERE.


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