Unmatched to a Surgical Specialty → Matched to a Non-Surgical Specialty in 2nd Iteration: An MS4’s Perspective
As the title suggests, I was one of the unmatched CMG MS4s this cycle to a surgical subspecialty. As some folks have commented/posted about the low match rates in surgical specialties this year, I wanted to share my story for students about my perspective going into competitive surgical specialties and pursuing something different after going unmatched. It’s a long one.
Let’s get this out of the way first: Not matching is crushing.
This is an experience that is felt by few CMG medical students. The first 24-48 hours are absolutely devastating, regardless of the type of medical student you are: 3 or 4 year undergrads, Masters, PhDs, etc. You’ll be emotional. You’ll feel intense feelings of sadness. You’ll be envious of your peers getting posted on instagram to their dream programs. All while you’re at home deciding whether or not to go to your school’s match day party without a Match Day T-shirt. These are all real experiences for folks who go unmatched.
After being in these moments, I will say with certainty: these feelings are fleeting. For those of you reading this in the future, you will get through this. Every mentor I reached out to as well as residents who went through the same unmatched process all say that these career bumps happen for a reason. And this career bump of going unmatched to a surgical specialty really resonated with me in the following 6 weeks leading up to second iteration match day.
On Match day, my medical school had a meeting with all the students that went unmatched in my year and you’re faced with these options: 1) Apply to second iteration, 2) not apply to second iteration and graduate, and 3) Not apply to second iteration and participate in a fifth year of medical school and participate in next years match. While 1 and 3 are simple, 2 would mean graduating but not being able to have any clinical privileges since you’re no longer a medical student. For me, 1 and 3 made the most sense.
After reaching out to my mentors (I’d say upwards of 10-15 MDs in various phases of their careers), many advocated for choice number 1. The biggest reason was that nothing is guaranteed after completing a 5th year. You are foregoing a PGY1 salary (73k + call stipends, roughly ~80k), paying a year of rent in HCOL city (for me), paying tuition (although heavily subsidized), and future staff salary by delaying 1 year. So with that in mind, I went to look through residency options for the second iteration.
To my surprise, a few spots in the surgical subspecialty I applied in the first iteration to had some spots open, which is a small but significant nuance to my situation. “I could still be a surgeon”, is what I thought when I saw the list come out Match day (all available residencies not filled after the first match are in a convenient list). In the moment, I thought about how serendipitous this was - how were there new spots open in the specialty I applied to? Regardless, I knew I would apply to it at the very least. However, more thoughts and reflection started to surface between Match Day to Match Day 2.0.
Specifically, I’ve been given an opportunity to re-evaluate my decision to be a surgeon, which comes with all of its sacrifices: 1:2 to 1:4 call, 530/6am rounds, weekends, time away from friends and family, time away from my children I hope to have during residency, not being able to travel the world, uncertainty of job market in my hometown, and others I am sure I am forgetting. These were thoughts I was able to think more about and what I want in my life. Despite having 7+ interviews and knowing these programs passed on me, a part of me wanted a clean slate.
Further, going unmatched in a small surgical subspecialty can create an inherent stigma in future application cycles. Whether fair or unfair, these specialties are small communities where programs often know each other well and discuss applicants. Through conversations with mentors and staff involved in residency selection, I came to appreciate that applicants may go unmatched for many reasons: limited research productivity, weaker clinical performance relative to peers, concerns raised during electives, interpersonal fit, or simply the extreme competitiveness of the specialty. Sometimes there is no major flaw at all. Just too many excellent applicants for too few positions, which I think may have been the case for me. The peers I met in elective were fantastic and I’m so happy to see them all succeed.
That reality made me reflect deeply on whether pursuing another cycle in the same field was truly what I wanted. While there are certainly people who successfully reapply after a fifth year and match to competitive surgical specialties, a few I have met through this process, nothing is guaranteed. From what I’ve gathered though, ortho, ENT and ophtho (with fifth year fellowship or research year) are more forgiving, while neurosurgery, cardiac surgery, plastic surgery are not so forgiving.
With all of these thoughts coming to mind, I ended up applying to the same surgical subspecialty, family medicine and a 5-year non-surgical specialty. In the following few weeks, I had interviews with 8 total programs to the specialties I applied to.
But ultimately, I ranked the 5-year specialty first (which I had no electives, did a core rotation, and one selective in). This was followed by family medicine and then last, my surgical subspecialty. I know, huge 180. Through my period of going unmatched, one thing that surfaced for me after going unmatched was that being a physician is a means to an end. It’s an occupation and career that I am really lucky and fortunate to be in. But at the end of the day, for me, family and my free time outside of medicine was something I valued more than being a surgeon. Going unmatched allowed me to see that. It took a lot of soul searching to accept this.
On second iteration match day, I was relieved that I was accepted into my first choice in the 5-year non-surgical specialty. It’s a specialty I really enjoyed in medical school and excited about. It was an extremely hard decision, but future me will thank me for not going down the surgeon path. I even had the PD of the surgical subspecialty I applied to reach out to ask where I matched. They even sent me an email to consider transfer if I don’t enjoy my 5-year specialty after PGY-1.
All of this to say, surgery isn’t everything. It may seem that way as you’re reading this while in a call room waiting for a consult or between ORs drinking a coffee to stay awake the rest of the day. If I could go back in time, it would be to look at the rotations you enjoyed in medical school and ask yourself if you’d be happy in that specialty too. Personally, my time with family/friends/partner, travelling the world (currently in SEA writing this), and being able to have a practice close to my home town were the biggest reasons for the switch in specialty. In another life, I’m sure I would have made a fantastic surgeon, as many of you will (or won’t). I think it’s important for medical students to educate themselves on their specialty choice before going down the surgery route and I hope I can help some you in the future.
Happy to answer any questions here or DM about going unmatched, participating in the second iteration, any surgical-related questions.
TLDR: Went unmatched first iteration in surgical specialty. Applied broadly in second iteration, including same surgical specialty. Ended up ranking non-surgical specialty instead and matched to it. Realized surgery wasn’t for me after going unmatched. Happy to help others!