Evaluating Your Application

If you were not successful in this year's Match, it is important to consider the various components of your ERAS application in order to determine where it is weak, and then take steps to strengthen it, both for use in the post-match scramble process, or for the next matching cycle. Here are some specific questions to help you evaluate your application and its overall competitiveness:

1. Did you have strong USMLE scores? If your scores were not that impressive, then you may want to consider taking the USMLE Step 3 and doing well to reassure program directors that you are already licensable (and can write prescriptions) when you become a second year resident. Program directors often see lower scores as a possible red flag, indicating that an applicant could fail Step 3, so anything you can do to reassure them you won't present this kind of problem is helpful.
2. Do you have any clinical experience in the US? If not, then pursuing observerships, externships, or research in US facilities should be a priority for you before re-applying in the match. Program directors want to know that you are familiar with how medical care is delivered in US clinical settings, and such experiences may lead to new letters of recommendation, which will further strengthen your application next time.
3. Was your personal statement strong and well written? Program directors expect to see well-written personal statements that present a strong case for why an applicant would be an asset if accepted. The statements should flow well and be not much longer than one page, grammatically correct, and error free. If your statement doesn't meet these standards, then it should be revised accordingly.
4. Did you have strong letters of recommendation? The most valuable letters are from US-based physicians and should include specific comments on your skills, traits, and ability to perform in the clinical setting. If your letters don't meet this standard, then you should work toward obtaining stronger ones by doing clinical experiences in US hospitals and clinical settings, where you will be able to request new letters from your clinical supervisors at those facilities.
5. Did you apply mainly to programs that were likely to be beyond your reach? If so, you should consider applying to more "safety" programs, in the specialty of choice, as well deciding to apply for positions in less competitive specialties and locations as well.
6. Did you look good "on paper" but feel you may have interviewed poorly? If this is a possibility, then it may help to compare your own interview experiences with those of successfully matched colleagues and learn from how they handled the expected questions common to many interviews. You should also consider strengthening your English skills and do some practice interviews before entering the next matching cycle.
7. Did you mainly apply to programs that rarely accept international medical graduates? If not, then you must do better research to find out which programs are more amenable to international medical graduates. To do this, look carefully at programs that are located in large urban areas with larger immigrant populations (New York, Miami, Chicago, etc.). Also, use a good search engine such as google.com to search for web sites that post the unfilled position lists from recent years of the match. Programs that do not regularly fill all of their slots are often more welcoming to international medical graduate applicants than programs which normally fill.
8. Evaluate the relative competitiveness of the geographic locations and the specialty to which you applied. Some states are more difficult (e.g., California), and also, certain specialties are extremely competitive (e.g., surgical specialties, diagnostic radiology, emergency medicine, ophthalmology, dermatology). Consider applying to a less competitive primary care specialty or Psychiatry next time, because these are historically easier to get into. Additionally, if you applied mainly to university-based programs, widen your list to include some community-based programs.
9. Residency positions do sometimes open up outside the Match (example sources include Find-a-Resident, postings in JAMA, or matched colleagues who may hear about residents leaving local programs).

After carefully evaluating your residency application, take whatever steps are necessary to strengthen any aspect of it that may have hurt your overall competitiveness. Here are some additional suggestions for what you can do until the next matching cycle:

1. Continue networking with other international medical graduates who matched into local programs. They may hear about openings, or be able to suggest opportunities for doing clinical externships or observerships.
2. Monitor local hospital web sites and hospital bulletin boards for notices about research jobs, free continuing medical education (CME) courses, medical assistant jobs, etc.
3. Check local clinics serving the homeless, the disabled, or the elderly in order to volunteer and get to know local physicians. Those who come to know you directly are far more likely to assist you than those to whom you direct phone calls, letters, or email messages.
4. Check the local public health agency for job or volunteer opportunities.
5. Enroll in some graduate courses or a graduate degree program (Public Health, Hospital Administration, or Medical Informatics, for example) to strengthen or broaden your credentials before the next match.