This was last Monday at 9am. I applied only to general surgery programs after choosing the specialty late, and with a passing but well below-average step 1 score. I only had three interviews (including my home program), so it wasn’t really unexpected that I didn’t match, but it was still a shock. My plan was to try to SOAP into a surgery prelim and reapply next year. My main advisor convinced me to put in some EM applications as well, and the EM faculty rallied to upload my SLOE and another recommendation within hours. My sister and two of my super-awesome classmates read my new personal statement, and I uploaded it and sent in my SOAP applications at 4am, then faceplanted into bed wondering how I was going to make the choice between EM and surgery for the second time in a year.

Turns out it was a non-issue. Out of 26 surgery programs I applied (or re-applied) to, I was called for ONE interview—my home program again. The other 19 applications were for EM programs; I had 10 EM interviews in two days (with another offered but we couldn’t resolve a time conflict). That was more interviews than some of my EM-matched classmates had in the main match. Most of them went well, a few went very well. There weren’t any I wouldn’t have ranked, although I had some clear favorites. Wednesday night when I went to bed, I was pretty confident that I would have a job next year, probably in EM. Then this happened:

I spent the next three hours frantically emailing programs to let them know I was still unmatched and interested. My advisor and some of the EM faculty made phone calls and sent emails. A few programs were nice enough to reply that they’d filled their spots, but I had no way of knowing if others were even getting my emails. I logged back in just after noon to find this:

I put my head down on the table and started crying for the first time all week. After I talked to my home EM PD about my options and crowd-sourced with EM-bound classmates (SERIOUSLY, my classmates are the absolute GOATS 💙), I made a choice with 20 minutes to spare.

I still don’t have much distance on this, but here are my take-home messages so far:

1. IT SHOULD NOT BE THIS DAMN DIFFICULT TO GET A RESIDENCY SPOT. I’m going to be a great physician. Everyone else I know that SOAPed this year is going to be a great physician. We should not have to beg for a job or game the system. It is ABSOLUTELY UNACCEPTABLE that this process lets so many good, strong future physicians (especially those who are URM) fall through the cracks because they’re less-connected to the network and don’t have anyone to make phone calls and send emails on their behalf. It should not come down to a game of who-you-know.

2. I used to say I didn’t want to be a surgeon because then I’d have to deal with surgeons all the time, and surgeons are assholes. I certainly don’t think that’s universally true, but the culture definitely discourages (or at least doesn’t encourage) supporting others. I knew that when I went all-in for general surgery in the main match, and was planning to do as much as possible to change it. But there is NO WAY the surgery department would do for me what the EM faculty did this week. In fact, they didn’t even offer, even when they knew I was in trouble. My surgery advisor was at our match day party on Friday and completely ignored me, even though I never contacted him with any updates. The EM advisor made it a point to come grab me for an EM group picture. It’s making it much easier to look forward and be optimistic.