Hi SDN. This is going to be a long depressing post, but I hope it can help the community and perhaps give insight to others to prevent them from potentially getting into the same predicament. Please forgive me if this post seems histrionic or overly dramatic as I am in a very difficult place.
I am a USIMG who just received my diploma (from one of the "stronger" Caribbean schools) a couple of weeks before getting the news that I didn’t match. Since then, my life has been falling apart in every way imaginable. It has thrown me into an existential crisis that likes of which I can’t even begin to explain and has shaken the very foundation of what holds together my professional, personal and spiritual identity. I've coped with a number of traumatic things in my life, but have never felt more alone, terrified, and disillusioned at any point in my life. I feel frightened as I slowly watch myself spiral into depression/despair. Every day is getting worse than the last, my self-esteem has gone from low to non-existent, and I feel my grip on life slipping.
I applied to psychiatry this year and while I realized my passion/fit for the specialty later than most (a few months before applying), I had a pretty good interview season. I struggled with crippling anxiety about going unmatched (as I am sure most IMGs do but don’t admit) every single day ever since I became a medical student and wasn’t really expecting more than one or two interviews considering I was towards the bottom of my medical school class. However, I was pleasantly surprised by how many invites I received (10+). I don't even know why I got so many invites, but after watching this forum for so many years, I never even heard of someone not matching with this many so I let my guard down and didn’t even have a chance to brace for this blow. Even my own typically pessimistic advisors reassured me I would match and didn’t think I had any reason to delay receiving my diploma since it was “highly unlikely” this would happen. It is ironic in a sad way watching myself now resemble more of a psychiatric patient after being so close to having my dream career as a mental health provider. I really couldn’t imagine myself excelling at any other field of medicine either which makes this all the more painful. It was the only topic in medical school I ever performed strongly in and is really the only thing I can see myself happily pursuing in medicine. Thanks to covid however, most of my 4th year was taken away from me and I didn’t even have the ability to do any electives in psychiatry. But I gave up on being happy a long time ago, as I went to a foreign medical school knowing I would quite possibly not get to pursue my specialty of interest. I can accept that but at this point I just want a residency in anything. That is the part I am really having trouble accepting.
I have torn apart every aspect of my academic and personal background looking for clues as to why I didn’t match aside from shear bad luck but every time I think I am getting close to figuring something out, I am told it wasn’t the cause of me not matching and I am brought straight back to the drawing board. I am told conflicting things by every person I reach out to and honestly feel gaslighted by much of it. I almost wish someone would just tell me to give up and do something else to make this nightmare end. I reached out to several program directors and others who have seen my application, and even they feel somewhat confused as to how this occurred without any glaring red flags. I tried to listen past all the “it was a competitive year” cliches and tried to look for clues to why this occurred. I have become deeply paranoid thinking there is something negative on the internet about me, that I have some criminal record I’m not even aware of, that my interview skills are just complete garbage or even that I am a undiagnosed sociopath. But no one I have reached out to has said this to me. One person says I didn’t stand out enough or show leadership. I was stunned to hear this as I never went into medicine thinking I needed to be a leader. I always saw being a physician as being synonymous with being part of a team and saw leadership as a nice quality a few people have, but by no means a requirement to join a training program. I tried my hand at something like that in high school (was elected president of my student council) and got impeached because I was so unliked. I never excelled socially but was a good/decent student in high school/college (top tier undergrad and 3.4/28 MCAT: could have been a shoe-in for DO schools in hindsight) and saw medicine to be a good fit for me realizing I would never survive in the business world or just about any other field where connections are most of what determine if you get ahead. Another person said I needed more volunteer experience. And another even said (indirectly) that I wasn't "diverse" enough to rank more highly.
I have found myself visiting very dark areas of my psyche lately. Repressed thoughts from childhood, coming to terms with trauma I’ve tried to ignore for close to a decade, and symptoms of a quarter life crisis all because of one email. Aside from feeling like I am talking to a wall by sending emails out to new programs trying to find the figurative “unicorn” in obtaining a position between now and July outside of the match, I am caught in a 24/7 cycle of negative thoughts that are making me actively hate who I am as a person. I feel like a burden on my family (what’s left of them since I’ve detached from most of them since starting this journey), I feel like a horrible human being, and like someone who doesn’t even deserved to be saved most of the time. I have said/done so many reckless, ridiculous things over the past several weeks that I don't even know what there is to save at this point.
At this point nothing is changing. I am running out of options, no one seems to really care, and doors are just closing without any more opening. I passed my boards on the first attempts and can’t retake them for a higher score. I also graduated and in doing so made things even worse since I can’t get any REAL clinical experience over the next year. I even got a couple SOAP calls and a post SOAP interview at one of the most malignant prelim places I’ve ever heard of (reading about the stories from this place sounded like something out of a 19th century workhouse or labor camp) and even they rejected me. I literally got rejected from perhaps the worst residency in the country that couldn't even fill after 4 rounds of SOAP. I know that spot wouldn’t have helped me much and would have certainly been just another dead end, but it still would have been something to give purpose/meaning to whatever existence I have left for the immediate future.
Things just keep getting dangled in front of me and I don’t even know who is safe to trust. Most days it is hard to get out of bed and the only thing I look forward to is going to sleep. I don’t have any close friends (or probably any real friends) and have slowly developed every self destructive habit you can probably think of short of hard drugs over the years to cope with this lifestyle (no exercise, poor diet, gambling, drinking alone, cigarettes, marijuana). I even ordered them chronologically as I pretty much picked up a new one each year since my freshman year of undergrad as the pressure increased. My own health suffers in the pursuit of trying to serve others. How I even made it this far and got this close going through this process entirely alone surprises me. My relationships have all been either toxic or short lived and is yet another thing I have sacrificed (that normal people get to experience) because of medicine. I feel like this profession has turned me into a broken, cynical, and morally corrupted degenerate. I wouldn't wish the aftermath of what I am dealing with on anyone. Even as someone who has been avidly playing chess since I was a child, this is right about the time I would resign as it is considered rude to continue playing a game you know you are going to lose. And it's not like I am even talking about medicine alone anymore, this is consistent with how I feel about life itself right now. But in case my mindset is making me not think clearly and anyone sees an angle to make this situation better that I can’t, I would be very grateful.
As none of the programs I interviewed at went unfilled (according to SOAP) and several have confirmed to me I was ranked (was literally something like 10 ranks away from getting a spot at a program I auditioned at), I am trying to figure out if this is something I can still salvage or if I should cut my losses and try to rebuild my life doing something else. I feel trapped as I have already invested so much time/money into this and can’t really escape even if I wanted to. I know there are "success stories" of people who have been in this boat and found residencies, but I feel like at this point especially, they are the exception to the rule. And now I just don't know where to pull any motivation from. Every person I know who applied with me from my school this cycle matched, many with half the number of ranks I had. I could go on forever but I think at this point the overall theme is clear. This is known to be something that ruins lives and I cannot bring myself to become one of the "chronically unmatched" people the media likes to talk about from time to time. My odds are not going to be better next year, only worse being a year removed from medical school and if more than a dozen interviews couldn't get me a position at one of the least competitive programs/specialties in medicine, I wonder if the universe is trying to tell me something that I refused to listen to for my entire adult life. Thank you to anyone who has read this far. I really appreciate it.
Tldr: Was expecting to match but didn’t this year. Have no support network and have been in a tailspin ever since March 15th that I am not recovering from.
I am a USIMG who just received my diploma (from one of the "stronger" Caribbean schools) a couple of weeks before getting the news that I didn’t match. Since then, my life has been falling apart in every way imaginable. It has thrown me into an existential crisis that likes of which I can’t even begin to explain and has shaken the very foundation of what holds together my professional, personal and spiritual identity. I've coped with a number of traumatic things in my life, but have never felt more alone, terrified, and disillusioned at any point in my life. I feel frightened as I slowly watch myself spiral into depression/despair. Every day is getting worse than the last, my self-esteem has gone from low to non-existent, and I feel my grip on life slipping.
I applied to psychiatry this year and while I realized my passion/fit for the specialty later than most (a few months before applying), I had a pretty good interview season. I struggled with crippling anxiety about going unmatched (as I am sure most IMGs do but don’t admit) every single day ever since I became a medical student and wasn’t really expecting more than one or two interviews considering I was towards the bottom of my medical school class. However, I was pleasantly surprised by how many invites I received (10+). I don't even know why I got so many invites, but after watching this forum for so many years, I never even heard of someone not matching with this many so I let my guard down and didn’t even have a chance to brace for this blow. Even my own typically pessimistic advisors reassured me I would match and didn’t think I had any reason to delay receiving my diploma since it was “highly unlikely” this would happen. It is ironic in a sad way watching myself now resemble more of a psychiatric patient after being so close to having my dream career as a mental health provider. I really couldn’t imagine myself excelling at any other field of medicine either which makes this all the more painful. It was the only topic in medical school I ever performed strongly in and is really the only thing I can see myself happily pursuing in medicine. Thanks to covid however, most of my 4th year was taken away from me and I didn’t even have the ability to do any electives in psychiatry. But I gave up on being happy a long time ago, as I went to a foreign medical school knowing I would quite possibly not get to pursue my specialty of interest. I can accept that but at this point I just want a residency in anything. That is the part I am really having trouble accepting.
I have torn apart every aspect of my academic and personal background looking for clues as to why I didn’t match aside from shear bad luck but every time I think I am getting close to figuring something out, I am told it wasn’t the cause of me not matching and I am brought straight back to the drawing board. I am told conflicting things by every person I reach out to and honestly feel gaslighted by much of it. I almost wish someone would just tell me to give up and do something else to make this nightmare end. I reached out to several program directors and others who have seen my application, and even they feel somewhat confused as to how this occurred without any glaring red flags. I tried to listen past all the “it was a competitive year” cliches and tried to look for clues to why this occurred. I have become deeply paranoid thinking there is something negative on the internet about me, that I have some criminal record I’m not even aware of, that my interview skills are just complete garbage or even that I am a undiagnosed sociopath. But no one I have reached out to has said this to me. One person says I didn’t stand out enough or show leadership. I was stunned to hear this as I never went into medicine thinking I needed to be a leader. I always saw being a physician as being synonymous with being part of a team and saw leadership as a nice quality a few people have, but by no means a requirement to join a training program. I tried my hand at something like that in high school (was elected president of my student council) and got impeached because I was so unliked. I never excelled socially but was a good/decent student in high school/college (top tier undergrad and 3.4/28 MCAT: could have been a shoe-in for DO schools in hindsight) and saw medicine to be a good fit for me realizing I would never survive in the business world or just about any other field where connections are most of what determine if you get ahead. Another person said I needed more volunteer experience. And another even said (indirectly) that I wasn't "diverse" enough to rank more highly.
I have found myself visiting very dark areas of my psyche lately. Repressed thoughts from childhood, coming to terms with trauma I’ve tried to ignore for close to a decade, and symptoms of a quarter life crisis all because of one email. Aside from feeling like I am talking to a wall by sending emails out to new programs trying to find the figurative “unicorn” in obtaining a position between now and July outside of the match, I am caught in a 24/7 cycle of negative thoughts that are making me actively hate who I am as a person. I feel like a burden on my family (what’s left of them since I’ve detached from most of them since starting this journey), I feel like a horrible human being, and like someone who doesn’t even deserved to be saved most of the time. I have said/done so many reckless, ridiculous things over the past several weeks that I don't even know what there is to save at this point.
At this point nothing is changing. I am running out of options, no one seems to really care, and doors are just closing without any more opening. I passed my boards on the first attempts and can’t retake them for a higher score. I also graduated and in doing so made things even worse since I can’t get any REAL clinical experience over the next year. I even got a couple SOAP calls and a post SOAP interview at one of the most malignant prelim places I’ve ever heard of (reading about the stories from this place sounded like something out of a 19th century workhouse or labor camp) and even they rejected me. I literally got rejected from perhaps the worst residency in the country that couldn't even fill after 4 rounds of SOAP. I know that spot wouldn’t have helped me much and would have certainly been just another dead end, but it still would have been something to give purpose/meaning to whatever existence I have left for the immediate future.
Things just keep getting dangled in front of me and I don’t even know who is safe to trust. Most days it is hard to get out of bed and the only thing I look forward to is going to sleep. I don’t have any close friends (or probably any real friends) and have slowly developed every self destructive habit you can probably think of short of hard drugs over the years to cope with this lifestyle (no exercise, poor diet, gambling, drinking alone, cigarettes, marijuana). I even ordered them chronologically as I pretty much picked up a new one each year since my freshman year of undergrad as the pressure increased. My own health suffers in the pursuit of trying to serve others. How I even made it this far and got this close going through this process entirely alone surprises me. My relationships have all been either toxic or short lived and is yet another thing I have sacrificed (that normal people get to experience) because of medicine. I feel like this profession has turned me into a broken, cynical, and morally corrupted degenerate. I wouldn't wish the aftermath of what I am dealing with on anyone. Even as someone who has been avidly playing chess since I was a child, this is right about the time I would resign as it is considered rude to continue playing a game you know you are going to lose. And it's not like I am even talking about medicine alone anymore, this is consistent with how I feel about life itself right now. But in case my mindset is making me not think clearly and anyone sees an angle to make this situation better that I can’t, I would be very grateful.
As none of the programs I interviewed at went unfilled (according to SOAP) and several have confirmed to me I was ranked (was literally something like 10 ranks away from getting a spot at a program I auditioned at), I am trying to figure out if this is something I can still salvage or if I should cut my losses and try to rebuild my life doing something else. I feel trapped as I have already invested so much time/money into this and can’t really escape even if I wanted to. I know there are "success stories" of people who have been in this boat and found residencies, but I feel like at this point especially, they are the exception to the rule. And now I just don't know where to pull any motivation from. Every person I know who applied with me from my school this cycle matched, many with half the number of ranks I had. I could go on forever but I think at this point the overall theme is clear. This is known to be something that ruins lives and I cannot bring myself to become one of the "chronically unmatched" people the media likes to talk about from time to time. My odds are not going to be better next year, only worse being a year removed from medical school and if more than a dozen interviews couldn't get me a position at one of the least competitive programs/specialties in medicine, I wonder if the universe is trying to tell me something that I refused to listen to for my entire adult life. Thank you to anyone who has read this far. I really appreciate it.
Tldr: Was expecting to match but didn’t this year. Have no support network and have been in a tailspin ever since March 15th that I am not recovering from.
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