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What it’s like when you don’t match

How my fifth year of medical school turned out to be the most important

Throughout my fourth year of medical school, I prepared myself to become the best candidate for General Surgery that I could possibly be. Most of my rotations were in general surgery and I’d travelled across the country to make my candidacy known. I worked closely with program directors who wrote me excellent letters of recommendation; I worked hard during all of my rotations, often staying post call to attend clinic or assist in more surgeries. With seven interviews during my CaRMS tour, I thought I had an excellent chance at becoming a surgeon.

And then it happened: I didn’t match. My worst nightmare had become a reality.

I felt completely isolated by the experience.

Before I could come to terms with my feelings of failure, I scrambled to put together another CaRMS application—this time for specialties that I’d never considered before.

It was a terrible feeling. After four years of medical school, my career came down to sifting through leftover spots. As the only student in my distributed class that did not match, I had plenty of support from others; my classmates and preceptors did what they could to help me meet the tight second iteration deadline. And yet I felt completely isolated by the experience. And then, after flying across the country for more interviews, I was still unmatched.

My only option was to do another year of medical school. I watched all my friends gear up for the next phase of their lives. They walked onto the podium at convocation and became the amazing doctors that they were destined to become. And the whole time I couldn’t help but think I should have been up there with them. Despite having passed my licensing exam and fulfilling all graduation requirements, I couldn’t call myself a doctor without a residency position.

I didn’t know where I belonged either.

My “victory lap” year of electives felt like a prolonged phase of stagnation. I tried my best to use it as an opportunity to consolidate my knowledge and develop new exposures, but every day I struggled to keep my head up high. I cringed every time someone asked me what year of medical school I was in because I didn’t know where I belonged either. I carried this feeling of shame with me on every rotation. I met with a few program directors across different specialties to gage their perception of unmatched students. The common theme was that I would be seen as a “red flag.” One program director told me, in not so many words, that I shouldn’t bother applying to his program, since there were so many other excellent candidates vying for it. Despite coming in to round and do call over the long weekend, being diligent and enthusiastic, my drive to succeed was no match for the stigma of being unmatched.

Electives at my home school weren’t any easier. I felt uncomfortable running into my former classmates, who were now residents, and who I now had to consult with as a medical student. I would always wonder if they were asking themselves: “what’s wrong with her? Why didn’t she match?”

The truth was, I’d been guilty of those very same thoughts.

There is such a strong tendency in medicine to hide our struggles…

It wasn’t until my palliative rotation that my outlook changed. When my preceptor asked me about being a fifth-year student on our first day together in his office, he simply shrugged. I was surprised by his reaction. He then told me his story about becoming an internal medicine resident who transferred to family medicine. Another physician who overheard our conversation also told me about how he had switched out of his specialty as well. Similarily, on my oncology rotation, my preceptor told me that his wife also had experiences with not matching. My long-term mentor from before medical school called me and also shared that he had failed a year of medical school as well.

It became very clear to me that my experiences with failure are much more common than we think. So why don’t we ever hear these stories? There is such a strong tendency in medicine to hide our struggles so that we can save face in front of our peers. I often hear about high levels of burnout, depression, and anxiety amongst physicians, and while there seems to be more discussion about these things recently, how can we ask resilience of doctors if, at the medical student level, we punish them simply for not achieved their goals within a predetermined timeline and label them as “red flags”? How many people can truly say that their lives have been an uninterrupted string of successes? I came to realize that there was no shame in what I had experienced, and that it was merely a setback to be overcome. Just like any other.

Throughout my fifth year, I had the privilege of working with some amazing physicians. They inspire and touch the lives of so many patients—and they do it all in ways that I had previously overlooked. My priorities changed also. Although surgery was my first love, I’ve come to truly appreciate all of the amazing work of physicians across different specialties. I realized that my failure was my greatest asset, and used this to demonstrate resilience in my CaRMS interviews this year. In the process, I found a new passion for medicine that I didn’t have before. I’ve come to realize how lucky I am to work in a profession where, regardless of the path I take, I will be able to make a tangible difference in many lives.

There is currently a record number of unmatched students.

All of my fifth-year peers matched successfully to our top choices in the first round of the 2018 CaRMS match. This was thanks to the unwavering support of the administration, but also to the support of our loved ones.

Unfortunately, my story is no longer unique. More and more medical students will face the same challenges. There is currently a record number of unmatched students, much of this due to political and organizational forces outside of their control. My hope is that, as key representatives strive to address the issues at hand, the culture of medicine will also shift to be more accepting and understanding of the path my peers and I have taken to get where we are.

Hot Tip: In February 2018, the Canadian Federation of Medical Students (CFMS) launched an unmatched peer mentorship network. If you are a CFMS member who is unmatched and would like to receive mentorship and peer support from previously unmatched students, please email to be connected with a mentor. If you are interested in being included in the network as a peer mentor, please email


Sandra Rao is an incoming PGY1 to the Family Medicine program at the University of Toronto but trained at the Windsor Campus of the Schulich School of Medicine & Dentistry. Outside of clinical obligations, she is an avid traveler and photographer. To better serve the needs of unmatched students in the current and upcoming years, she is involved in the Unmatched CMG Task Force with the Canadian Federation of Medical Students (CFMS).