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No its not the end of the world, but thats also not a guaranteed path. The match gets harder every year, especially on anyone who isn't an MS4 med student. Not saying its impossible, but its certainly not something you could count on.
Yes, but you can also apply for and obtain open PGY-2 positions out of the match. Who would programs rather have if they need to fill a position during the year, their pick of the prelim litter or an IM attending? There's an anesthesiologist at our program who is board certified in Ob-gyn and fellowship trained in maternal fetal medicine and anesthesia-critical care...
Never mind that you could work as a hospitalist or whatever while you're applying.