MedicalPodiatry

The Unmatched Student’s Guide to Successfully Dealing with Failure 

I was in the middle of a fairly busy day on the palliative care ward, so I had to slip away to the quiet stairwell in order pull up my Match Day result on my phone. The words “We regret to inform you that you did not match” felt like a punch in the gut. I kept refreshing the page, hoping the words will somehow go away or that someone will email me to inform of the ridiculous error the system just made. But of course that didn’t happen. In that one moment I felt as if all that I had worked for and thought was just in my reach was suddenly pulled away from me into a distant future that I couldn’t access.
People were slowly and painfully dying around me, but I felt like my world was over.
I know I wasn’t alone that day but going unmatched felt like one of the most isolating experiences in my life. In medical school, we celebrate and cultivate achievement but we can be pretty ill-equipped to deal with failure. Medical students live in a world where hard work and success are tied together in a neat little equation. We come to expect success as a natural process of professional life and when that doesn’t happen, it is easy for our sense of identity to feel threatened.
So although I received a tremendous amount of administrative and faculty support as an unmatched candidate, it became clear to me that my own emotional and psychological devices were navigating through foreign land. And they were on this journey alone.
What I didn’t anticipate was this: failure has a way of forcing perspective on to you. In its messy aftermath, you must take the time to reflect deeply, and not just ride a superficial wave of emotions and consequence. There is a certain clarity of thought that comes to you, gradually but inevitably.
The experience of not matching is not identical for everyone. I do hope, however, that by committing my own thoughts and experience to the written word, I am able to give the unmatched student a voice, a sense of direction, and an assurance that he or she is not alone.
What you feel 
When the bad news first hits you, you must do what you need to feel what must be felt: shock, sadness, hurt, disappointment, even anger. To deny yourself this would be to deny yourself an important human need. But it’s important not to let the emotion overpower your abilities to cope.
I personally found it helpful to turn my disappointment into gratitude. Not matching made me feel as if I had been cheated. Why would I feel cheated out of something that wasn’t mine? I realized that so much of my reaction stemmed from a place of privilege and achievement. I was blessed to have attended a prestigious university in a world-leading country to pursue the career of my dreams in medicine. I had come so far. And it was important for me to remember that.
Examining the roots of my feelings and attitudes, towards work, life, failure and success, gave me insight into the reasons I felt what I felt. And also allowed me a chance to develop important emotional and cognitive tools to process and understand those feelings. I now know: this is an important part of successfully dealing with failure.
What you think
Pretty soon after not matching, you start to mull over what could possibly have gone wrong. This is an important next step too. When something goes wrong it’s human nature to try to assign fault to someone or something concrete, preferably to something beyond our reach. This helps us make sense of the world and lighten the burden of responsibility we can place on ourselves. But we shouldn’t stop here.
The residency matching process in Canada is certainly not transparent (for many good as well as unclear reasons). But as an unmatched candidate, it is even more difficult to obtain objectifiable feedback or to pinpoint what exactly contributed to this outcome. When you’re kept in the dark about why you didn’t match, it’s easy to think that the system has failed you. It might even be comforting to think that, but it’s not very helpful.
There are very few unalterable truths in life, but one is this: no one is perfect. All of us harbor the potential to become better people. (Believe it or not, even those of us who match!) So I used this time as an opportunity to do some serious self-reflection. I asked myself some tough questions: what are the things I excel at? What are some things I can improve? Did I give this my all? Where did I falter? Did I manage to convey the essence of who I was to my interviewers? Was my application strategy too narrow or weak? What am I passionate about?
Where do I see my future?
What you do
This is the final and most important part of all. After processing a barrage of emotions and doing some serious introspection and critical thinking, I had to act. This was a chance to reclaim my identity and self-esteem.
When I didn’t match, I saw a whole year of uncertainty just stretching before me. A common fear among unmatched medical students is that their whole year will be wasted as they wait for the next round of applications to start. People often tried to assuage this fear by reminding me that I attended a three-year medical program, meaning in reality I was actually on par with my cohorts across the country who would be applying in the same residency application cycle as me next year.
Thinking this way made me feel like we were all missing the point.
Yes, on the one hand I had a whole unplanned year ahead. But on the other hand, I had a whole unplanned year ahead. Which means it was an opportunity to pursue the things that mattered to me.
In medical school, I was exposed to healthcare in a multitude of ways. There were many things that excited me, ignited my passion, and piqued my curiosity. But with the overwhelming clinical and academic responsibilities, it was hard to convert any passions into meaningful work. Things I wanted to do just kept piling up, but medical school took up all my time.
So it was important to me to use this year to do what I loved as well as what I felt would help me grow personally and professionally. Something that not only improved my residency application, but that excited me and made me a better future physician. With this in mind, there were many options available to choose from. I could choose to extend clerkship and gain valuable clinical exposure, complete a Masters and expand my knowledge base, take up a non-clinical job, dive into research or undertake clinical projects. So I did a little bit of each.
The possibilities really are as numerous as your interests. But it helps to talk to friends, student support, preceptors and mentors to get their feedback and advice. You must mobilize to search for opportunities and seize them.
Meaningful Failure
Kickboxers condition their bodies by repeatedly kicking hard pads or weighty bags. This repetitive stress induces micro-fractures in their shin bones. As the bones heal, they remodel to become denser and stronger. They adapt.
Not matching is hard. It’s demotivating. It was my first real taste of “failure”. But it was also an important human experience that allowed me to remodel, adapt and strengthen.
I decided to speak out about my experience in order to start a conversation. Unmatched students need to know that failure, in any sense of the word, is absolutely normal. Even healthy. But in order for failure to become meaningful, it has to be actively processed, not experienced in a vacuum.
Being a physician is a lot more than just filling the space and time between career milestones. And although our career trajectories are measured by these milestones, they are not defined by them. We must continue to be fascinated by the world, explore our passions, learn from every experience and constantly strive to become better. Some of the best physicians I have met do exactly that.
You can follow Romesa on Twitter at @RomesaKQ.

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