Best Strategies to Follow if You Don’t Match

Best Strategies to Follow if You Don’t Match

Nov 02, 2020 Published by Kathrin O'Neill

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Thousands of foreign and international medical graduates compete for the coveted US residency spot against native graduates every year. The reason why so many applicants want to become part of the US health system is the unbounded array of opportunities and benefits it offers. The status of being a doctor in the US is regarded as an award in itself. That’s because, in the US, physicians earn a higher salary and become a part of the world’s best medical services. Hence, medical graduates from around the world want to compete for residency spots.

However, the process is not an easy one. The US health system works differently from other healthcare systems in the world. This is why international medical graduates need to get accustomed to the new rules and guidelines. Moreover, they need to follow certain steps to become licensed physicians and obtain medical residency in the US. The most crucial step is competing for The Match.

What is The Match?

The Match system is instituted and maintained by the National Resident Matching Program®(NRMP®). It is a uniform system of matching residency candidates and residency programs to fill 1st year and 2nd-year post-graduate training positions. The positions are accredited by the US Accreditation Council for Graduate Medical Education (ACGME). Generally, all 1st-year positions enrolled in the ACGME-accredited training programs participate in the Match. Candidates who are part of some subspecialty program will have to participate in other matches for residency positions. However, they would need to participate in the NRMP for securing a preliminary position for their respective specialties.

Match Dos & Don’ts You Must Follow

There are specific strategies to follow when appearing in the Match system that can increase your chances of success. Here are a few do’s and don’ts that may prevent you from getting into trouble.


  • Rank those programs that you are genuinely interested in, even if you believe that you don’t stand a chance matching to it. Ranking your preferred programs higher cannot affect your chances of matching to less competitive programs and ranked lower on your list.
  • You must remember the order of your programs’ ranking. It is a crucial element of the Match process. Though the Match program is fair, it is entirely indifferent to anything other than the provided rank order list. In most cases, if you have ranked a program above another, the system will place you in the first program as per the indicated priority level.


  • Never make a concise list, even if you think you will match your first choice. If you list just one program, you will increase the chance of not matching. Moreover, the lists of unmatched students are usually shorter than that of matched students. Therefore, we suggest that if you are selecting highly competitive specialties, don’t make a shorter list.
  • Avoid listing programs that you don’t want because you may end up with a program you don’t want. Take your pick- is it better to be unmatched or matched to an unwanted program?

No Match? Here’s What You Should Do

If you didn’t match, and couldn’t also obtain a position through the Supplemental Offer and Acceptance Program (SOAP), don’t lose hope. Some strategies can help you keep your dream of making a career as a practicing physician in the US alive. Let’s find out what are your options:

Keep in Touch with your Medical School

You don't need to feel embarrassed about being unmatched. Many applicants make the mistake of hiding their status while they should do the opposite. Staying in touch with the dean of your medical school and other faculty members can help you immensely. You can seek their support, such as asking them to involve you in a research project. You can also search for mentors at your school working in the medical field and need volunteers to help them.

Get a Job in a Clinic

You must get a job in a clinical setting to keep your skills updated. Programs will need to know how you could keep your clinical skills up-to-date since you sat out around one year. As per the rule, you cannot care for patients until you get the residency; however, you can remain a part of the fraternity through different tactics. Such as you can scribe for a physician. Some states allow unmatched graduates to get employed as assistant physicians. In this regard, you will have to do sufficient research to determine the possibilities. However, you don’t necessarily need to be involved in direct patient care. There are several other options, such as you can work as the clinic’s electronic health record trainer for volunteer physicians, medical students, and residents.

Taking the USMLE Step 3 Exam

The US Medical Licensing Exam (USMLE) Step 3 test checks the participant’s clinical knowledge and decision-making skills. Since the exam covers the core disciplines, we recommend taking the Step 3 exam when your knowledge in the core areas is still fresh. Taking the exam when you are struggling for residency can pay dividends. Passing this exam will make you a better and more competitive applicant for The Match the next time around. Some residents who started their intern year without passing the Step 3 exam had to settle for a shorter program as a doctor. On the other hand, if you pass it, your legitimacy as a candidate will improve substantially, and the program directors will feel that they don’t need to worry about you.

When the time comes, you should adopt a different approach to interviewing and even applying for the program. Thinking out of the box and implementing newer strategies can help you become successful in the Match.