I'm sorry you have to go through this. I know a couple people who also weren't successful with EM this match. Search the general residency forum, there are a bunch of threads asking the same thing. There haven't been any open EM positions in the SOAP these last couple of years and I don't expect that to change next year. From what I've seen you have a few options depending on your specific scenario. Keep in mind that I'm just about to enter residency so none of this is from my personal experience, just from what I've seen from others/read. Hopefully someone with much more experience than I can give you more info.
1) Finish FM and try to get an EM job as a FM boarded attending. From what I understand this is most attainable if you are cool with working in a rural area with a lack of boarded EM docs. You could do a fellowship in EM, but from what I've read the hospitals that will take you on as an EM doc don't care if you have a fellowship and having a fellowship won't change the minds of the hospitals that won't take you. So it's more for your own training. I imagine it would be difficult to find an EM job as a FM boarded attending in a large city/popular area. Some have argued that a FM residency doesn't adequately prepare you to safely practice solo coverage EM, hopefully someone more experience than I could chime in on that.
2) Finish FM and then try to apply for an EM residency. People have argued this has the benefit of having FM to fall back on if you are unable to match EM, but of course that means more years of lost income.
3) Apply for EM again sometime during your FM residency. This is risky because you have to let your current PD know that you will be applying again for EM. (Not only because it is the ethical thing to do, but you will need a letter of good standing from him/her). Once you inform your PD of this, he/she is going to immediately look to fill your spot, and they will fill it. So that means if you fail to match this second time around, you are without any residency and your chances of getting back in to any categorical residency have become even lower. If you go this route you need to be very careful because of this. You need to evaluate why you didn't match this cycle and make damn sure you fix it. One big problem is that if you are planning on applying for the 2018 cycle, you only have about four months to do this. As stated above, the best option is usually to get friendly with your home EM program (if you have one). If you can impress them and they like you then that will be your best shot. There are also quite a few new EM programs popping up, so you may be able to catch one that is accepting positions outside of the match. I think one in CA did that this cycle.
4) Finish FM and practice in the realm of FM. I know this isn't your ideal choice, but depending on your situation it might be the safest route to being a physician.
For others to better help you out, you will have to give some details. Step scores, IMG vs US MD vs DO, SLOEs, red flags, etc.
I sincerely wish you the best of luck. Again search the residency forum because this topic has been discussed a lot already.
