What if you don’t match? 4 things you should do

On Monday, March 17, medical students participating in the 2025 Main Residency Match will find out if they matched with a program.

Those who get the unfortunate news that they did not match and who are then unsuccessful in obtaining a position through SOAP, the Supplemental Offer and Acceptance Program, might wonder what their options are for keeping their dreams of a career as a practicing physician alive. Physicians who have worked with unmatched applicants and an applicant who went through the process without landing a Match offered insights on what can be done in the coming year to improve the odds of matching the next time around.

For unmatched applicants looking to understand their options in the next cycle, FREIDA™, the AMA’s comprehensive residency and fellowship database, includes more than 13,000 Accreditation Council for Graduate Medical Education-accredited residency programs, and has a new look and feel that offers a streamlined user experience.

Family physician Margarita Loeza, MD, MPH, is assistant dean of student affairs and admissions at the Charles R. Drew University of Medicine and Science and formerly served as chief medical information officer at Venice Family Clinic, a community health center in Los Angeles. Having worked with unmatched applicants in the past, she has seen firsthand, in both those graduates and her peers, the steps applicants can take to make themselves more attractive to residency programs.

One key, she said, is to stay in touch with your medical school after you graduate. 

It’s true that some unmatched applicants “will be embarrassed, hide out and not tell anyone, but they ought to do just the opposite,” Dr. Loeza said. “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.” 

The AMA helps medical students master the residency-application process so you can make the right decisions about your career, prepare for a knockout interview, explore residency opportunities—all so you can successfully match.

Dive deeper: 

• If you don’t match, take these 5 tips from a SOAP survivor
• Match: Which specialties place most residents through SOAP
• “Meet Your Match”: How to find a position through SOAP

“You have to get a job that helps you keep your clinical skills, so you don’t forget medicine,” Dr. Loeza said. “Programs are going to want to know how you kept your clinical skills current, because you sat out a year. 

“As a rule, you aren’t allowed to care for patients unless you’re in a residency, but you can, say, scribe for a doctor.” 

But the work does not have to be in direct patient care.

A family medicine resident, Thomas Irwin, MD, went unmatched in 2021. Working with a faculty member from his medical school, he worked to understand why he may not have matched. He offered the research positions done in your year off can be viewed favorably. 

Ideally, you are looking for “paid research positions, preferably, that give you some clinical exposure, but also give you a chance to advance your resume by publishing research, anything that will demonstrate to programs you're going to apply to the following year, that you're continuing to work within the field,” Dr. Irwin said during a recording of the “Meet Your Match” podcast series.

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

The United States Medical Licensing Exam (USMLE) Step 3 tests more in-depth clinical knowledge and decision-making. Because USMLE Step 3 covers the core disciplines, it is recommended that you take this exam while your knowledge of these core areas is still fresh.

Taking the exam while you’re in between medical school and residency can pay dividends.

“Passing it will make you a more competitive applicant the next time around,” Dr. Loeza said. “Some residents have started intern year and then didn’t pass Step 3, so their program was short a doctor. Passing it will make program directors feel they don’t have to worry about you. 

“A couple years ago, I had two unmatched graduates working for me. One took Step 3 and passed it, and he got 14 interviews. The second student didn’t take Step 3 like I asked him to—he got only one interview invitation and didn’t match. The next year, he took Step 3 and passed, and then he matched.” 

Dive deeper: 

• “Meet Your Match”: How a physician found a residency slot outside the Match
• The SOAP process—what applicants need to know
• Key advice on for unmatched applicants
• “Meet Your Match”: A guide to reapplying

After going unmatched Dr. Irwin worked with a faculty mentor—Carla Keirns, MD, PhD—to understand what may have been his application’s weak points. 

“One of the things that we did to make sure that some lessons were learned from this was we went back and systematically deconstructed everything we did,” said Dr. Irwin, now a family medicine resident at HCA Research Medical Center in Kansas City, Missouri. “What worked? What didn't work?”

In conducting what Dr. Irwin termed a “systemic deconstruction” the duo left no stone unturned. That involved reviewing every aspect of the application and changing what they could. 

“Every letter, every personal statement. We customized them as much as we could to every program,” said Dr. Keirns, associate professor of medicine at the University of Kansas Medical Center. “And we made sure that what was changeable, what could be improved had been addressed. The things that you can't change, you're not going to be able to change the board scores you already have. But the things that we could change, we made sure that they were as optimized as they could be.”

Dr. Irwin also had to open his mind about applying to non-surgical specialties. 

“I did not include the medicine specialties until my second reapplication cycle,” he said. “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.”