@Doctor Bob will do that to you.
Maybe he's right a clinical path ain't going to do it. There are rare stories on SDN linked to articles where people could get the student loan debt discharged by court as an unreasonable hardship if you can show enough evidence that you can't get any jobs above a certain amount. IBR can keep payments low and it will go away after 20 years. Not awesome, that kind of debt even paying on it your credit is ruined. That's the debt part of it.
I don't look down on you if your home program isn't helpful, I got funny looks for not being interviewed by my program on the trail but my school makes no bones at all about the fact that they simple DO NOT take their own. They have like a quota that for like IM, out of 30 students (less slightly less than 1/4 the class size total) only 3-4 would get interviews or match, for a program size that was somewhere between 30-50 can't remember. Not everyone can be in the top 10% to even get looked at by their own well-regarded school, doesn't mean they're losers.
Beyond the first match cycle there's no incentive for them to give a **** about you matching. THIS HAPPENS. SOME SCHOOLS WILL NOT TAKE THEIR OWN AOA OR ELSE AS A MATTER OF POLICY. Those folks were not competitive at their own program but lesser tiered/snotty programs snatched them up.
That said, yes, programs don't want to take anyone who's ever failed a Step. This is ridiculous if it's really the only red flag first time around. Waste of an MD that would probably be totally fine in primary care or psych. True that then next year things don't get better. The scramble is a joke as a solution when you look at how few spots are actually left vs how many still going for them.
Anyway, with an MD and nothing else, there is hope for a better job. Won't be easy. People try to get an informatics, public health, MBA, law degree. Probably the only thing that will really work well is informatics. There are unpaid internships I have heard of with FDA that can help you try to get experience to move into pharma trials stuff.
Community college teaching maybe. If you get a masters in teaching you will be able to be a teacher somewhere. Community college or high school. I know someone who was an excellent math/physics/science tutor making $20/hr (6 years ago) under the table but of course crazy hours and not rich but OK.
Medical consulting or writing will be piecemeal work, nothing to bank a future on but can get some cash or experience.
The wanted ads here on SDN look for EHR go live people, Kaplan, USMLE stuff. The drop out club network is mostly for docs looking to get out of clinical practice but there's some other stuff there.
Again, there are people who make miraculous comebacks although yes it is rare.
One person I know from China who was post-doc researcher at a good US university for 5 years post grad got an off cycle position. Of course they were otherwise attractive applicant but IMG that had to find something else in US to get a foot in door.
Despite what Doctor Bob said, if you do something otherwise nice on your resume, keep those clinic skills alive somehow, network, publish, get advocates, and keep your eyes peeled feelers out and try to look for positions outside the match, NYC, new programs, programs on probation, programs that don't fill, programs in undesirable location, or try to have an in or be besties or ingratiate yourself somewhere there is a program, there is a chance that one day there will be an opening, a program will be desperate, and give you a shot.
So you need to move on with your life job wise, be the best you can be at that, and totally move on, or else keep an eye open for the rest of your working life. You can't bet on a miracle, but you can work for one and keep an eye to the sky.
Looking at other countries might work. I know in Ecuador they pay a **** ton to docs to recruit from other countries from like Cuba because of their doc shortage. The hurdle there is getting Spanish fluency.
If you went to say random third world country X amd did amazing stuff there, and kept your eye open for a program that needs a doc bad when the NBME can't help them, that could be your only chance. No, for real, docs go and do anything medical somewhere else and sometimes then they can return. If you keep yourself medical adjacent things may one day change and allow you another chance.
Keep treading water, maybe with the AOA merger things can help (maybe not).
Definitely go practice in Missouri if that program ever gets off its feet. That might poise you for something later.
Become a blogger and be involved in medicine in any small way.
If nothing else, do you have family? Friends? Maybe tell them your feelings. Have a beloved pet? Read all the SDN threads about how wicked and evil medicine is, start a blog about its evil. Grow to hate it and its syncophants not yourself. Develop your hobbies. What was the second occupation you might have wanted to do? Go to Adult Children of Alcoholics/Dysfunctional Families website and see if that fits you at all.
Hopefully all of this will help you convince yourself you are a human being, a child, a parent, a romantic partner, a pet owner, a cello player, a blogger. You are NOT your job. You ARE Doctor Chicago2012, you earned the title you deserve it. But you are also just Chicago2012. And medicine was the ****ty ****ty miserable job that just tried to rob you of everything including your life. And it isn't worth it. It really isn't.
Most of the people in your life aren't Doctor so and so. The idea that they might lose you over this horrible horrible job and debt, would be horrific and unfathomable to them. Seriously, if you have people in your life that really love you, tell them you've considered suicide. The look on their faces might just be enough to shock you out of it.
They did some study of people jumping from the Golden Gate Bridge, the ones that lived, and asked them what went through their minds as they were about to die flying through the air. Apparently almost all of them expressed regret and thought of their families and it finally got through to them just how much it woukd hurt them. Depression can give you a kind of tunnel vision, a sort of seizure keeps you in a loop that can really affect your empathy and make it very easy just to feel your pain. Sometimes you need a wake up call.
The times I felt suicidal I was too ashamed to tell anyone, and partly I knew if I did it would be harder to indulge in that sort of thinking. I'm glad I did though, because feeling THEIR sadness and persepective that they might lose a loved one over a ****ing JOB put things into perspective.
I was born Crayola227, that's me. And don't let the profession that robbed you get away with it and steal anymore than it has a right to.
You're grieving your dream. The truth is, you didn't lose what you thought. It's mostly a meat grinder that will suck your soul and put you in the company of condescending sociopaths that make up a considerable minority. Any system that would do this to you isn't worth dying over, it isn't worth being miserable over. It did damage your life. Time to reclaim it.
Get bitter and tell everyone within shouting range what's what.
Medicine doesn't have to be this way. That might not change anything for your circumstances.
The debt and lack of money from medicine, and not being able to care for people like you've always dreamed, now that's hard. But this can be a blessing in disguise. If you can find anything else in life to give your energy to, you might find that you can get your life back. Your relationships, your sleep, eating meals, stretching, going for walks. Smelling flowers. Not being emptionally abused.
Contact Dr. Pamela Wible maybe. Advocate for the topic of physician suicide. Even without residency, you are a physician.
Good luck.
