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What Do You Do If You Don't Match?


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When applying for CaRMS do people typically prepare for the scenario that they don't match?

 

What do the unmatched folks do during what would have been their PGY1 year? A fellowship? An MPH? You can't work in medicine, I don't think...

 

Is it fair to say that those who don't match likely gunned for one specific (usually competitive) residency and didn't get it?

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People generally don't prepare in the first round and going unmatched comes as a surprise. There are many reasons for going unmatched after the first round, and it may not be due to how competitive a specialty is. If people don't go unmatched after the second round, I've noticed that most tend to do research in their field of interest to get facetime in the department and, obvious, get more research in that field.

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Most of the unmatched candidates I knew were either gunning for a competitive field without applying broadly, gained interest in a competitive field late in third year, or were splitting their efforts down two specialty lines without concentrating only on one, thus making them appear dedicated to neither.

 

Of the ten or so folks I know who were unmatched, one went into family but switched into their choice field and program after a year, one took a year off, did a lot of research and managed to go into their field of choice in a city they do not like one bit, another matched to psych but transferred out after the first year. The other seven got stuck in their second round choices. None of them are happy about it.

 

Avoid going unmatched. At best you may end up in a career you never thought you'd like but end up loving. This is unlikely. For those who want to change, you lose a year at best, and a career at worst.

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Of my year, including me,

 

One matched in the second round in family medicine in a remote city, two matched to another speciality on the second round which they are really about, one matched to her speciality in her first choice of city after a year of research, and I matched in my speciality in my third choice of city also after a year of research.

 

Basically, it is not the end of the world. But yes, try to avoid this situation.

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I applied to 3 fields I would be able to enjoy, all for different reasons, and matched to one of them. I was thinking of applying to only my first choice but that would have been a serious mistake.

Were those 3 fields related (i.e. IM, FM, ER)? Otherwise, it doing that could potentially backfire due to a perceived lack of focus, right? 

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Is it disadvantageous if you wait a year for CaRMS? Are you still 1st iteration?

 

I'm also assuming you want an H1 visa. If you're applying as a CMG to NRMP and you did step 3, how long does it take to process H1B? Since NRMP match results come out March 13 and you need the H1B at July 1, there's only a 4 month window.

 

Are you applying NRMP this year? Please keep us updated :D . Inquiring minds want to know.

I think they meant to apply a second time for CaRMS and then NRMP simultaneously....unless they meant that one should willingly not apply to CaRMS as a graduating 4th year and wait a year to further improve the application. That is silly and definitely not a good idea in the majority of cases, maybe it could be plausible for the very small minority of specific applicants. But I don't think they meant that?

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  • 1 month later...

My advice (see my recent post about my experience in 2011), is that if you don't match 1st iteration, apply for anything and everything that you can (that fits your schedule financially, and in terms of flights you will have to make for interviews, and keeping in mind that you will have to re-write your essays and application and loosely justify your sudden switch, and also if there is time do a brief rotation in the new area(s) although your school can help with this).

 

Pretend that you are interested in any available position - take anything you can, you can always transfer out later if the opportunity arises.

It is better to have a lousy position 2nd round (rural family, lab medicine or whatever that you are not at all interested in).

 

Spots open up and people transfer in residency all the time. Take something even if you know you don't like it in the 2nd round rather than going unmatched and re-apply next year.

Any question PM me, I don't check this board at all these days but if I do I will try to answer.

Otherwise, I just came on today to share my thoughts as I happened to think about CaRMS today.

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Were those 3 fields related (i.e. IM, FM, ER)? Otherwise, it doing that could potentially backfire due to a perceived lack of focus, right? 

I only now notice your post. One was FM as a backup that I would enjoy but preferred the others. The other 2 were surgery related, but entirely different, one with a great lifestyle and the other being the opposite.Each stood on it's own merits, I barely had to tweak my Motivational Letter for my first choice. And there was no lack of focus issue. I got my 2nd choice and am loving it! 

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  • 5 months later...

I didn't match to PEDS this year. Big shock, as I had 9/9 interviews. I'm likely going to re-apply for next year. I love research so in my mind, it's barely a lost year and I would have done it anyway as a resident. I've talked to a number of PDs and they said never to bank on a transfer, especially from FM (funding discrepancies). 

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I didn't match to PEDS this year. Big shock, as I had 9/9 interviews. I'm likely going to re-apply for next year. I love research so in my mind, it's barely a lost year and I would have done it anyway as a resident. I've talked to a number of PDs and they said never to bank on a transfer, especially from FM (funding discrepancies). 

 

Did you get any feedback as to why you didn't match to the programs you interviewed at?

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I didn't match to PEDS this year. Big shock, as I had 9/9 interviews. I'm likely going to re-apply for next year. I love research so in my mind, it's barely a lost year and I would have done it anyway as a resident. I've talked to a number of PDs and they said never to bank on a transfer, especially from FM (funding discrepancies). 

Same here. Applied to IM but didn't match, talked to the PD and I wasn't far down the list actually, it's just that this year lots of people applied to IM first choice because of new laws in Quebec. 

Planning to do some research, and reapply next year hoping for a better chance. Might apply across Canada, but that might mess up my marriage.

 

Know a guy that applied to anesth and went unmatched, but he's taking the year to travel and plans on going FM after.

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I didn't match to PEDS this year. Big shock, as I had 9/9 interviews. I'm likely going to re-apply for next year. I love research so in my mind, it's barely a lost year and I would have done it anyway as a resident. I've talked to a number of PDs and they said never to bank on a transfer, especially from FM (funding discrepancies). 

 

good luck! Seems to be the tried and true response to going unmatched - the route with the best chances if your heart is set on a particular career.

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  • 2 weeks later...

I went unmatched this year. I plan on doing an online masters program. Any idea what masters degree most medical graduates do? Thanks

 

Someone in my class did a MPH, but I heard it didn't help that person's application this year and they still went unmatched.

 

If I were in that situation I'd also focus on writing USMLE1/2 CK and apply to NRMP next year to increase chances. 

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Someone in my class did a MPH, but I heard it didn't help that person's application this year and they still went unmatched.

 

If I were in that situation I'd also focus on writing USMLE1/2 CK and apply to NRMP next year to increase chances. 

 

Had one person do a masters of education - to date that didn't help either. All just one off examples of course.

 

the first and most important thing is to figure out what went wrong if at all possible.

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I went unmatched this year. I plan on doing an online masters program. Any idea what masters degree most medical graduates do? Thanks

Masters are pretty useless and plus you'll have to explain them during your interview. There are only a few thing you can really do.

 

Either delay graduation so you can continue to take elective.

 

If you have already graduated I would urge you to take your us step so you can apply to the nrmp. Other things include research with actual Publications. Try to find a clinical job that involves patient interaction like scribing or ask prev preceptor if you could work at their office. do not do a masters unless you can actually get Publications from it or it is something you are passionate about the Masters is really a waste of time on your year off

 

Options are limited unfortunately if you can Pony up the dough you can actually do electives in the US after graduating their companies in the USA provide electives

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Masters are pretty useless and plus you'll have to explain them during your interview. There are only a few thing you can really do.

 

Either delay graduation so you can continue to take elective.

 

If you have already graduated I would urge you to take your us step so you can apply to the nrmp. Other things include research with actual Publications. Try to find a clinical job that involves patient interaction like scribing or ask prev preceptor if you could work at their office. do not do a masters unless you can actually get Publications from it or it is something you are passionate about the Masters is really a waste of time on your year off

 

Options are limited unfortunately if you can Pony up the dough you can actually do electives in the US after graduating their companies in the USA provide electives

 

Wrong. Had me and another student in my class did a masters and we both matched the next year. As long as you advisor is also an attending in your specialty of choice who can give you a great reference letter and push for you to get in.

Interviewer were actually interested in knowing what my research project was about and saw it a sign of motivation to go into ortho. Plus, while doing a masters you can work on other smaller research projects and get publications done in that year. Also I used my free time to shadow at different ortho programs and get myself known by preceptors.

Finally, at least in ortho, an attending told me you can't get a job anymore unless you have two fellows and a master. So I did not loose that year...

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I'm an IMG (Canadian went to med school in Ireland) and I went unmatched last year... actually I didn't even get any interviews. I was gunning for IM and only applied to 7 of the programs that IMGs could apply for. 

 

So in my Gap year I had to do some serious soul searching.

 

1. I focused on getting quality reference letters. I think the year before I was trying to get references from "big names" that didn't quite know me as well and didn't quite go the extra mile to write a stellar reference. This year I focused on getting letters from people that I knew me well and would fight for me. I also gave each reference a cheat sheet with a brief summary of my relationship with them, my achievements, my career plans, stories of patients that I treated with them, thing I learnt etc. I think that really helped their letter become more personal when they wrote them.

 

2. Masters - I ended up starting a long distance MSc in Clinical Trials with the London School of Hygiene and Tropical Medicine. I know that this is something I want to be involved in the future and research is a strong area for me... so for me this was the right masters. I wouldn't dive into any random MPH or equivalent if you actually have no interest. 

 

3. Work - I still had to pay the bills, so I contacted some of my preceptors and asked if they would email around their colleagues and see if anyone was looking for recently graduated med student for research work or equivalent, preferably in your discipline of choice! I got lucky and ended up walking into a job as a clinical trials coordinator, which was great as I got to see the practical side of my MSc. This is also a great way to meet potential reference writers!

 

4. Research - Like it or not, having some extra research will probably help your application next year. For me, I love research, so it wasn't a problem to dive into this. But I totally understand that this is not everyone's cup of tea! In that case, you can still get some "research experience" and publications by doing research like activities. For example, ask your preceptors if they have come across any interesting cases that they want written up and published as a case report. Otherwise, pick a topic you are passionate about and write a review article on it. Otherwise, if you have an opinion... on anything... chance your arm at writing a viewpoint or editorial.

 

5. Fun stuff - One of the greatest things about my year off was the flexibility I had. It gave me the chance to pursue activities that I never would have had the time to do as an R1. I volunteered with some amazing organizations, kept up my interests outside of medicine, started painting and started a blog! Make the most of this time off... delete netflix! 

 

6. Next round - I think anyone who goes unmatched  has to do some serious soul searching about what to do when they apply next year. Do they love "insert specialty here" so much that they would risk going unmatched again? Chances are you are probably going to be more open to exploring other specialties. use your year to explore those other specialties, get references from them and see if it will be a good fit for you. I was pleasantly surprised to see that I really liked paeds, even though it wasn't my cup of tea during med school. I would also highly recommend exploring the podcast "The Doctor's Paradox" about careers outside of traditional medicine, I met some interesting family docs by trade, but who don't really practice family medicine anymore! Find your passion!

 

My story: I was really fortunate this year to have a great cycle, got 15+ interviews across IM, Paeds and FM and am really excited to be heading to Calgary for IM! I know you are going through a rough time, but really use this year to explore what it is about medicine that you are passionate about... and just dive into it for the year!

 

Best of luck guys!

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