All your friends matched, except you. 6 steps to dealing with failure and matching next year.

IMG Residency for International Medical Graduates

I have been getting many emails after the match results. A lot of students who visit my website are going through an extremely difficult time. Be it frustration because you have tried everything and still did not match or anger at an unfair system who prefers people with super high scores or contacts and leaving out genuinely hard working people or pure helplessness because the mistakes you made in the past with your application cannot be undone.

In this emotionally overwhelming time of your life, you open facebook or any social media and see your friends and people who you know celebrating their match success and sharing stories. And here, you are planning to go underground or disappear for an indefinite period of time.

I have been there many times. I felt something similar when I saw my low scores on my usmle results. I was able to turn it around in my favor when I eventually applied, but I have lived this painful experience through some close friends and family members who did not match. Now I stand together with students who have reached out to me before and were not able to match.

People deal with severe degrees of stress differently. Some take a downward spiral route with alcohol, drugs, persistent self-pity and inaction.

For those who know me and my principles, that is not the AlphaIMG way.

I prefer another way to deal with extreme personal or professional stress and failure.  I came across this years ago in a book “Extreme Ownership” by Jocko Willink.

It is called Prioritize and Execute.

You can sit here in a puddle of misery for next 6 months and go through the same emotions at next match or you can prioritize the areas of your application that are going to create the most impact and start to execute each of those areas. Then you can celebrate and post pictures on facebook next match when you get that residency you deserve.

If you are clueless on how to prioritize and execute your application for the upcoming match, read on.


Step 1: Identify your target market

Every IMG who I coach for the match, the first thing I am looking for when I speak with them is what kind of programs I will target for them. Is she a university program (UP) candidate or a community program (CP) candidate. Applicants who have research and teaching experiences, who have rotations in specialty fields and who are aspiring to do fellowships are some markers of university program candidate. Community experiences, interest in primary care fields, strong volunteer focus display qualities for a community program resident. Identify if you are a UP candidate or a CP candidate.

Step 2: Look at your application from PD point of view.

Now that you know what category you are in, look at your application form the program director (university or community program) point of view.

Most PDs and interviewers are looking for a candidate who is going to provide the most value to their program. Not the candidate who has the highest scores or the one with most published papers. Candidate with a stellar resume may not be a good fit for a small community program focusing on serving a minority population.  In this regard, every program is somewhat different.

If you are a UP candidate, is your application entirely consistent with what a university program is looking for?

If you did not match with 4 or more interviews and decent interview skills, I guess not. What is missing? Do you not have enough university clinical experience? Or are you lagging in research papers/posters? Same with if you are a CP candidate but your application is not true of a community physician. Be honest with yourself and list things that make you a wholesome UP or CP candidate.

Step 3: Prioritize. Make a list of your modifiable deficiencies.

Don’t worry about how you are going to get those research publications or clinical experiences yet, just make a list of things that make you a wholesome UP or CP candidate.

Don’t list low USMLE scores or old Year of Graduation on there. Those cannot be changed. But a lot can be. Prioritize based on what is deficient the most.

Step 4. Plan and Execute on those deficiencies.

Now that you have a list of things you need to make yourself be a perfect university or community program candidate, think about the ‘how’. How are you going to get that research papers or that rotation in a university program? If you are a CP candidate, how are you going to get strong LORs from community practitioners? Here are some articles to get you started on this process.

Step 5: Make 3-month plan.

Write down a plan for next 3 months. Not longer than that as things most likely change in 3 month period. Pick one thing on your list and target that for next 3 months. Explore every possibility you can to get that goal achieved in 3 months. Email every program that you know of. Reach out to every contact you have, even if you have not spoken to them in years. Plan on attending every conference in that field and meet as many attendings as you can.

I picked up side jobs and a loan to get the money I needed for the application. The interest rates on that loan were ridiculous. I paid it off very quickly once I got the residency. Never regretted it.

We all have a savage in us to get us what we want, it just needs to be unleashed. I know this because I saw it in myself and now I see it every year in some students.

Step 6. If you have less than 4 interviews.

It is very difficult to match for an IMG with less than 4 interviews. Your #1 goal this year is to get more than 4 interviews. Start reading this guide to make sure you get more than 4 interviews this year. All of the above still applies to you but you have to redo your entire application to get those interviews.


To summarize, start following these six steps to get over the misery of not matching as soon as possible and move on a positive spiral towards matching.  

Step 1. Identify your target market- university or community programs

Step 2. Look at your application from a PD point of view- are you a UP or a CP candidate?

Step 3. Prioritize- make a list of your modifiable deficiencies in your target category.

Step 4. Execute- Start at the top of that list and make a plan to clear the first deficiency.  

Step 5. Make a 3 month plan to execute on the first deficiency.

Step 6- Revamp your application if you have less than 4 interviews. Follow this guide.


There it is. 6 powerful steps to deal with the pain of not matching and ensuring that next year is a big success for you.


Download my free residency match resources

You will receive

  1. "Ultimate Guide to Avoid Red Flags in Residency" Ebook
  2. Professionally written sample email to request observerships and externships
  3. USMLE strategy which includes a study guide, daily schedule and benchmarks to achieve before taking the test to prevent low scores of failures.
  4. Professionally written sample email to ask the program to review you application for interview
  5. Sample thank you note for post-interview communication

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