Lessons from a Tough Match: What to Do If You Don’t Get Your First Choice
Lessons from a Tough Match: What to Do If You Don’t Get Your First Choice
Match Day is a rollercoaster of emotions—joy, relief, excitement, and sometimes, disappointment. For many students, it's the culmination of years of hard work, and the moment they've been waiting for. But what happens if you don’t match into your top-choice program?
It’s completely normal to feel disappointed, frustrated, or even anxious about what this means for your future. However, the truth is that where you match does not define your success as a physician—how you approach the next steps does. Here’s how to shift your mindset, make the most of your residency, and turn this challenge into an opportunity.
1. Acknowledge Your Feelings—Then Reframe the Narrative
First, give yourself permission to feel disappointed. You worked hard, and it's okay to grieve the outcome you had envisioned. However, don’t let disappointment turn into despair. Residency is what you make of it.
The joke in my household is that my husband matched at his #7-ranked residency program—but he met his #1 person in life: me! We can only imagine how differently our lives would have turned out had he matched higher on his list. His Match Day disappointment was very real at the time, but looking back, he wouldn’t change a thing. Residency still provided excellent training, and we found ways to make life fun and fulfilling despite being in a less desirable city. More importantly, he gained invaluable experience, treating far more critically ill patients than he might have at a "cush" community program in a more attractive location. What felt like a disappointment then turned out to be one of the best things to happen in both his career and personal life.
Instead of viewing this as a failure, consider:
✅ You matched! Many students go unmatched entirely, so securing a residency spot is already a significant accomplishment.
✅ Residency is a stepping stone, not the finish line. Where you start doesn’t determine where you’ll end up in your career.
✅ Every program offers opportunities. You may have to be more proactive in seeking them, but you can still get strong training and mentorship.
2. Find Mentors Who Will Advocate for You
Success in residency is often about mentorship. If you’re in a program that wasn’t your first choice, seek out attendings, faculty, or senior residents who can guide and support you.
One of the specialists I rotated with had attended Ivy League institutions for both medical school and residency. Yet, despite her stellar credentials, she failed her board certification exam. For someone so qualified, it was an unexpected setback. But did it make her any less of a physician? Absolutely not. Today, she is a renowned subspecialist, and her patients can’t tell whether she passed her boards on the first or second attempt—they just know she provides excellent care. That experience made me realize that a few bumps along the way, whether in the Match or beyond, do not define the caliber of physician you will become.
This is the same perspective to take with your Match outcome. Whether you match at an academic or community program, a brand-name institution or not, it does not dictate your future success. What matters is how you show up, learn, and grow from the experience.
3. Excel Where You Are—It Matters More Than Where You Are
Residency is demanding, but your performance and reputation matter far more than the name of your institution.
Be proactive in learning and patient care.
Show up prepared—read ahead, ask thoughtful questions, and engage with cases.
Develop strong relationships with faculty and co-residents.
Stay positive and professional—your attitude can set you apart.
I have seen students devastated by their Match Day outcome. Some matched into the lowest-ranked program on their list, while others had to scramble through SOAP. I’ve seen classmates cry, lose weight from stress, and struggle with self-doubt. But I’ve also seen something else: people who matched, then quit their residency; people who initially felt stuck but ended up thriving; and even friends from my college class who, years later, are re-matching into entirely different specialties.
Match Day does not define you. If you have to SOAP, keep your head up. If you don’t match, try again next year. If you land in a program you weren’t excited about, make the most of it. What matters is how you respond.
4. Keep Your Long-Term Goals in Sight
One of my close friends from medical school matched at her last-ranked location. On Match Day, she was devastated. Amid the sea of smiling faces, she was one of the few who walked away in sadness. But what she didn’t realize at the time was that this experience would set her on a path to becoming a successful ICU pulmonary critical care doctor, working in an area that deeply connected to her cultural roots. While she struggled with self-doubt during medical school, her resilience and determination during residency transformed her into one of the most impressive doctors I know today. Her positivity, despite the negative Match Day experience, was what kept her going. And that’s what made her shine. You can do the same.
Didn’t match at a big-name academic center? That doesn’t mean you can’t still achieve your dream career. Many physicians:
Use residency as a stepping stone to a competitive fellowship.
Build strong reputations in their fields regardless of where they trained.
Network and leverage connections for future job opportunities.
If your program doesn’t have a strong track record for your specialty or fellowship goals, be proactive about building your application—seek out research projects, case reports, and faculty sponsors who can help strengthen your chances.
5. Consider the Big Picture: Medicine Is a Long Journey
When you look back years from now, this moment will be just one part of a much larger journey. Residency is temporary, and your career will be defined by your skills, work ethic, and how you treat patients—not the name of your program.
Many successful physicians didn’t match into their dream residency but still found ways to thrive, grow, and shape their careers on their own terms. You can, too!
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Need support during Match Week?
If you're feeling uncertain or need guidance during Match Week or beyond, reach out to me for support. I’m here to help you navigate this journey and ensure you make the most of your residency experience.
