What If I Match a Residency Program I Don't Want?
Posted 05/05/2008
Question
What should I do if I wind up matching a residency program that is not even near the top of my rank list?
Response from Daniel J. Egan, MD
Attending Physician, Emergency Medicine Department, St. Vincent's Hospital, New York Medical College, New York, NY
The residency application season is by far one of the most stressful times for a medical student. You spend months thinking about where to apply, large sums of money traveling around the country, and then days to weeks struggling with the list. Who should I rank first? Do I have a chance of matching there? What happens if I don't get my top choice?
The last question is one that I can vividly recall asking myself and hearing my medical school friends repeat time and again. The entire process of the match creates a sense of success or failure based on where you wind up. Schools have match ceremonies. The lists are published and bragged about. It is, after all, somewhat of a competition, with the ultimate prize being your "first choice."
Nearly every student who enters the match worries about not getting their first choice, or worse, not getting one of their top 3 choices. What if that actually happens?
The first thing I have to say is, "Congratulations!" you matched. Approximately 6% of US graduating medical students do not match at all and have to scramble. A stressful process has thus become even more stressful for those individuals. Furthermore, according to the National Resident Matching Program
www.nrmp.org, in 2007, 58.6% of US students matched at their first choice. That may seem like a lot, but it also means that many students are not going to their first choice.
In my experience, most people will tell you that the match actually works. You are going to a program that wants you to be there. Remember, the same way that you were told not to rank any program where you cannot imagine doing your training, residencies also do not rank students who they do not want working for them. If you have a spot, it means that both you and the program managers agree that you fit in there. This is exciting when you think about it. Of course you will be disappointed when you first get the news, which is a normal response because of the amount of time you spent thinking about that list. However, allow that disappointment to be brief, because residency is challenging by design and you will need positive energy.
Residency is an exciting time. Any residency program is going to introduce new aspects to your life. Regardless of the program's ranking on your list, you will be embarking on a journey that will form you into a true physician. Your knowledge base and skill set will increase exponentially. You will forge friendships like you never had before. Each new resident begins the journey alone, but you will soon have a group of people with whom to share that journey. You will bond, rely on each other, vent to each other, disagree with each other, learn from each other, and ultimately graduate with each other. Many of you will start a life in a new city and realize that it may be the beginning of the rest of your life.
So fear not. Your residency program is excited to have you. You are finally a doctor. Keep in mind that almost half of the applicants do not get their first choice. It's okay. The match works. People will tell you that, somehow, everything seems to be fine in the end. Try to move on from the initial disappointment because, literally, these are the most important years in your future. Embrace them and enjoy them!
