What Happens If You Do Not Match?

Pamela Spicer-Moehring, MD, Vice Chair of the Pennsylvania Radiological Society Resident and Fellow Section and Diagnostic Radiology Resident at Jefferson-Einstein Montgomery Hospital, contributed this piece.

The radiology residency match has been incredibly competitive in the last few years. While there was a slight decrease in applicants applying for a Diagnostic Radiology (DR) position last year, DR as a specialty remains competitive. The chance that a medical student may not match is a reality that is difficult to fully prepare for, but I am here to encourage you to not despair and tell you that there is hope. 

I entered medical school wanting to pursue a career in radiology. Nothing along the way changed my mind and I did my best to position myself as a decent applicant. However, I was applying at the time that radiology suddenly became a very lucrative choice to students finishing medical school during the COVID-19 pandemic and the competition was fierce. That Monday morning of Match week, I was one of the handful of medical students who received the dreaded email. I had partial matched into a transitional year program but had not matched into an advanced diagnostic radiology position. I chose to graduate and complete my intern year while re-applying to radiology. But after applying again, I did not match. 

Nothing truly prepares you for the gut punch of reading that email. However, despite all the sadness and disappointment I felt in that moment, I am grateful for the path I had to travel navigating how to get to radiology without matching into it. I learned that not matching occurs more often than we acknowledge – it is just not talked about enough. A winding pathway in a career in medicine is common. I heard anecdotes from a few of my attendings who did not match but obviously had found their way to where they are now. I found an online community of people who every year during Match week sit on the Unmatched Reddit thread to offer condolences and advice (as well as $20 to an unmatched medical student to buy themselves a pity-party pizza). I heard the story of a physician who completed an entire residency, fellowship and started working as an attending to one day say, “No more, this is not for me,” pivoting to a completely different medical specialty and completing a second residency. I know physicians who did not match into radiology but ended up finding a position in a different specialty through SOAP who are happy with how things ended up. 

I do not think those stories are amplified enough for those who go unmatched to know that there are other pathways besides the straight and narrow. 

I am one of the fortunate ones that was able to find a DR position offered outside of the Match. I stumbled upon a program that heard my story during the interview and gave me a chance. 

There are many options available to you if you do not match. Be honest with yourself, reflect on what you want to do and why. Utilize your community of support (SOAP is incredibly tough to do alone, accept those offers of help and use your support system). And know that not matching is not a reflection on you or your abilities. It is but a blip in the road, and while your journey may not look like everyone else’s, it can still lead you to exactly where you are meant to be.