Unmatched or "Not Favorably" Matched: Insurmountable Obstacle or Opportunity?

It is mid-March (NRMP Match Day) and you are opening your envelope (or email) to see where you matched for residency. It is not the specialty you expected. It is not the program you expected.

Alternatively, it is the Monday at the beginning of Match Week in March and you find out you are not fully matched. You are either partially matched or not matched at all.

Your heart stops. You think, "What now?". You think, "What will my family, friends, and others think of me?". You think "I don't know where to go from here." All of your visions of the future are not what you dreamed. You perceive a stigma associated with your match results, and you may be unintentionally intertwining your identity and full being with your future career plans.

So, how do you go on? How do you face such an obstacle after the culmination of years of education and training? Will this obstacle end up stopping you in your tracks or, after temporarily breaking down (crying, screaming, and feeling the unfairness of it all), can you convert it into an opportunity?

Life is not easy. We know this. But if we work hard and do all the right things, shouldn't it go our way?

I think this is the key question that can convert a feeling of devastation to that of opportunity and of hope for the future. What exactly is "our way"? What does our future hold and could it actually be better than what we planned for and envisioned?

I will share my personal story. I am an internal medicine physician by training and had followed the established path through medical school, into residency, and finally into medical practice. I was blessed with having a beautiful family and made the difficult decision to stay home for a few years to raise my children before returning to the workforce. My career shifted and has led me through a journey that I would have never expected, yet am thriving in. Looking back on my life and periods of uncertainty, I see how those periods and events that I considered obstacles and seemed devastating to me actually have led me to grow. I have found joy and fulfillment through an unexpected path. My path is one for which I will be forever grateful and look back on with acceptance and true happiness.

Similarly, I have heard from students who have either not been accepted into medical school or who have been unmatched or have been matched into a "suboptimal" specialty/residency program. Initially distraught, they shared their subsequent growth and joys as their journeys pivoted to the road unanticipated.

How do you shift your mindset? It is not easy and everyone is allowed and needs to grieve. Going through the stages of grief with denial, anger, bargaining, depression, and acceptance ("DABDA") to ultimately be at peace with the existing situation I believe is completely normal,

Once you have then reached such a state of acceptance (or near-acceptance), first remember that you are not alone. You are not the only one who has been in such a situation. Reach out to your support group and loved ones. There is nothing embarrassing about not matching, not getting accepted to a college or graduate school, or achieving that for which you have worked hard and hoped to attain.

Returning to the concept of a growth mindset, you can take what you are faced with and think about the infinite options available. Open your mind to the possibilities. Consider the adventure of it all. There is a path for you, and you just have to search for it. Having supported others through their journeys, it is amazing to me to see how we can all be resilient and come out better on the other side.

So, in answer to the question of whether facing an unexpected outcome will serve as an insurmountable obstacle or if it will open the door to future opportunity is in your hands. Having walked this path, I am confident in saying that there is hope for joy, perhaps even more than you could have dreamt of when faced with the unknown.

To all of those who are facing any obstacles in their path, I wish you the ability to pivot (or transform) the unexpected into that which brings you true acceptance, peace, and joy.

You will find your place, and who knows, it could be better than you could have ever imagined!

With gratitude for all of the bumps in my road (and yours),

Sincerely,

Dr. Vora

Rupal Vora, M.D., MPH, FACP

Founder MedStudentCoach LLC

Associate Clinical Professor, Internal Medicine, Creighton University School of Medicine

(Assistant Dean, Student Achievement ATSU-SOMA 2014-2022)