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I Didn’t Match, What Am I Going to Do?

Match day is very nerve racking. You opened your email and… you didn’t get matched! You have worked very hard and spent lots of time and money for the match. Everybody else seemed all matched, even the ones with less credential than you. You are very frustrated, disappointed, and you felt like a loser. Now what?

First, please keep in mind, you are not the ONLY ONE. 65% IMG don’t get matched. The people who didn’t match keep their mouth shut. You have an IV invitation so you are better than 20% of IMGs already. Then take a deep breath, talk to your loved ones, think about your life, then ask yourself, is this something I want to do again? Is this something worth doing again? There are many other things in life that are very important and you probably have missed in the past few years. With the extremely intensive training, stressful job, pressure from insurance companies, sky high malpractice insurance, lawsuit, more and more physicians left medical practice. It may not be as a great career choice as you thought to be.

If you decide you want to give another shot. It is time to reflect and plan. The things you learned during this match season is invaluable to you. Learn from your and other people’s mistakes – this is what medicine and life is about.

1. Attend the online webinar to hear other people’s success stories. DO NOT compare credentials. Please keep in mind, people may not tell you everything. What people think important for the match may not be the real reason to get matched.

2. Sit down and look at your file critically and carefully. Know yourself. During my mock IV, I have met a student who failed CS once. When I asked him which part did he fail, he didn’t remember. If you don’t know what you have done wrong, how can you convince the program that you will be a good resident? The most important thing is to know yourself.

3. Write down the reasons you think you failed. The most common reasons are:
• Long year of graduation
• Low test scores
• Poor interview skills
• Bad application materials
• Lack of US clinical experience
• Weak LORs

4. Take action plan. There are things that you can’t change such as your score and YOG. However, there are many things you can improve in a relatively short amount of such as US clinical experience, LORs, document preparation and communication skills. Many things are related to each other. For example, without better US clinical experience, you will not get strong LOR. Without understanding of US health care system, you will have a hard time to ace your OB/EX and get a strong letter.

5. Talk to people and ask for help. The more people you talk to, the more you learn from success and failed stories, the more help you will get.

Please keep in mind, persistence and careful planning will eventually pay off.

Use Your Brain!

The most common problem for a resident is "they do not think, don't ask why, just follow routine and order". Here is a typical example: In my hospital, when oncology patient develops fever with neutropenia, the standard of care is to add meropenam. If patient looks sick, add vancomycin and amikacin. One of my leukemia patient developed fever on a Saturday night. The resident started with meropenam, then quickly added vancomycin and amikacin. The patient received multiple fluid bolus due to low BP and went to ICU the next day.

If you looked at the management overnight and early in the morning, you would think the physicians did everything right, started antibiotics on time and gave fluid bolus appropriately. However, the patient had "capapenam resistent klebsiella sepsis" a month ago. The Klebsiella is resistant to
meropenam and amikacin, only sensitive to gentamicin. This is everywhere in the medical record and sign out - but no one bother to think "should this patient be on meropenam and amikacin just like other neutropenic patients?" The patient could have died.

It is extremely important for the trainees to follow the order from attending and standard of care. However, it is even more important for the trainee to use their brain!