Preparing for Residency

Didn't match? How to come back stronger next residency-selection cycle

One failed Match should not define your career. Bounce back with expert advice on reapplying to physician residency programs.

By
Brendan Murphy , Senior News Writer
| 6 Min Read

AMA News Wire

Didn't match? How to come back stronger next residency-selection cycle

Jul 1, 2025

After an unsuccessful Match, reapplying to residency is a tough road, but it’s a well-worn one. With strategy, support and self-awareness, it can lead right back to where you belong: caring for patients.

An episode of the “AMA Making the Rounds” podcast series featured a faculty member and former unmatched applicant—now a resident physician—break down what they’ve learned from closely analyzing the Match process. Drawing on both research and lived experience, they offer advice for applicants preparing to reapply with a sharper, more competitive strategy. 

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These tips can help reapplicants navigate the Match process successfully. 

After not matching, your first move should be a thorough, unflinching audit of your application. That means reviewing your specialty choices, board scores, personal statements, and letters of recommendation. 

After going unmatched, AMA member Thomas Irwin, MD, contacted his medical school to tell the advising staff that he didn’t match. From there, he paired with a faculty member with whom he had a strong relationship to give his application an objective assessment. 

It’s key to have a “trusted adviser who's going go back over your application and figure out why you didn't match.” said Dr. Irwin, now a family medicine resident at HCA Midwest Health Research Medical Center in Kansas City, Missouri. “And that takes a certain level of introspection and harsh evaluation of what did and didn't happen. That can be very tough.”

HCA Healthcare is part of the AMA Health System Member Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.

Dr. Irwin worked with Carla Keirns, MD, PhD, with whom he later went on to research the characteristics of unmatched applicants who go on to eventually Match. 

“You want to make sure that you're talking to someone who will be honest with you, who is aware of what has changed since their own Match, and who will help guide you to what you could do differently,” she said.

The AMA Road to Residency series provides medical students, international medical graduates and others with guidance on preparing for residency application, acing your residency interview, putting together your rank-order list and more.

There is publicized data, most notably that posted by the National Resident Matching Program, related to how medical schools select candidates for interviews, and what characteristics are common among matched candidates in most specialties. That data should inform your reapplication strategy.

You also will have to understand that certain realities of your application simply are set in stone. 

“There are things that you can't change. You're not going to be able to change the board scores you already have,” Dr. Keirns said.

For those still finalizing the list of programs to which they plan to apply, FREIDA™—the AMA’s comprehensive residency and fellowship database—captures more than 13,000 Accreditation Council for Graduate Medical Education (ACGME)-accredited residency and fellowship programs.

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While it is often an intense exercise to tailor your personal statement for each of the dozens of programs you are seeking a residency position with, it might be worth doing—at least for a portion of the programs to which you are applying. 

A direct, compelling message in one’s personal statement can prompt a program director to look for your application, even if it would otherwise be filtered out. Reasons that Dr. Keirns cited that a personal statement may resonate include ties to a geographic region, longstanding interest in a program’s mission and experience working with the community a residency program serves. 

In addition to a tailored personal statement, using your professional network can help your application get noticed. 

“Think about this like applying for any other job,” she said. “Do your homework about the people that you're applying to. And if you have a compelling reason why you would be a great fit for a program, you can reach out or you can have an adviser reach out.”

Dr. Keirns did highlight that any communication outside of your application should adhere to Match guidelines–under which applicants are free to express interest and programs may express interest in return, but no party can solicit or require a statement of intent.

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If you’re taking a year off before reapplying, avoid large gaps in clinical experience. 

“Programs are wary of applicants who’ve been away from patient care,” Dr. Irwin said.

Program directors want assurance that you’re still clinically ready. Drs. Irwin and Keirns highlighted several ways to stay active and strengthen your application in the process, including getting involved in research roles with clinical exposure and volunteering or working in medical education. 

It's also important to take and pass Step 3 of the United States Medical Licensing Examination.  

At the 2025 AMA Annual Meeting in June, the House of Delegates took action to help unmatched medical school graduates. Learn how the AMA is standing up for medical students and catch up with the other highlights from the Annual Meeting.

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One of the most common reasons applicants go unmatched is targeting overly competitive specialties without sufficient board scores or credentials. 

While his initial goal had been to pursue surgical residency, Dr. Irwin realized that pursuing the type of clinical work and patient care he wanted didn’t necessarily require being in the operating room. He began to explore other routes to a fulfilling physician career, such as internal medicine and family medicine, which aligned more realistically with his credentials and still allowed him to care for patients in ways that he found meaningful.

“Once I was able to see what I wanted to do and a path to it from internal medicine, from family medicine, a lot of doors began to open,” he said.

In their research, Drs. Keirns and Irwin found that the vast majority of reapplicants will eventually match into a residency program. While going unmatched may be painful, it is unlikely to prevent you from having a rewarding career in medicine in most instances. 

“You’re still a doctor,” Dr. Irwin said. “And now it’s a question of persistence.

“You've earned the right to be here. It's yours. Go take it.”

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