As a medical student, matching to a residency position is a thrill. Yet—in terms of landing your No. 1 ranked choice of residency program—there is no guarantee that things will work out according to your plan come Match Day. And when they do not, you may feel as though you’re alone in your disappointment.  

In advance of Match Day 2025, two physicians who were surprised and initially disappointed with their Match results shared some insights on how to cope and adapt. 

Personal disappointment on Match Day is hardly an aberration. 

According to data on the 2023 Match—the most recent cycle for which such data is available—

48% of seniors from U.S. allopathic medical schools got the top choice on their rank-order list, while 73% wound up in one of their top three on Match Day. The numbers for seniors from osteopathic schools were similar, with 46% landing at their top choice and 75% getting one of their top three spots, according to the data compiled by the National Resident Matching Program (NRMP). 

“If something feels off or feels wrong, it’s really common. A lot of unexpected things can happen and no one really has control over the algorithm,” said AMA member Laura E. Halpin, MD, who completed her psychiatry residency and fellowship training in Los Angeles.  

“The disappointment is a real challenge. … It’s easy to feel you failed or did something wrong if you don’t get your top choice.” 

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.

Dive deeper:

• Want to switch residency programs? 5 things you should know
• What I wish I knew about matching outside my top-ranked choices
• Big party, or private affair? Considering how to spend Match Day
• Waiting on Match Day? Ease your mind with this expert advice

Students are often advised to envision living and training at any of their top five choices prior to Match Day. But for some, it is difficult not to get fixated on No. 1.   

As a medical student, Myphuong Phan, MD, MPH, had her heart set on returning to Houston, her hometown, for residency. But things did not go as planned.

Upon reading her Match letter, Dr. Phan “literally froze for 30 seconds—it was like I was not reading what I was reading,” she said. “I didn’t see ‘Houston’ and I was shocked. I found myself crying and it took a few minutes to calm down and be OK.”   

Dr. Phan, an AMA member, ended up at her No. 3 choice, a family medicine residency program in Austin, Texas. Instead of being a few minutes from family as she had hoped, she was a few hours away. 

Yet she found several positives with the structure of that program. For instance, the program was smaller than her top choices—taking about seven residents per year. She discovered that working with a smaller team of residents creates a solid support system.   

“I’m challenged, and I’m growing in ways that I’m happy with,” said Dr. Phan during her residency. She is now practicing sports medicine in the Houston area. 

Dr. Halpin ended up in a program she wanted to go to for general surgery, her preferred specialty in her Match rankings. From the start, however, it just did not feel right. 

“On Match Day, I looked around and saw happy people and didn’t feel that happy,” she said. “I didn’t understand what was off at the time. A few months into the program, I realized that it [general surgery] wasn’t the specialty choice that I wanted.”   

Follow the road to residency

Get tips and insider advice from the AMA on how to successfully Match to a residency program—delivered to your inbox.

Subscribe Now

She began to explore the possibility of leaving the specialty. For residents who take this step, Dr. Halpin cautioned, you must read your employment contract at your program and with the NRMP. Anyone who matches through the NRMP is required to remain in the training program for 45 days after their contract takes effect. Failure to do so could prevent an applicant from being able to re-enter the Match.   

Eventually, with help from her medical school advisers, Dr. Halpin identified psychiatry as her preferred specialty. She left her first residency program and re-entered the Match. The following spring, she wound up matching with the residency program from which she would eventually graduate.   

“My Match Day the second time around was me at work opening an email. I was super excited, but it wasn’t the same,” Dr. Halpin said during her residency. She now practices child and adolescent psychiatry in the Los Angeles area. 

“In the end, the place I’m at now is a perfect fit for what I want to do as far as specialty and career,” Dr. Halpin noted.

Dive deeper:

• Want to switch residency programs? 5 things you should know
• Meet Your Match: Maintaining wellness during the long wait
• So you matched to a residency program—now what?
• Make the most of your post-Match time in medical school 

Typically, less than 10% of U.S. medical school graduates experience the much greater disappointment of not matching at all. In 2024, the number was 6% for senior graduates of U.S. MD-granting schools, and 7% for graduates of DO-granting schools. 

During Match Week, unmatched applicants and unfilled programs will work to match with one another through the National Resident Matching Program’s existing Supplemental Offer and Acceptance Program (SOAP). Four rounds of SOAP are planned for 2025. In 2025, SOAP runs March 17–20. 

FREIDA™, the AMA Residency & Fellowship Database^® (registration required), enables unmatched students to research residencies from more than 13,000 programs both during and following SOAP. Access is free, but extra benefits—such as a dashboard that helps users save, rank and keep notes on each program—are available to AMA members.