Medical Graduating DO, did not match. No idea why.

[AlteredScale]

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I will graduate this May from one of the "established" DO schools and I did not match into anesthesiology, nor did I find a spot in the SOAP. Currently working on scrambling into prelim years to reapply next year. I have ZERO failures of anything, and step scores are 22x/23x. COMLEX scores are above average. I had a career prior to medical school with a lot of good/unique allied health experience and what I think is a pretty interesting application. No red flags that I can think of, other than class rank just below 50th %ile. I was given copies of my LORs after the cycle was over and they are extremely positive.

I applied broadly, to 70 categorical and advanced programs and 10 prelims. I got 5 categorical interviews in this cycle, and I believe at least 4 of them went very well. In the SOAP, I got an interview for prelim-IM that went well with great feedback from the PD to my dean and a categorical interview that indicated "we'll do everything we can to get you here". My dean of student placement is at a loss for what happened.

I know the odds of getting a spot next year are even worse than they were this year, so I'm seeking some guidance on what to do. I can always work a year in my old field and make some money in a niche clinical position, but I would rather do research to try and bolster my application. I also plan to take step 3 before the next cycle. What else can I do? I can't do auditions because I'm no longer a student and my networking opportunities are extremely limited with no home department. I 100% want anesthesia and can't imagine seeing myself doing anything else. It's just extremely disheartening.

Thanks in advance!

I am sorry you did not match. That is very difficult to deal with. And tbh, sometimes there are no red flags and the system just gets the best of you. I am wondering, what sorts of places did you apply to with those programs? were they all univeristy? how many of them were DO-friendly?

I suggest asking your school if you can continue to enroll for a fifth year in which you can continue your clinical exposure..essentially a repeat 4th year. If you can do that try your best to get in touch with nearby anesthesia programs to continue with research.

If you cannot do that I think taking a research year would be good while continuing clinical exposure as much as possible. The worry here is that you will begin to lose your clinical acumen. So I really thing the first thing you should do is ask your school to stay enrolled so you can continue with elective clinical work without any issues.

 

[GoSpursGo]

I'm really, really sorry that you're going through this. Nobody deserves this feeling.

That said, I am going to give you some cold, hard truth: your application reads like a textbook unmatched DO anesthesiology applicant according to charting outcomes . Match percentage in 2020 was only 79%, and the mean steps for unmatched applicants were 221/230. Mean contiguous ranks was 4.7. I'm sorry if nobody told you this ahead of time, but your application had a very real risk of failing to match, and maybe it was worth shooting your shot but unfortunately it did not work out.

I suggest you take a week and clear your head. Then really think hard about whether you could be happy doing something less competitive. Again, you shot your shot and the answer you received was that you weren't competitive for anesthesiology. The safest, most sure-fire way to make sure that you are practicing medicine in some capacity going forward is to change plans and apply for a different specialty. If your heart truly burns only for anesthesiology, then the question you will need to answer is "What is going to be different next time," and you can consider some of the ideas that @AlteredScale suggested.

 

[TheBoneDoctah]

I am so sorry that you are dealing with this. Keep your head up.

I have to agree with @GoSpursGo here on your scores though. When applying in the match, you need to be honest with yourself. "Are my scores and application going to LIKELY get me to match SOMEWHERE?" With your scores, I would have been applying to backups. I know that you said you only wanna do anesthesia, so maybe this cycle was worth it not matching, but if you are going to reapply, you NEED to have a backup (FM and IM) because you are at real risk of not having a job.

 

[TheBoneDoctah]

Thank you for the response. I agree with you and as I move forward I will apply to backups. I'm not trying to make excuses, but I will say that when I sought advice in WAMC threads here and on Reddit, I was given this advice: "you'll be fine to match somewhere because you are a DO and not IMG/FMG. If you apply broadly and do not have a top-heavy list you will be good."

I say this not to validate my reasons for not having a backup. I chose not to apply to backups and that decision is my own. It does, however, seem that the conventional wisdom re: the competitiveness of anesthesia and what makes one a "decent" applicant appears to be shifting. When I applied to medical school, I was told that DO was fine for most non-surgical subspecialty residencies. I'm not blaming my degree on where I am, but I know that it 100% did not help. I think that seeing applicants before me enter into university programs with step scores >10 points lower than mine also gave me false hope.

Regardless, I appreciate your reply and I hope this doesn't come off as too dismissive or defensive. That's certainly not my intent.

The DO degree is good for most specialties, however, you need to score at least as good or higher than your MD counterparts usually to get that same spot.

The average Step 1 score for matched applicants into anesthesia last year was around 234 with 15 ranks. You had said your Step was in the 220s and you only had five interviews. Chalking this up to being a DO is kinda drastic as I don’t think that’s why you didn’t match. There’s a lot more than just scores that go into getting an interview and being ranked high enough to match.