Some Students Don’t Match on Residency Match Day. Do they Need More Support?

Match rates improved across all applicant types in the 2023 National Match. U.S. MD seniors garnered a 93.7 percent match rate (+0.8 percentage points from 2022) and U.S. DOs achieved an all-time high with a match rate of 91.6 percent (+0.3 percentage points from 2022). Among international medical graduates, who historically match at lower rates, U.S. citizens achieved a record high match rate of 67.6 percent (+6.2 percentage points from 2022) and non-U.S. citizens matched at a rate of 59.4 percent (+1.3 from 2022).

The Match generally brought positive feedback for the improving rates, but what about those who don’t match? “After the match, of course, there's an uptick [in calls] every year," said Pamela Wible, MD and Founder/Operator of a mental health helpline for doctors and medical students. "Matchless medical students reach out to me who don't know what to do with their lives, sitting on $300,000 of student loans, sobbing on their couch" continued Dr. Wible, in a MedPage article published after the 2021 Match.

A recent MedScape op-ed considers the challenges for matchless medical students and urges the medical community to provide more proactive and structured advice and guidance on how to navigate not matching to a position. The authors suggest the following ways that medical schools or national medical organizations can offer more meaningful support: 

• Prior to Match Day, organizations can facilitate webinars/meetings that both normalize not matching to a position and also provide guidance on useful actions. The meeting might include topics such as how to adjust career plans, approach loan repayment, enter the SOAP process, explore alternative positions in research or other fields, and reapply to a future Match process. 

• Medical schools should focus on providing mental health support services and ensuring that students know how to access these resources both prior to, on, and after Match Day. In addition to providing access to emergency counseling services, the authors suggest that schools offer stress reduction workshops/tips and opt-out mental health services prior to the Match.

• Finally, schools and the medical community must work together to destigmatize not matching. Students should feel comfortable and safe pursuing next steps knowing that their school and the wider medical community will support them as they determine how they will continue to pursue their dream of practicing medicine. 

“Stay in touch with your dean and others at your medical school and ask them for help…Also, get involved in a research project. Look for mentors at your medical school who are working in the field of medicine you want to work in and volunteer to help,” said Margarita Loeza, MD, MPH and Assistant Dean of Student Affairs and Admissions at the Charles R. Drew University of Medicine and Science in AMA article published last month. 

Despite Stress and Burnout, Most Students Feel that Medical School Prepared Them Well for Board Exams and Residency

In Medscape’s 2022 Medical Student Lifestyle report, which included responses from over 2,000 medical students, many respondents reported experiencing burnout: 37 percent of students reported occasional burnout, while a full third of respondents (33 percent) reported frequent burnout, and 12 percent reported constant burnout. And while 37 percent said that they rarely or never experience doubt about becoming a doctor, many said they did experience doubt sometimes (44 percent), frequently (15 percent), or constantly (4 percent).

Despite many medical students experiencing stress and even doubt, most reported feeling that their medical schools prepared them for the future. The majority of students (64 percent) noted that they felt prepared or very prepared for the USMLE, with half favoring the move to a pass/fail format for the test. Just over two-thirds of students, 67 percent, reported satisfaction with the relationships they formed with their professors. And 59 percent reported feeling prepared or very prepared for residency, with that proportion increasing to 75 percent among fourth year respondents. 

Many students also reported that they found meaning during the pandemic. Over one-third of respondents, 39 percent, reported that Covid reinforced or strongly reinforced their drive to become a doctor. In terms of specialty selection, 24 percent noted that Covid slightly or somewhat influenced their specialty choice, and 12 percent said that Covid influenced or strongly influenced their selection of a specialty. The majority of students (54 percent) said that they felt satisfied or very satisfied with how their medical school handled Covid.