Curve Ball! The Day I Didn’t Match

The NRMP algorithm is designed to optimize the choices of both incoming residents and residency programs. But what happens when the algorithm fails you?
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Sometimes life throws you an invisible curveball that hits you in the head, knocking you out onto a red ant hill as a buffalo stampede roars in and tramples you into a crippled shell of the excited person you were moments before. This is how I felt on Match Day when I did not match, which, as you can imagine, was a huge surprise and disappointment.

Here’s how I dealt with the news and what happened next.

 

Match Day or Doomsday?

The National Residency Match Program (NRMP or The Match) is a program medical students use to be placed into residency at the end of their 4 years of medical school. Students apply to 40-80 programs, hoping to get around 15 interviews.

At the end of the residency interview process, students make a ranked list of their top choice program down to their last choice program. If you would rather not match than attend a program, you can choose not to put that program on your list. Each program also makes a ranked list of the students they interviewed. It is said programs put an emphasis on regionally close applicants, as students are more likely to stay local, but this process is largely concealed.

Upon entering The Match, you are bound by the contract to attend whichever residency program you are matched with. An algorithm favoring student choices then takes the two lists and attempts to fill every program.

Then, on a Monday in mid-March (Match Week), emails are sent out from the NRMP stating either “Congratulations, you have matched!” or “We are sorry, you did not match into any position.”

The latter was the email I received on March 16th, 2020, sending me into a meltdown.

 

Life After Not Matching: SOAP

Ironically, you don’t actually have any time to “meltdown.” Within 3 hours of this email, I had to drive an hour to school and enter the Supplemental Offer and Acceptance Program (SOAP) while I was still stuck in a nightmare I couldn’t wake up from.

This involved getting a list of all unfilled OB/GYN programs (2), available preliminary OB/GYN positions (6), and available general surgery preliminary positions (tons). My school required that everyone who “SOAP’ed” had to apply to the maximum number of programs, 40.

I applied to both available categorical OB/GYN programs, all 6 prelim OB/GYN programs, and 32 general surgery preliminary positions all over the country. After applying, you are not allowed to reach out to any program personally, or you may be banned from The Match in the future.

When I hit submit, I looked at the room around me. Every student was 3 computers distanced away from the next, adhering to the social distancing rules in place at that point in time. Many downcast eyes were red and puffy, just like mine. Others were better at concealing their pain. Failing to match into their dream specialty after four (eight if you count undergraduate education) years of hard work and dedication was now their reality—and mine!

On the ride back home, I opened Instagram, which was a big mistake. All of my friends posted screenshots of their “Congratulations, you have matched!” emails. Of course, I was so proud and excited for my friends, but the pain was too fresh to feel happiness at that moment. I had to focus on the next steps. I couldn’t tell you what I did for the rest of the day, but at 9pm, I got a phone call.

 

The Cold Calls Begin

The person on the line said their name and asked how my day was going. I believed that they were my primary care physician, so I let out an exasperated sigh and said, “Oh, I’ve had WAY better days,” expecting him to have no idea what I was talking about, as I haven’t been to my doctor in months.

Instead, he laughed and said that was very understandable. I realized this was probably not my doctor right as he said he was the program director of a local general surgery position and that he would like to talk to me about his program. I apologized profusely at my unfiltered greeting and told him he had the same name as my PCP. I was immediately put at ease by his appreciation for my authentic response.

This phone call was the first of seven that came over the next day and a half from various general surgery program directors. I tried to keep myself busy playing board games and watching my favorite movies, but my level of anxiety never truly went down.

There was still the possibility of being an OB/GYN next year if I got the right call, but I never got that call. Each of the surgical program directors who called me during this process opened the conversation by expressing their confusion as to how I didn’t match, which became more and more frustrating.

I still have not gotten a clear answer as to how this happened. According to my counselor, I had one of the strongest applications for OB/GYN that year. My board scores were well above the national average. I had a ton of volunteering experience and ample research.

I did everything I was told to do, but it didn’t work, and no one could tell me why. I think that is still the hardest part to wrap my mind around.

 

Accepting an Offer

On Wednesday at 11 am, the first set of offers for SOAP were sent. I logged in and was relieved to see two local offers. I accepted one quickly, having decided which program I would prefer if offered ahead of time.

You are given two hours to decide. It was only then that I could finally relax a tiny bit, as I at least knew what the next year of my life would look like. Match Day proceeded to happen digitally on the following Friday, where the rest of my friends opened their emails at noon to see where they would be spending the next 3-5 years training in their various fields.

This was another day I felt both extreme happiness and jealousy looking through my Facebook page. Proud family members and partners were boasting about their hard-working loved ones. I couldn’t help but imagine what I “should have been” posting right then, imagining how much better life would be if I had just matched at my number one, two, or three program.

Alas, I did not match, and I had to accept that fact. It was definitely a challenge to adjust the way I viewed my future, and I couldn’t have done it without my partner, my friends, and my family.

My partner drove me to school that day and entered new schools into ERAS for me as I rewrote my personal statement to be geared toward general surgery. They reassured me that no matter what happened, we would get through it.

My friends were always there to give me words of encouragement when I felt hopeless. I am so glad to have so many friends in my life who build each other up in good times and bad.

At the time, I did not want to initiate conversations about not matching, but I appreciated when my friends sent encouraging messages reminding me of my great qualities. I would recommend this for anyone who hears that a friend has not matched. A few words can go a long way during this extremely stressful time.

For those of you who do not match, please try to keep hope. I know it is easy to feel like a failure, but just because you didn’t match does not mean you cannot have a successful and rewarding career as a physician. You just won’t be taking the path you originally planned.

Read our guide: What to Do If You Don’t Match Into Residency (After SOAP).

Moving Forward

I will still be an OB/GYN; I will just take a year to hone my surgical skills first! To say that week was the worst week of my life would be an understatement (I also hit a bunny with my car).

I’ve had time to reflect and know that statement means I have not faced worse hardships or much adversity at all. For that, I am grateful. I don’t know what the future holds for me, but I am going to try to enjoy every day and learn as much as I can along the way.

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This Post Has One Comment

  1. Sarah Ottum

    Hey Guys! OP here. If you are reading this today because you or someone you know didn’t match, I am so sorry! Keep up hope. I matched into a great OBGYN program my second try, and am loving it! If you have any questions or want to talk, please do not hesitate to reach out to me

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