Docta21
My class started with 90-95 people, and there were 70 something that entered the match.
A few dropped out in Australia because they didn't like it/couldn't handle being away from home. A few failed a semester and had to redo a year (thus dropping down to the 2017 class). That ALSO happened the opposite way, meaning my class inherited so people who failed a class who were originally class of 2015.
One or two people actually got hard core into research and took a year off to do that at UQ. Also, despite it being more difficult now we had 6 people stay in Australia to pursue their medical careers there.
Unfortunately more than a few people did not pass step 2 in time and therefore could not enter the match. The school makes it very clear that if you don't take step 1 before phase 2 you are shooting yourself the foot, but still a lot of students make that very bad decision, then get behind, and never catch up.
For those that do not match most will try to do research for a year (Ochsner can help with this) and then they will reapply next year. They will most likely try to find a community IM or FM program but if you do not match your first time around it's much harder to match a second. The people who failed a rotation, did not take step 1 or 2 on time, etc who do not enter the match will also be at a significant significant disadvantage when they try to match next year. (If you have any time off in medical school residency will know about it and they will want a really really good explanation as to why).
Other options for those who don't match - someone got a job with firecracker or one of those step studying companies. You can try to get a job with a pharmaceutical company, medical device, etc. Having an MD give you options, but remember you will have that debt hanging over your head no matter what and the job security/compensation if you don't go into residency is scary.
All of this being said, if you put in a modicum of effort and sustain that for 4 years then you should never be in that position of not passing rotations, graduating, and/or matching. There is always an exception to the rule (death in family, your own health problems, etc), but those extreme circumstances obviously do not account for the majority of the 20 or so people who started with my class but did not match with us.
(Just wrote this all on the phone so excuse any weird autocorrect, will go back and edit if I see any)