Failed to match as an international medical graduate? Here’s what to do next

Key takeaways:

• Failing to match is not the end of your medical career but presents an opportunity to learn and grow.
• Reviewing and improving your application can increase your chances of matching in the next cycle.

The number of medical graduates applying to the Main Residency Match, or “the Match,” has grown dramatically each year since 2004, with 52,498 medical graduates applying to the program this year.

Of those applicants, 16,052 were graduates of international medical schools (IMGs), including U.S. citizens and non-U.S. citizens, according to data from the National Resident Matching Program.

The Match rate for IMGs is lower compared with residency applicants who attend medical school in the U.S. This year, 67.8% of U.S. citizen IMGs and 58% non-U.S. citizen IMGs matched. Comparatively, 90% to 95% of graduates of U.S. medical schools typically match, with 93.5% of U.S. MD seniors and 92.6% of U.S. DO seniors matching this year.

This disparity may be due to the barriers IMGs face in the U.S. throughout their medical journey, including navigating the U.S. health care and graduate medical education (GME) systems, need for visa sponsorship for residency training, and lack of experience of several GME programs with an IMG workforce.

Considering these data, how should IMGs who don’t match proceed in their medical career journeys?

Understanding the Match

The National Resident Matching Program is an independent, nonprofit organization that was founded in 1952 to bring order and fairness to the chaotic system of matching graduating medical school students with the residency programs that want to train them.

During the process when students apply and interview at residency programs, the students and programs alike will seek to determine whether the match would be a good fit. Residency programs will be looking for applicants with strong United States Medical Licensing Examination (USMLE) scores, good grades, excellent letters of recommendation and a positive Medical Student Performance Evaluation. On the flipside, graduating students should determine if the program is a good fit for them based on their priorities and desires, research into the program, and answers they receive to questions they ask during visits and interviews.

By early February, the students and the programs will submit their ranked lists to the Match, which then uses an impartial proprietary algorithm to match the preferences of applicants with the preferences of residency program directors. In March on the first day of Match Week, students learn whether they matched with a program, giving time for those who did not match to apply for additional positions before the final results are announced later that same week.

Coping with disappointment and moving forward

The emotional impact of not matching can be devastating. However, it is crucial to remember this is not the end of your career.

In a webinar the AMA hosted on this topic, a panel of physicians, including current residents and program directors, stressed that after failing to match, it is important to reflect on past successes.

Further, seeking support from friends and family can help you to cope with negative feelings, remain positive and regain motivation.

The best strategy for managing this difficult situation is to keep moving forward and be persistent. IMGs who fail to match have the opportunity to learn and grow from this defeat and improve their chances of matching the following year.

For specific steps on what to do after you haven’t matched, and to connect with other IMGs, join the IMGs & FMGs Connect group on Healio Community. There you will also find resources on electives vs. observerships, how to pursue a residency in the U.S., personal stories of other IMGs, and more.

References:

• Essential tips to help IMGs successfully navigate the Match process. https://www.ama-assn.org/education/international-medical-education/essential-tips-help-imgs-successfully-navigate-match. Published Oct. 15, 2024. Accessed Jan. 10, 2025.
• Evaluating and choosing a residency. https://students-residents.aamc.org/applying-residencies-eras/publication-chapters/evaluating-and-choosing-residency. Accessed Jan. 10, 2025.
• How to land the medical residency you want: 7 criteria you’ll be evaluated on. https://www.sgu.edu/blog/medical/how-to-land-the-medical-residency-you-want/. Accessed Jan. 10, 2025.
• If you don’t match, take these 5 tips from a SOAP survivor. https://www.ama-assn.org/medical-students/preparing-residency/if-you-don-t-match-take-these-5-tips-soap-survivor. Published Feb. 26, 2024. Accessed Jan. 10, 2025.
• Madaan M. USMLE: How To Match Outside of the Match | SOAP and Alternative Match Strategies (2025). https://www.youtube.com/watch?v=RBCIdoaXARw. Accessed March 21, 2025.
• Match Day 101: How does the medical residency match work? https://scopeblog.stanford.edu/2024/03/13/match-day-medical-school-residency/. Published March 13, 2024. Accessed Jan. 10, 2025.
• Match Week FAQ: How to move forward when you don’t match. https://www.ama-assn.org/medical-students/preparing-residency/match-week-faq-how-move-forward-when-you-don-t-match. Published Feb. 21, 2024. Accessed Jan. 10, 2025.
• National Resident Matching Program Releases the 2025 Main Residency Match Results, Celebrates the Next Generation of Physicians. https://www.nrmp.org/about/news/2025/03/national-resident-matching-program-releases-the-2025-main-residency-match-results-celebrates-the-next-generation-of-physicians/. Published March 21, 2025. Accessed March 24, 2025.
• What to do if you did not get a residency match. https://www.massmed.org/Membership/Medical-Students/What-To-Do-If-You-Did-Not-Get-a-Residency-Match/. Accessed Jan. 10, 2025.
• Zepeda CM, et al. Cureus. 2022;doi:10.7759/cureus.27351.

For more information:

Abhishek Bhardwaj, MD, FACP, is assistant clinical professor at University of California, Riverside and director of critical care medicine at MemorialCare Orange Coast Medical Center. He also is host of Healio’s podcast, Vital Capacity.

Niharika Tanwar, MBBS, is an incoming PGY-1 in internal medicine at Advocate Illinois Masonic Medical Center, Chicago.

To contact Bhardwaj and Tanwar, email community@healio.com.