Unmatched, now what? The Hazy Path of the Qualified Medical Residency Candidate 

by Jessica Obi, MD

On March 15, 2021, I found out I didn’t match. Needless to say, I felt alone, disappointed, and uncertain of my next step(s). “Dr. Obi!” is what family and friends would call me. The next question I would hear and would still feel uncomfortable answering was, “Which hospital do you work in?” or “What residency program did you match to?” My reply would always leave them asking, “It’s not automatic to match into a program?” followed by “I thought there weren’t enough physicians?” Then my favorite question, “So what are you to do now?” Although these questions are asked from a sincere place and valid, I could not, and still sometimes can’t help but question my worth, intelligence or if I made the right decision to pursue a medical degree. I feel the medical educational system is broken in that it lacks support for candidates like myself – support that includes mentors for such situations and jobs that would allow our degrees to still be useful. Instead, unmatched candidates are left to scramble for positions and other areas of work to repay student loans. The worst part of not matching is not having a sure direction to follow that would guarantee matching during the Supplemental Offer and Acceptance Program (SOAP) or the next  cycle. 

As any unmatched candidate would do, I began searching for mentorship and guidance. I happened to join Twitter to network and follow physicians, and by chance stumbled upon a few accounts dedicated to helping the unmatched. I was able to learn of zoom webinars dedicated to guiding unmatched applicants down this tricky road in terms of personal statements, letters of recommendation, curriculum vitae, and networking.1-2 Of  course, my family, friends, and medical school have been supportive; however, to my utmost surprise, social media, particularly Twitter’s @Inside_TheMatch and @unlikelymds, has provided the most useful support. I have met and networked with awesome physicians and mentors via social media, and I have also found a peer support group  with the same goal of matching. This has undoubtedly powered my strength to persevere. 

The recent match cycle left many unmatched with unanswered questions. There were 42,508 active applicants and roughly 6,254 candidates that went unmatched. Yet, we are forced to forge a unique path to residency. As I reflect on this, I find myself finally at peace to have had this experience. I can use my struggle to gain empathy and experience that will help my patients navigate their struggles e.g., decreasing blood sugar or losing weight. My struggle to achieve residency is analogous to a patient’s struggle to achieve healthy outcomes, and in both cases, it is crucial to have proper guidance and strategy. My attributes of resilience and perseverance developed over this period, will fuel my passion and strength. 

I believe every path, albeit hazy, is unique to the individual whether one is a patient, student, resident, or a physician. Some practices I’ve adopted to cope include remembering my why and my faith, mentorship, networking with other qualified candidates, and following the stories of others   who have previously tread this path and are now residents. Currently, I’m also working on a few  projects that I’m hopeful will be ready for the next match cycle. 

Creating a path to reach this goal is not easy. I find on this journey that I’m developing resilience, endurance and relationships. I’m essentially creating a story, my story, that just may provide enough hope for that competent unmatched candidate – who may be on the verge of quitting – to not give up. 

To all the qualified unmatched reapplicants, you’re not alone. There is a virtual community of faculty, residents, physicians, your peers, that are supportive and are willing to aid as you carve your unique path to matching. 

There is hope. Keep going. 

Dr. Jessica Obi is a 2020 medical graduate of Ross University School of Medicine, from Los Angeles California, and learned in 2022 that she matched in Internal Medicine. She is passionate about health equity and medical education, and outside of Medicine, Dr. Obi enjoys spending time with her family, traveling and fashion and hopes to positively impact the medical field. 

References
1. van de Ridder, J.M.M. [@MvdRidder]. (2021, April 28). INVITATION Zoom network meeting for UNMATCHED STUDENTS, organized by UNMATCHED students. Please register in advance. Please RT.[Tweet]. Twitter. 
 
 2. Stulak, J. [@JohnStulakMD]. (2021, April 19). As promised, for those who went unmatched in #MatchDay2021, feel free to sign up for an informal webinar in which we give our insights and your answer questions No matter who or where you are, we are happy to help and be a resource [Image attached]. [Tweet]. Twitter. 

Acknowledgements 
I would like to thank Kyle Swearingen, MD, Emmy Abraham, MD, and Monica van de Ridder, PhD for their support and feedback on the earlier drafts of my reflection. 
 

The Power is Yours: An Exhortation from an Undocumented Medical Student

By Sumbul Siddiqui

My parents immigrated to the United States when I was 4 years old, hoping to give their children a better life. I was raised in Georgia with my three younger siblings, two of whom were born here. Georgia has a policy called 287(g), in which some counties are proud to work together with ICE agents to detain immigrants.

My first encounter with ICE officers was probably when I was 14 years old, just about to enter the 9th grade. I remember this moment very well, because the night before I had watched this scary movie called Saw. So, I was terrified that someone was going to kidnap me. I checked my closet and slept with the lights on that night. No one came for me, but my mom was taken. Two ICE officers entered our home that morning. I only heard bits and pieces because my mom had closed my bedroom door and told me to go back to sleep. Eavesdropping, I heard them tell my mom to go with them, and she would return back to her family soon. That took 3 months. She was taken to the Atlanta Detention Center, and then transferred to an Alabama detention center.

I don’t remember much of what happened during that time, but I do remember visiting my mom in the Atlanta Detention Center. We were only allowed to see her for a brief moment. She was wearing an orange jumpsuit – crying. Her handcuffs were taken off so she could talk to us through the glass window. I told her that everything was going to be okay even though I had no idea what was going on – or really, a clue about our immigration system. When my mom returned, I started high school, and I didn’t think much about immigration again.

Fast forward to my sophomore year in college. They come for my dad. Within just a few months, they come for my brother. My dad was gone for 2 years, and my brother was gone for 7 months. They were both in two different detention centers. Sometimes, I had to figure out who to visit – whether I would drive an hour up from Atlanta to see my father or 3 hours down to see my brother.Read More »

No Smoking This Side of Room: Reflecting on things that aren’t there any more after 42 years as a student and a teacher in a medical school

By Michael Dauzvardis

In The Beginning

It was June of 1977 and I had just begun my graduate career in anatomy.  Little did I know that I would be taking all my major classes with the medical students.  A lifelong journey in accompanying medical students in various ways had begun.

The Lecture Hall

A typical day in anatomy class began with 130 or so medical students, shuffling sleepy eyed into their small seats with swing out mini desk tops. They came bearing newspapers, coffee mugs, 3 course breakfasts, adorned in hair too long and shorts too short.  Bell bottoms, blue jeans, and baseball caps ruled the day.  I quickly assimilated by wearing my new Levi overalls. On the right side of the room (while facing the podium) was a sign affixed to the wall which declared “No Smoking This Side of Room.”  Now I must say that on the opposite side of the room I did not observe a lot of smoking but on more than one occasion I observed a student chewing tobacco and spitting into a large plastic cup during lecture.  The class of 122 consisted of 90 men, and 32 women– with a racial and ethnic composition of 1 black person, 3 Latinos, 7 Asian-Americans, and 111 Caucasians.  Forty-six of the men had mustaches, with the majority of those also sporting beards.  It was the prime of the disco period and it showed.

A portion of a newspaper containing the daily crossword puzzle would be passed around for each student to contribute. The instructors drew on a thing called a chalk board while some students tried to keep up on their yellow pads of legal paper. Audiovisuals consisted of carousels of 35 mm slides projected onto a pull down screen in the front of the room. On more than one occasion I observed a professor drop his entire tray of slides before lecture.  The slides would fly in all directions. Students and staff, eager to be helpful, would assist in reloading the carousel, but since slides needed to be placed upside down and reversed in order to be projected correctly, this usually resulted in much confusion and sore necks during the lecture.  These slide carousals also provided for the mischievous opportunity of inserting bogus slides into the lecture.  If a lecturer wanted to show a “film strip” he had to notify the AV department in advance so they could bring in a reel-to-reel projector, whose sound never worked and which often melted the film.

There were no computers or cell phones (two payphones were mounted outside the lecture halls).  Pocket calculators were the rage–and I even saw an occasional slide rule.  Virtually all students participated for 15 dollars in a co-op note club.  Each student would be assigned a lecture at which he or she would take detailed notes.  These were typed out, mimeographed and distributed to the entire class.

The lecture hall had a center aisle, but no side aisle.  As a result, students had to climb over each other to get to and from the end seats.  Furthermore, the floor slanted at almost 45 degrees toward the front such that a dropped pencil or spilled cup of coffee made it all the way down to the lecturer.  The lecture hall spanned two floors with the upper half flanked by the outer windows in a manner leaving a precarious eight-foot drop hidden by curtains– which on more than one occasion gobbled up a medical student like a bug in a Venus flytrap.

The Pub

There was a long, often leaky, run-down hallway that connected the medical school and hospital with the dental school, a dark tiny basketball court, an old theater, and the beloved pub. The pub served pizza and sandwiches and soft drinks for lunch during the week.  But, at 2:55 pm on Fridays, students, staff, and faculty could be seen with their tongues attached to the outside of the pub Read More »

A Quick Method for Faculty and Students to Serve as Role Models for Personal Wellness Activities

By Jeffery D. Fritz, Sandra Pfister, Diane Wilke-Zemanovic, Sally Twining and Jose Franco.

Can we incorporate into the curriculum a quick and easy way to promote awareness and the practice of wellness by both medical school faculty and students? At the start of the fall 2017 term, course directors overseeing first- and second-year pre-clinical instruction at the Medical College of Wisconsin encouraged each faculty member to develop a simple communication slide. These instructors were asked to include an introductory slide noting their practices of wellness to be shown at some point in their instructional block. The exact content of this slide was not prescribed; however, all participants were encouraged to include images and personalize the content to the degree that they felt comfortable. Given the magnitude of this initiative – it would involve over 300 different faculty members and reach over 500 first and second year students across three campus locations – it was hoped that voluntary participation by faculty would be sufficient to would significantly enhance student and faculty awareness and practice of wellness/wellbeing.

Faculty participation across the 13 pre-clinical first and second year courses was surveyed throughout the academic year by reviewing the recorded sessions for inclusion of the introductory wellness content at any time during the session.Read More »

Working on my MD and PhD degrees as a DACA recipient

By Cesar E. Montelongo Hernandez

Last week a federal appeals court upheld the ruling that blocks the Trump administration from ending DACA. This means the nationwide injunction that allows DACA to remain will stay in place. Despite this, the legal battle will continue and likely head to The Supreme Court of the United States. DACA recipients have been granted a few months of respite but their long-term outlook is still very uncertain.

I am currently in my fourth year of medical school. In total the combined MD-PhD program takes eight years to complete (an MD degree alone takes four years). Students begin by completing two years of the MD, switching over to the PhD for about four years, then coming back to complete the last two years of the MD. At present I have completed two years of the MD degree and I am in the second year of the PhD degree. Ideally, I will complete the PhD degree by 2021 and the MD degree by 2023.Read More »

A Response to Alumni Disappointed in Stritch’s Support for DACA

By Sunny Nakae

In May the Stritch alumni magazine published a cover feature article about our first cohort of DACA recipients admitted to the Loyola University Chicago Stritch School of Medicine and their impending graduation.  We received both positive and negative correspondence about this feature.  What follows is a compilation of complaints I received from some alumni and a summary of the responses I offered.

“As an alum I am disappointed in your policy to admit DACA recipients over US citizens.  Because you are admitting non-US citizens that means a US citizen will not get a seat. Supporting undocumented students violates Federal Law.  Did these DACA recipients get ‘affirmative action’ status?  Candidates should get admitted because of their credentials, not because they are minorities or immigrants.  What constitutes the right minority?  It seems like Japanese, Korean and Chinese are no longer considered minorities but smaller Asian groups like Hmong are? In my graduating class there are many of us who will no longer be supporting the school.”

Dear Stritch Alum,

Thank you, sincerely, for expressing your current views on our decision to accept MD applications from DACA recipients.  This happened in 2012 with the support of our then dean, Dr. Linda Brubaker, and our then president, Fr. Michael Garanzini, S.J  The inclusion of DACA recipients continues to receive full support from our current dean, Dr. Steven Goldstein, and our president, Dr. JoAnn Rooney.  It seems from your email that you might not have all of the facts for the situation, so I would like to open a dialogue and provide those facts for you and any colleagues with whom you wish to share this information.  I understand that at first glance this decision may appear to disenfranchise other applicants, specifically those of Asian descent or US citizens. Read More »

Emotional Rollercoaster: Learning to Doctor through Humbling Experiences

By Kihyun Kwon

It was an eventful start to the morning. My attending saw the first patient, who voiced murder ideation towards her unfaithful husband. I imagined myself being taken aback in a troublesome situation like that. I was still in a state of shock when my patient arrived. The clinic schedule had no regard for my emotions and gave me the most difficult patient I ever came across.

The nurse came back shaking her head and said, “The patient will not talk or make any eye contact.” The preparation notes I took earlier said she was a college student with Autism spectrum disorder, depression and anxiety. Never having had any interaction or personal experience with autism, I was nervous. My attending offered to see the patient with me, but I took the initiative to interview by myself. The patient was lying on the examination table playing on the phone while her mother greeted me. I introduced myself to the disinterested patient; I was utterly ignored.

I asked the mother about the patient’s history.

“How has she been doing?”

“Have her symptoms improved?”

Talking about the patient in her presence without actually conversing with her felt awkward. Answers that the mother gave seemed impersonal, and I could not empathize with the information especially with the patient being engaged in her phone.

I wasn’t sure if it was out of annoyance, or concern, but I started directing questions toward the patient.Read More »

A Reflection on The Match: Appreciating and Addressing the Financial Burden on Students

By Justin D. Triemstra

Match day.

Those two words can bring back a fountain of emotions for physicians.  For some, excitement and thrill. For others, anxiety or sorrow. But for most, a significant financial burden during a time of limited income. A recent discussion with a fourth year medical student reminded me of this important, yet under-recognized dilemma. One that can affect the geographical diversity of residency classes and increase disparities for students coming from low resource settings.

Since 1952, The Match has placed medical students into residency training programs. In 2017, 43,157 registrants entered The Match with 31,757 filled positions. To obtain a filled position, many students attend a significant number of interviews with the mean number of interviews attended at 12 for matched applications in 2017.1 Each interview adds to the financial burden for students with recent studies in Emergency Medicine reporting an estimated cost per trip to be about $350.2,3 With an average number of interviews attended at 12, we estimate an average medical student will spend $4200 during interview season; a significant burden for a non-salaried trainee and a number that is likely much higher for a significant number of applicants.

Read More »

My Classroom Is Empty: Is That a Problem?

By Kamran M. Mirza

I am no stranger to disseminating information to a group of individuals junior to me.  As a resident and fellow, I have taught many medical students in a classroom setting.  As I think back to these sessions now, I find that they were all in a setting where the student’s presence was mandatory; a review session, a laboratory etc. Nevertheless, my love for teaching grew in those sessions.  My passion for novel pedagogical approaches to pathology education led me to seek a faculty position.  I felt that there was so much I could try and achieve.  I was very excited to become pathology faculty.  What a great honor.  I couldn’t wait to meet my students.

Last fall, as I walked in to my first lecture, I found a half-empty classroom. Rows upon rows of…. no one.  Who will be the beneficiaries of my innovative theoretical pedagogy?  This was even more unusual since the lecture in question is one of the first three lectures of the M2 curriculum, typically scheduled for the first day! In the few years I have been teaching this course, I always found the entire class showing up for Day 1.Read More »