Why medical students aren't matching--and what happens next?

AMA Wire
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More than 250 of this year’s graduating seniors from U.S. allopathic schools did not match to a residency position, which has medical educators troubled amid growing concerns of a physician shortage. During a discussion at the 2015 AMA Annual Meeting, experts examined where these unmatched students are going and strategies for making sure they get to use their MDs.

According to the Association of American Medical Colleges (AAMC), the top seven reasons this year’s seniors failed to match were:

  1. Had low scores on a United States Medical Licensing Exam (USMLE)
  2. Weren’t competitive for their first choice specialty
  3. Didn’t have an appropriate backup/alternative plan
  4. Didn’t follow guidance from their faculty adviser or dean’s office
  5. Had poor interviewing/interpersonal skills
  6. Did not rank enough programs
  7. Failed a USMLE exam

Of these unmatched students, nearly one-half had been discussed in promotions committees at their schools, indicating they had performance problems, said Geoffrey Young, senior director of student affairs and programs at AAMC.

“The issue becomes, ‘How do you counsel students to think more realistically [about their options]?’” Young said.

AAMC data show most students who don’t match either re-enter the Match the following year or continue to seek a residency position. Others re-enter with a different specialty or take a research year.

Schools should explore how to better advise and counsel students for the Match, Young said. They also may need to re-examine their promotions standards, which may be a tough discussion.

“At some point, you need to help a student make an exit plan [from medical school],” he said.

But it’s important to remember how each of the 254 students who didn’t match this year felt when they got the news, said Kathleen Kashima, senior associate dean of students at the University of Illinois College of Medicine.

How one school is taking action

When a student has trained for years to be a physician, then sees a message on Match Day that says, “We are sorry, you did not match to any position,” they feel shocked, embarrassed and betrayed, Kashima said.

“They think, ‘Is my career over?’” she said.

Kashima’s institution decided to take action and ensure its students were as prepared as possible to match. To start, the dean of the University of Illinois College of Medicine started a residency preparedness initiative.

Part of the initiative is a course all medical students must take on career development, which requires them to develop a strategic plan for the Match or alternate career paths.

The school also started a loan assistance program. If a student graduates with medical school debt, has participated in the residency preparedness initiative and hasn’t secured a residency position through the Match, the college will assume the interest of the student’s medical school loans for up to one year.

These two initiatives demonstrate how committed the school is to ensuring its students go on to become physicians, Kashima said.

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It would be enlightening to know what specialties these students were trying to match. Until the incentives to fill (or not fill) the less glamorous (and currently lower paying) specialties are corrected, there will probably be a mismatch.<br/> <br/> Also, folks with poor communication skills have no business being in healthcare. They probably should have been weeded out earlier on, and if their promotion committees didn't do it, perhaps it is good that the match did...<br/> <br/> Anyone who has had to deal with credentialing and/or behavior issues in a medical staff or employment setting knows that many of the most troublesome physicians should have been removed from the profession long ago.
It is really sad situation ,after many years of hard study, for the candidate to get the crushing news . The responsibility lies squarely on the medical school . they should have detected the shortcoming of the students and advice either corrective plan or exit plane .
I am a US medical graduate and I have associated with Medical schhols for many years. <br/> In my opinion, an internship position should be guaranteed to every graduate of US medical school who has passed part I and II of USMLE. This will atleast allow them to get their medical licence and practice in a area of need or try again for a residency of their choice. In many countries students don't get to graduate unless they complete their internship year of training. Since so much of public money is spent on bringing a college grad to the level of a graduating medical student, it is an act of finacial irresponsibility for a medical school to deny him completion of training and him eligible for a professional licence. Medical schools should be penalized for every graduating student who does not match.
Sorry about the typos. It was a combination of typing on a small screen and aging eyes. <br/> I hope I got my point across. <br/> Medical educators, please give our grads a financial break. Guarantee them a year of Internship in Transitional or Primary Care medicine and don't just abandon them with a piece of paper that proclaims them as Doctors.
Ever read the 'Quiet power of introverts'? An interview isn't everyday life to be the measure of how well one communicates, nor is an eight hour exam a measure of someone's intellect or success as a doctor!<br/> Everywhere else in the world they don't waste bright minds who have invested emotionally, financially and with their youth in pursuit of medicine. Everyone gets a chance at training and residency.<br/> I am appalled to hear of the alleged doctor shortage while bright minds go wasting year in and year out not matching. I am appalled to see doctors replaced with nurse practitioners or physicians assistants to keep the big salary for the head honchos and cheat patients out of proper care and we all know as we work in hospitals that there's no doctor supervision with people who like to play doctor - a person with toothache is sent home on ibuprofen ends up dead from a heart attack but hey so long as those undesirables are weeded out early. <br/> I have personally completed all my steps including step III with scores above 200- & I do have an undergrad in molecular bio... yes I have had failures and yes it is difficult to discuss oneself in nine minutes or less in a sea of applicants. Btw the way what is a good backup plan when all your life you've been studying to be a doctor? Is that filler? Or what does it matter if you didn't listen to your counselors whose job is to tell you to have good backup plan? What is that backup plan exactly care to shed light in lieu of listing unnecessary drivel? <br/> Also, how can you rank enough programs when you're only offered one or two interviews at most after spending $5000 or more?<br/> It is obviously not as painful for the author or the commentators as it is for the people living it. I wonder how you'd behave if in your life you're met with such draining difficulties and then have clueless individuals no matter how high ranking their position ridicule and reduce your entire life into a clueless statement. <br/> I do fantastic working for other doctors pro bono, I receive a recommendation letter if at all for doing scut work that even people out of high school wouldn't do with the lure of a salary as motivation or simply to get published only to have others dismiss in what in their mind is deemed important like hiring their own kids. Both sides taking full full advantage, talk about troublesome and opportunistic personalities!<br/> You're not really offering a solution when you speak in retrospect of what should have been done and who should be weeded out! And I don't think anyone is waiting for you to dole out your sympathies least of which when you're so condescending you speak of them as a herd of heifers or school children, how long will this game of artificial prolongation of childhood and wasting of people's lives going to go on? Who the heck are you really outside of where you work and the title you hold there, have you human qualities? the kind of qualities that should be found in a physician?<br/> Einstein was kicked out of school, some of the most brilliant minds suffer from asperger or panic attacks or a host of personality disorders that by today' standards they should have been aborted in the womb!<br/> Some of the most appalling personalities in medicine have had no failures and do a great job hiding their pomposity- it is all an act, even compassion is taught for funding, making top dollar is really what matters at the end of the day.
Maybe the whole USMLE standardized exam thing is a money making scheme. Did they ever think of that? Everybody knows it. Maybe some very brilliant people are NOT standardized thinkers. Why is there even a step 3? Yes, I've take and passes all of the exams. Our intelligence and ability to be a great doctors has no bearing on a USMLE score result. These questions are generated by a mindless, compassionless, frankly bizarre computer system. Did you know that any doctor that graduated before 1992 DID NOT take any of the USMLE exams? Many of the older docs only did one year of residency. THESE ARE THE PEOPLE WHO ARE JUDGING US. What a disaster. Ask them what their score was on these exams. Ask them how many patients have ever asked what their score was on step 1.<br/> <br/> There are so many people applying for so few slots that program directors are "cherry picking." Thanks to the lack of effort on the AMA's part, there are thousands of us now sitting around with useless M.D. degrees and hundreds of thousands of dollars in student loan debt. The AMA should have done something when congress froze residency funding in 1992! Now we have a really big problems! None of us can pay back our loans to the federal government, our country is 2 trillion dollars in debt, congress refuses to budge and we're about to face a doctor shortage. The U.S. is essentially shooting itself in the foot.
Is the truth painful? I removed it so it wouldn't hurt so much
Is there a possibility of learning more on the creation and implementation of the course on career development at the University of Illinois?
My son is medical student with high score in part 1 and 2 , it is very socked and nervous break down with him and family with 300000 loan and his future is unknown, lack of guidance he is not match. I canot effort to support him any more , if you give training and education for many year should be sure about their future, please advice on this situation<br/> <br/> Thank you<br/> one mum
It is very sad here telling people my son and daughter didn't match both. My son is a very bright young man with scores above 220, speaks 3 languages fluidly including Chinese and Spanish, he's a biomedical engineer, with publications in breakthrough research, and a recognition with honors in his neurology rotation from Harvard. He was highly promised a residency position in neurology by a medical institution in Houston whose directors called my son's professors and told them he would be selected and they didn't. My son was interviewed by other greater schools but he his heart was with the Houston school whose doctors who interviewed him begged him to rank them number one. My son wouldn't lie. Now he is with no match trying to go through this with dignity. This is incredible for us and very costly in so many ways. His people skills are great so that wouldn't be the problem. But what was it? Why did they lie to him and caused so much grief?<br/> <br/> My daughter is an international graduate with rotations in US hospitals. She is bilingual with great people skills. She also has publications but for what? One of her scores is above 220. She got only one interview but no match. You all can imagine this happening to anyone. Probably a first in history. We are so embarrassed and in so much pain we seem to be in hiding from so many people who know this. <br/> <br/> A totally unfair situation after my children are such role models, great people's people I wish you all meet them. They put the work, did the volunteering, all. Sad sad times. <br/> <br/> Thanks for reading and understanding this if you can. I can sympathize with those in this unbearable predicament. <br/> <br/> If you have some helpful info pls email me at [email protected] We are desperate.
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Apr 19, 2017
The University of Connecticut is one of several medical schools using an adapted EHR for case presentation. The platform features thousands of records with real patient data.