If I go unmatched, I plan on going into long haul truck driving. Great pay (up to 80K/yr) and you get to see the country! In addition, you get your own special bathroom and lounge at the Flying J...
Seriously, there are several choices. Quitting medicine all together and driving a truck is just my choice. You can scramble for a position in your desired field, scramble for a position in another field (i.e. FP which will have unmatched positions), scramble for a prelim position, or take a year off and do research (i.e. take time to politic for a position in the next years match
🙂).
Also, you can pursue an advanced degree such as an MBA or MPH or join Dean's grass roots organization and make life better for "ordinary Americans", whoever those people are.
You can also opt for one of those career paths that don't require a residency. For example, one brilliant gentleman I know ended up hating medicine but finished medical school. He has a flair for writing and is now working as a medical editor. One Yale guy that I know of who couldn't even get into truck driving school, let alone medical school, is now serving in a very high public office.
While I hope that we all match, there is always hope as long as you're not afraid of being a bit creative.