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My Experiences Being Unmatched


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Hey everyone!

 

I know today is the second iteration's match day and I wish you all the best! Last year I, unfortunately, didn't match and it was scary trying to figure out how to tackle this year. I found there were some pretty loud voices online about how terrible it is to be unmatched and how even 10+ years into practice, they're still miserable.

 

It certainly isn't like that for everyone. I really feel that this year has been pretty darn good! Definitely hard and frustrating at times, but good. I learned a ton about myself, my goals, and medicine and I know I am better off for this experience. I just wanted to wish you all the best as you tackle this next year!

 

If you want to hear more about what I did this year, I kept a blog and there are a couple other blogs out there from other unmatched students. Mine was in part a reflective exercise for myself and an attempt at creating a bit of a resource for other people who don't match (maybe it'll be helpful?). Although this year was BUSY and I did not manage to write as much as I'd hoped... doctorinterrupted.wordpress.com

 

:)

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Hey LittleDaisy,

 

I matched to my top choice family program this year! I'm very excited and happy about it! I decided that I didn't want to be identifiable by my blog so I'm just going to say that last year I applied to two very competitive specialties (but broadly, to all the English programs for both).

 

I got interviews last year, but not a ton. Over this year and after lots of reflection, I decided not to apply to one of the specialties (and this is actually one of the big reasons I am happy I didn't match last year! I don't think I would have been happy in that field). I did apply to the other one and got one interview, but it was actually a bit of a toss up as to whether I wanted that or family more by the end.

 

This year I did a masters program (I think a lot of medical schools also have one year masters available), worked clinically with family docs and specialists (like part-time rotations), and worked on a research project I'm now getting ready to submit for publication. There's TONS you can do with the year off! I know people who found a doc to work with and pretty much worked with them full time, another who started an MBA (I think that's a 2 year program so I don't think they finished it) or did other cool online master's, people who went on big trips, and people who got really involved in research. My advice is to figure out what you want in your career and how you can use this year to strengthen it. I enjoy clinical research and want to stay involved in it, which is why I picked the masters program I did.

 

I'm more than happy to point people in the direction of resources if they like! Or answer any questions. I have a contact page on my blog.

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Yeah you are, I understand that you must be very agonized now!

You could always refer to CaRMS websites, you are always eligible to apply for CaRMS first round.

 

Those who can't apply first round, are those CMGs who broke their contract. I.E: matched to a program and decide not to go ! Or those who lied in their applications (I don't think that happens very often).

 

If you are uncertain, refer to the CaRMS websites!

 

I totally understand how anxious and stressed you are feeling, but rest and refuel :)

To confirm, if I go unmatched in the first and second round, I can apply for the first round the next year right?

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To confirm, if I go unmatched in the first and second round, I can apply for the first round the next year right?

 

yes that is correct. The only way to lose access to the first round is to actually match somewhere. Actually that is one of the reasons medicine is so "sticky". Completing a residency in a particular area for instance means you had to have matched and thus if you want to retrain to something else you can only go into the second round (which is kind of interesting to me). 

 

Anyway it is one saving grace that if you don't match at all at least you get another chance at the 1st round coming around later. 

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Hey everyone!

 

I know today is the second iteration's match day and I wish you all the best! Last year I, unfortunately, didn't match and it was scary trying to figure out how to tackle this year. I found there were some pretty loud voices online about how terrible it is to be unmatched and how even 10+ years into practice, they're still miserable.

 

It certainly isn't like that for everyone. I really feel that this year has been pretty darn good! Definitely hard and frustrating at times, but good. I learned a ton about myself, my goals, and medicine and I know I am better off for this experience. I just wanted to wish you all the best as you tackle this next year!

 

If you want to hear more about what I did this year, I kept a blog and there are a couple other blogs out there from other unmatched students. Mine was in part a reflective exercise for myself and an attempt at creating a bit of a resource for other people who don't match (maybe it'll be helpful?). Although this year was BUSY and I did not manage to write as much as I'd hoped... doctorinterrupted.wordpress.com

 

:)

 

Congratulations. Would you recommend that anyone who doesn't match in round one should sit out until next year's match?

 

In hindsight I wish I had done that.

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I think we're missing some data which would make that decision (sitting out til next year vs not) an informed one.

 

For instance, how many people that go unmatched are successful the following year in getting a spot in their first choice specialty? I think this piece of information would clear up the confusion - because the % of people that go unmatched --> match the next year doesn't account what those people are matching to. If 50% of them are in fact matching to their back-up, then that's something that would be useful to know. We all have anecdotal evidence, but national data is what we need - what is the match rate once you've gone unmatched? 

 

Going unmatched is undoubtedly something you'll need to account for in your application next cycle. Whether it's a 'redflag' or not remains debatable, but it's definitely an obstacle that those who are doing CaRMS for the first time don't have to address. Whether or not it's worth taking the risk and trying again for round one (i.e. are you more likely to end up in your specialty of choice if you try again? Or will you end up in a back-up/less competitive specialty that would've been achievable in round 2?) is a big question that I think we need more data to answer. 

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I think we're missing some data which would make that decision (sitting out til next year vs not) an informed one.

 

For instance, how many people that go unmatched are successful the following year in getting a spot in their first choice specialty? I think this piece of information would clear up the confusion - because the % of people that go unmatched --> match the next year doesn't account what those people are matching to. If 50% of them are in fact matching to their back-up, then that's something that would be useful to know. We all have anecdotal evidence, but national data is what we need - what is the match rate once you've gone unmatched? 

 

Going unmatched is undoubtedly something you'll need to account for in your application next cycle. Whether it's a 'redflag' or not remains debatable, but it's definitely an obstacle that those who are doing CaRMS for the first time don't have to address. Whether or not it's worth taking the risk and trying again for round one (i.e. are you more likely to end up in your specialty of choice if you try again? Or will you end up in a back-up/less competitive specialty that would've been achievable in round 2?) is a big question that I think we need more data to answer. 

 

To make it more complex -  It is really common for people to change their primary specialty choice the second time around. I am sure most in the second round also spend a lot more time thinking about backups as well - hopefully reducing the chances they will not match overall. 

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I think we're missing some data which would make that decision (sitting out til next year vs not) an informed one.

 

For instance, how many people that go unmatched are successful the following year in getting a spot in their first choice specialty? I think this piece of information would clear up the confusion - because the % of people that go unmatched --> match the next year doesn't account what those people are matching to. If 50% of them are in fact matching to their back-up, then that's something that would be useful to know. We all have anecdotal evidence, but national data is what we need - what is the match rate once you've gone unmatched? 

 

Going unmatched is undoubtedly something you'll need to account for in your application next cycle. Whether it's a 'redflag' or not remains debatable, but it's definitely an obstacle that those who are doing CaRMS for the first time don't have to address. Whether or not it's worth taking the risk and trying again for round one (i.e. are you more likely to end up in your specialty of choice if you try again? Or will you end up in a back-up/less competitive specialty that would've been achievable in round 2?) is a big question that I think we need more data to answer. 

 

Even with the full picture, I think drawing conclusions would be difficult. For first-time applicants in the first round, we have data sets of 3000 people per year and can generally assume a person to be a generic candidate where the average result in the match will apply to them. Once we hit the second round (or second shot at the first round), we don't have that many people to look at and, more importantly, the assumption of a generic candidate becomes much less reliable - first round unmatched candidates' backgrounds, preferences, and reasons for going unmatched are pretty diverse. More data would be good to get a better sense of the overall situation for unmatched candidates, but I suspect even the most complete data would be too granular to be overly useful for generating advice for individual candidates.

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  • 2 months later...

I graduated in 2010, went unmatched. I have been working as a GP For 4 years now.

Overall, I think I'm happy with my current life, but that is only because I "gave up" on medicine in the sense that I focus more on my private life, friends/family, hobbies etc, which fortunately Family Medicine allows me to do because of the flexiblity/portability. I can literally work anywhere I want and make my own hours. (I am currently doing a full time practice with my own roster of patients). Often, I feel like the work isn't really challenging for me, but at the same time, medicine in general is a wonderful job compared to about 99% of other jobs out there, so I'm still fortunate to have this job. I definitely don't work as hard as I did in medical school or had I gotten into specialty. I feel like matching to family definitely took that "drive" out of me.

 

I mostly came here to post this on account of the Robert Chu case. I still feel anger about unmatching and the whole CARMS system to this day.

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4 minutes ago, Andrew said:

I graduated in 2010, went unmatched. I have been working as a GP For 4 years now.

Overall, I think I'm happy with my current life, but that is only because I "gave up" on medicine in the sense that I focus more on my private life, friends/family, hobbies etc, which fortunately Family Medicine allows me to do because of the flexiblity/portability. I can literally work anywhere I want and make my own hours. (I am currently doing a full time practice with my own roster of patients). Often, I feel like the work isn't really challenging for me, but at the same time, medicine in general is a wonderful job compared to about 99% of other jobs out there, so I'm still fortunate to have this job. I definitely don't work as hard as I did in medical school or had I gotten into specialty. I feel like matching to family definitely took that "drive" out of me.

 

I mostly came here to post this on account of the Robert Chu case. I still feel anger about unmatching and the whole CARMS system to this day.

I was unmatched in the first round this year and matched to family in the second round. 

I find your post reassuring and scary scary at the same time. I'm glad you've found a way to be content despite not loving family medicine, but I also hope I like the job more than I think I will. 

Like you, I'm angry every time I think about it. I hate that I had to "settle" (don't get me wrong - I'm grateful) in the second round because I knew my chances of matching to the specialty I love next year were poor due to this ridiculous stigma about being unmatched. Yes, some people are unmatched for a reason, but lots of us are just unlucky. It's so isolating. 

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1 hour ago, shikimate said:

I suppose technically if you REALLY want to match to something competitive once you're done FM. You could ace USMLE Step 1 (assuming you haven't wrote it), and try for the NRMP. I suppose the big plus side with NRMP is that everyone is in the same pool.

No immediate way to get around the visa issue.  J-1 is the default, but that won't help for many specialties. The available number of SONs is almost mocking - sometimes way too many (i.e. very very difficult to match to) and other times too few.

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On 6/28/2017 at 0:00 PM, Andrew said:

I graduated in 2010, went unmatched. I have been working as a GP For 4 years now.

Overall, I think I'm happy with my current life, but that is only because I "gave up" on medicine in the sense that I focus more on my private life, friends/family, hobbies etc, which fortunately Family Medicine allows me to do because of the flexiblity/portability. I can literally work anywhere I want and make my own hours. (I am currently doing a full time practice with my own roster of patients). Often, I feel like the work isn't really challenging for me, but at the same time, medicine in general is a wonderful job compared to about 99% of other jobs out there, so I'm still fortunate to have this job. I definitely don't work as hard as I did in medical school or had I gotten into specialty. I feel like matching to family definitely took that "drive" out of me.

 

I mostly came here to post this on account of the Robert Chu case. I still feel anger about unmatching and the whole CARMS system to this day.

do you find ur self working more at work to make up for income $ 

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On 6/28/2017 at 3:49 PM, calcan said:

No immediate way to get around the visa issue.  J-1 is the default, but that won't help for many specialties. The available number of SONs is almost mocking - sometimes way too many (i.e. very very difficult to match to) and other times too few.

You can aim for h1b if you write all 3 steps. Even then most competitive specialties still have decent amounts of SON for j1. Essentially everything except IM, if you can match, youll get a j1. Problem is actually matching to one of those programs. As a CMG you might be better off than IMGs in the eyes of programs due to less stigma. 

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4 hours ago, 1997 said:

Hey! Do you think it would be advantageous for matching to take 2 years off in the middle of medical school to pursue an MBA + research/pubs? I'm interested in getting an MBA at some point anyways. Also, since my school uses grades, it would allow me to completely focus on academics and then during the MBA, completely focus on publishing research. I currently have nothing significant on my CV.

There are very few reasons to voluntarily extend your medical degree, and that wouldnt be one of them. Unless you got a prestigious scholarship on the international level for research, dont be taking time off.  Especially not for an MBA..many american schools offer MBAs.. And people can complete it alongside their medical curriculum (less breaks of course).

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9 hours ago, JohnGrisham said:

You can aim for h1b if you write all 3 steps. Even then most competitive specialties still have decent amounts of SON for j1. Essentially everything except IM, if you can match, youll get a j1. Problem is actually matching to one of those programs. As a CMG you might be better off than IMGs in the eyes of programs due to less stigma. 

Yeah - that's the issue - and increasing the limit to really large number doesn't make a difference.  And for IM there's also almost no sub specialization is supported, which could leave someone without a lot of options.

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On 6/28/2017 at 0:08 PM, amichel said:

I was unmatched in the first round this year and matched to family in the second round. 

I find your post reassuring and scary scary at the same time. I'm glad you've found a way to be content despite not loving family medicine, but I also hope I like the job more than I think I will. 

Like you, I'm angry every time I think about it. I hate that I had to "settle" (don't get me wrong - I'm grateful) in the second round because I knew my chances of matching to the specialty I love next year were poor due to this ridiculous stigma about being unmatched. Yes, some people are unmatched for a reason, but lots of us are just unlucky. It's so isolating. 

I am going to play the Devil's advocate here and make a bold statement. While luck is definitely a factor in CaRMS, I prefer to say that many of the applicants who go unmatched are simply not as good as their competitor applicants, whether it's elective performances, reference letters, research or simply the connections/degree of networking they have with staff in the program. It is therefore, unfair to claim that one is "just unlucky" if one goes unmatched.

Most medical students, by nature, come from strong academic backgrounds and rarely face huge failures in life. For some of my unmatched classmates, going unmatched seems to be their first (and only) failure in life ever. In such circumstances, it is easy for them to attribute their failure to luck without any self-reflection of their personal strengths/weakness and how their application compare to those of their peers who matched successfully. Sometimes, it is very important to have some degree of self-awareness of your own ability.

Is luck a factor? Certainly. If one is lucky, one would be able to meet really nice preceptors who will write excellent references for you and give you great evaluations even if you are a total train-wreck on the wards/in the ORs. But personally, I like to think that merit and personality (are you a likeable person?) play a more important role than just luck.

Sometimes, it's not that you are not good. It's just that you are not as good as your fellow competitive applicants, in the eyes of the selection committee.  

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40 minutes ago, hamham said:

I am going to play the Devil's advocate here and make a bold statement. While luck is definitely a factor in CaRMS, I prefer to say that many of the applicants who go unmatched are simply not as good as their competitor applicants, whether it's elective performances, reference letters, research or simply the connections/degree of networking they have with staff in the program. It is therefore, unfair to claim that one is "just unlucky" if one goes unmatched.

Most medical students, by nature, come from strong academic backgrounds and rarely face huge failures in life. For some of my unmatched classmates, going unmatched seems to be their first (and only) failure in life ever. In such circumstances, it is easy for them to attribute their failure to luck without any self-reflection of their personal strengths/weakness and how their application compare to those of their peers who matched successfully. Sometimes, it is very important to have some degree of self-awareness of your own ability.

Is luck a factor? Certainly. If one is lucky, one would be able to meet really nice preceptors who will write excellent references for you and give you great evaluations even if you are a total train-wreck on the wards/in the ORs. But personally, I like to think that merit and personality (are you a likeable person?) play a more important role than just luck.

Sometimes, it's not that you are not good. It's just that you are not as good as your fellow competitive applicants, in the eyes of the selection committee.  

 

Please excuse my bluntness, but no, you're very wrong. 

Not to mention mean - seriously? "Are you a likeable person?" 

I had excellent evaluations, good reference letters, research, everything you mentioned. Were there people who were "better" than me who matched? Of course. Were there people who were worse, who also matched? You bet. People who I've worked with and who are definitely not likeable people, or struggled with basic things. People who I met on the tour who gave off seriously bad vibes. (Now, most people were lovely!) Can some of those people turn it on in an interview? Of course. But are you really going to claim that these people are "better"? 

The CaRMS system is such that in a specialty with 5-8 spots per program, you could be in the top 10 on everyone's list (and therefore the top 10 applicants out of nearly 100 interviewers) and go unmatched even though the match rate overall is 80%. Or, you could be #1 on someone's list but the "worst" applicant in the pool and match to your first choice. 

Now, I'm sure you'll say that this wasn't luck because that applicant "networked" at that program or something. Which may be true. But there is no way you can make the argument that said applicant is "better" than the unmatched one. 

Lastly - in the wake of Robert Chu's suicide and all the discussion about how awful going unmatched is - I can't believe you'd write something like this. I'm always amazed at how anonymous forums encourage people to be much crueler than they would in real life. 

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2 minutes ago, amichel said:

It looks to me like you haven't gone through CaRMs yet, from your posts. If you have, my apologies. 

I am lucky to have matched to my first-choice specialty.

5 minutes ago, amichel said:

Not to mention mean - seriously? "Are you a likeable person?" 

Some applicants are more likeable than others. That's why some do better than others at networking/interviews. That's a fact.

6 minutes ago, amichel said:

I had excellent evaluations, good reference letters, research, everything you mentioned. Were there people who were "better" than me who matched? Of course. Were there people who were worse, who also matched? You bet. People who I've worked with and who are definitely not likeable people, or struggled with basic things. People who I met on the tour who gave off seriously bad vibes. (Now, most people were lovely!) Can some of those people turn it on in an interview? Of course. But are you really going to claim that these people are "better"?  

I am not on the selection committee for your specialty (i believe it's peds). Therefore, I can't comment on how strong your application is. But these people are "better" than you, in the eyes of the CaRMS committee. That's why they were ranked highly. Are they truly better than you in reality? I don't know, and I can't comment. But what I know for sure is that they definitely managed to convince the selection committee that they are

14 minutes ago, amichel said:

The CaRMS system is such that in a specialty with 5-8 spots per program, you could be in the top 10 on everyone's list (and therefore the top 10 applicants out of nearly 100 interviewers) and go unmatched even though the match rate overall is 80%. Or, you could be #1 on someone's list but the "worst" applicant in the pool and match to your first choice. 

Now, I'm sure you'll say that this wasn't luck because that applicant "networked" at that program or something. Which may be true. But there is no way you can make the argument that said applicant is "better" than the unmatched one. 

Again, I am only making the comment that the matched applicant is better than the unmatched one, in the eyes of the CaRMS committee.

16 minutes ago, amichel said:

Lastly - in the wake of Robert Chu's suicide and all the discussion about how awful going unmatched is - I can't believe you'd write something like this. I'm always amazed at how anonymous forums encourage people to be much crueler than they would in real life. 

Going unmatched is awful, and you can be sure that anyone who goes unmatched (especially Robert Chu) will have my sincere deepest sympathies. But I just want to highlight that it is very important to have some self-awareness of your own abilities. And always back up even if you think you are a strong candidate. Again, I wish to emphasize that sometimes, it's not that you are not good. It's just that you are not as good as your fellow competitive applicants, in the eyes of the selection committee.  

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I think what hamham is highlighting is that for unmatched applicants, there are aspects of their application that they can improve on relative to their competition for a particular specialty. Just to sideline a bit, if someone didn't get into medical school, it's usually not all based on luck, there are always aspects that someone can improve on i.e. research etc. Similarily, same goes for CaRMS. Also, the number of interviews a med applicant gets is largely indicative on how good their application ranks.

Amichel, just out of curiosity, did you get interviews to all the schools/programs you applied to for CaRMS? More importantly, did you get interviews to all the schools you did electives at?

Not trying to be mean, but I do agree with hamham, that basing a failure all on luck is not realistic in my opinion. 

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1 minute ago, saskgrad001 said:

I think what hamham is highlighting is that for unmatched applicants, there are aspects of their application that they can improve on relative to their competition for a particular specialty. Just to sideline a bit, if someone didn't get into medical school, it's usually not all based on luck, there are always aspects that someone can improve on i.e. research etc. Similarily, same goes for CaRMS. Also, the number of interviews a med applicant gets is largely indicative on how good their application ranks.

Amichel, just out of curiosity, did you get interviews to all the schools/programs you applied to for CaRMS? More importantly, did you get interviews to all the schools you did electives at?

Not trying to be mean, but I do agree with hamham, that basing a failure all on luck is not realistic in my opinion. 

Indeed, the number of interviews one gets is usually testimony of the strength of his/her application. Most of the unmatched students I know had only 3-4 interviews out of the 10-12 programs that they apply to.

Again, going unmatched is awful, and I only want to help future students avoid this mess if possible. That's why I tried to empahsize on self-awareness and the need to back up. 

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