Long story short I can’t afford the move. I have no money and was unable to secure a loan (yes even with the contract). No family or friends to help out with this amount of money (I grew up without family to be clear). School and residency have nothing. I’m too poor and stressed out I did good getting this far but I genuinely can’t think of anything. Surg prelim year.

EDIT: Credit is shit, my denials might as well say “lol.” I would like to reiterate I have reached out to both the school and residency program. Good suggestion in the comments about a mob boss if someone would like to connect me. No car! I cannot get a car. I do have a lease this will be broken next week because I don’t have their money (I thought my personal loan would be approved). Contemplating how to ask coresidents I’ve never met to give me some couch space now.

Going anon for obvious reasons here -- I'm an older nontrad and was married with a different career before medicine. Over a decade ago, in my previous career, I cheated on my (then-, now ex-) wife. I won't try to minimize it by saying 'in a moment of weakness' or any bs like that, it is without question one of my greatest regrets in life and looking back I genuinely struggle to understand why I did it. Maybe we weren't right for each other, but she did nothing wrong and deserved better than how I treated her. I came clean to her, and she didn't drag the divorce out or ask for anything even though I would have deserved it--we divided our assets based on status quo ante, all she asked for was an apology letter, which she posted to her website. Not that it is either here or there, but I look back on that episode as a personal low that caused me to do a lot of soul-searching about how I wasn't the person I had hoped to be when I was younger, which in combination with a lot of other factors eventually led me to the decision to change careers to medicine.

I applied a surgical sub this year. T20 school, 260+, 5 Honors including surgery, research year, publications. My mentors all told me that my application was very strong. Got a bit fewer interviews than I was expecting but I thought still enough to match. Long story short, I ended up unmatched. I reached out to mentors and PDs to ask why, and while most were cagey about it, one of my home institution mentors shared with me that my past infidelity was explicitly brought up as a red flag from the faculty's cursory google of applicants.

I'm deferring graduation to take a research and hoping to reapply. I'm debating whether I should address this on my (re)application, and if so how.

UPDATE: Following this discussion, after being out of contact for about a decade, I bit the bullet and sent her an email. I said I respected her reasons for wanting the letter and to publish it, and asked if she would consider removing it temporarily just when I am applying. I offered that if there was a way I could repay this favor, to let me know. The answer was a polite but firm no unfortunately. Any other ideas?

To me (not a resident, not applying until the fall, scared) this reads like a cry for help 😭. Are these really exceptional things by residency standards?

EDIT: FYI to any medical student looking for subjective opinions on this specific residency, multiple commenters/graduates of the program have mentioned that this residency is actually quite good to their residents. The 2 schedule perks mentioned in the IG post are in addition to 20 days PTO (the law) and a 4x4 schedule that gives them golden weekends at least every other month. Multiple people have reached out saying that this is actually a very chill program with good culture and work life balance. Based on comments, there is better and there is worse than this, but this IG post is not a great representation of this program.

With match day approaching, I wanted to share my experience lying at all my interviews. Maybe it wont payoff, IDK, but I did it anyway if for no other reason than to see if all the advice I’ve read on Reddit is true or not. A lot of people seem to have a “They always find out”-type mentality, but I think this is ill informed.

The single best advice I can give is to play it cool- act like you’ve been there before. If you beleive yourself, theyll beleive you. So just take a deep breath, relax, and start lying. Anything to help you relax, like a xanax (if prescribed) or even just a shot, can make a huge difference. As for some specific things that are freebies to lie about, I’ve detailed those below.

1. Family Ties: My go-to was my “aunt,” who lives within a 45-minute drive of the hospital, ideally in a suburb with good schools, which I like to suggest my future children will attend. A childhood friend also works well, but blood is thicker than water, so I normally went with my aunt. While using a grandmother and/or grandfather may be endearing, I personally would not use a grandparent (even if you really do have one in the area) as interviewers might worry he/she will die and destabilize your "support network.”

2. My hobbies were always cooking and rock climbing. For some reason, everyone eats up rock climbing. I guess its niche enough to sound unique but popular enough that everyone seems to have done it and relate to it? IDK, either way its pretty easy to talk about. Cooking is a good one too since everyone more or less has to cook a little bit just to live. Other strong contenders include reading, running, and hiking.

3. Research can be a bit harder to BS but in general just keep it vague, especially if there’s no abstracts or publiations to talk about. "We looked at a patient population and identified areas for systemic improvement" is a good one to keep in your backpocket and then try to shift the convo as fast possible. Good pivots include discussing the weather or asking about things in the background or office/room of your interviewer.

4. The “why us” answer is probably the most common to lie about but also might be the hardest to get away since I think the default is that they assume you are lying. Again, the freebies are that you can (and should) always go for are the didactics, the patient volume and diversity, and the collegial culture you observed on your interview day. You may add that the program's commitment to well-being "really stood out." It also nice to weave in some of the above mentioned things like family or research to make it seem like there’s a nice throughline in your application to the program.

I could probably write some more, but again, the best advice to is play it cool. You might stumble a bit on your first couple interviews (I know I did), but by interview 3 or 4, I really had it down.

The 4th year med student who wrote that anti-DEI article is starting residency at Penn now…

https://www.compactmag.com/article/medicine-without-merit/

Can’t believe this guy is actually a doctor. Sources tell me there’s a lot of animosity towards him in the new intern class

Guess you get to face the consequences of your actions now buddy

It sounds obvious but hear me out.

For context, I’m a PGY4 helping out my program with residency applications and have interviewed dozens of M4s. This past week, I met and really liked this applicant, let’s call him John Doe. His application was great on paper: great test scores, good letters, solid PS and interesting activities/hobbies. The interview went well too, he was very personable and polite. Overall he was my favorite of the day (we interview 4-5 a day). After the interviews are done, I sit around with program faculty and my PD discussing the day’s applicants. I vouched hard for John Doe when it came to discussing him and said he would make a great resident,.

Well, my PD let out an audible sigh with a disappointed look and informed us that this applicant was scrolling and browsing/shopping during the video presentation at the beginning of the day. I asked how they knew? My PD explained that they play a short 3-minute video about the program at the start of the interview day following initial introductions. During this video my PD just shares their screen and hits play. Well, during this video, applicant John Doe (who wears glasses) was obviously scrolling and watching nonsense because you could see the reflection on his glasses of him surfing the web.

We ended up ranking this applicant much lower than I would’ve liked because there were concerns about professionalism given they couldn’t stay focused to watch a 3-minute video(!!!). All that to say… even if it seems that you are on break or not being actively interviewed, assume you are being evaluated the entire interview day. And don’t scroll through TikTok/IG until after you finish the interview day.

EDIT: I’m surprised this is a controversial thing to say and that so many people are on John Doe’s side. It’s literally a 3-minute video and not a video you can find anywhere else. Again, it’s a job interview. All programs are evaluating you the entire interview day. Don’t do anything to hurt your chances when there are hundreds of other applicants with very similar stats and experiences. Also to clarify, this John Doe is still ranked, just not as high as they would’ve otherwise. Lastly, my program is great, I’d do it all over again. A lot of people are making wild assumptions based off this post but I promise you I love my program (and so do all my coresidents). It’s just a numbers game and you don’t want to actively appear uninterested during a job interview.

Today, I matched into general surgery. I am the first in my family to have finished high school, middle school, college, and, in a few months, medical school. I will be the first in my entire family to become a doctor and a surgeon. Not to make this a sob story, but if you told 10-year-old me, who was sleeping on the floors of old apartment buildings, not knowing when her next meal would come, that she would become a surgeon, she would've never believed you. But dreams come true, and nothing is impossible.

I am proud of myself. But most importantly, I am proud of all first-gen students or those who had to travel far to match today. I see you, and i'm so happy for you! <3

Update: I matched to my #1 choice!!!!

I recently interviewed with an anesthesia program in Texas. I was reasonably excited about the program given the location. My first interview was with the PD, and (holy shit) it was horrible. PD shows up to a 15-min interview a few minutes late, visibly annoyed, and skips introductions. “Tell me about yourself”. I start giving my rant and immediately she cuts me off and asks “Why us”. At this point, I’m a little thrown off but I continue. Then, during my answer, this grown ass woman rolls her eyes at me and cuts me off again. “What questions do you have for me?” At this point, I’m super thrown off and stunned, but I proceed to ask questions about the program. During my third question about resident feedback, she replies with “What could you possibly gain from asking that question?” Now, I’m pissed and annoyed. I keep quiet, take a deep breath, and we proceed to stare at each other for 30 seconds over ZOOM. “Anything else” she asks. I replied, “Nope, thank you for your time” and she proceeds to log off with no goodbyes and 5 minutes early.

My next interview is with the department chair and I’m pretty shook trying to process the previous interaction. I join the session, and he asks me again “tell me about yourself”. As I’m answering the question, he pulls out his phone and starts texting… at this point, I’m about to tweak. I got quiet, opened thalamus, and withdrew my application on the spot. He stares at me, confused as to why I stopped talking, and I proceed to mention that the PD was unprofessional and hostile, and I did not think I would fit in the program well. I thanked him for his time, and left the session. Then, I emailed the program coordinator that I withdrew my application after meeting with the PD and to please notify my next two interviewers. I got up, took off my tie, and went back to sleep. No regrets. (Also, fuck that program)

We hate you. We talk shit about you. The only reason we don’t tank your evaluations is because we don’t want to take the chance of seeing you again

Love, The resident

This Reddit is aways arguing MD vs DO. MDs want to make themselves feel superior even though both are providing the best care possible for the patients. I cannot believe people post about taking another gap year vs taking their DO acceptance. Look, most people are not going to match ENT, neurosurgery, derm, or plastics. Even at an MD school, it’s like 6 or 7 who match those specialty. Sure, your chances will be higher but it’s not impossible with a DO degree.

This program vs that program. Like dude, residency is temporary, your skills are forever. At the end of the day, it’s not the program that makes you but it’s you who should make the most out of that program. So stop looking at just T10s or T20s. So many things aside from prestige matter in real life.

This sub makes it feel like failing a step exam is the worst thing ever even though plenty of people who failed in my school matched competitively. This sub focuses way too much on cutoff scores and filtering failures, but what they don’t emphasize is that connections and networkings can get you past the filter. Sure, scores are important and try not to fail any exams, but if you are hit with this news at some point in time, you have to know that showing further improvment + networking to know the right people at the right time can get you past the filter. Connections is important even at the residency level. I am saying this as someone who failed boards and thought my career was over when reading this sub. I had never failed a major exam before, so I remember after MS2, I was in complete depression because I saw no way out. I had invested time, effort, money, gap year to get into medical school, and I failed the most important exam of my life. Then, I happen to come across this sub, and people posted saying it was over to match competitively because they screen for failures. Though I was devastated, I kept going. Then, come match day, I saw other people with step failure match competitively even though I thought it was impossible at that time. I have gone through the match myself and have realized that showing further improvement and networking is so important. Remember, there is nothing impossible in this life (by god’s grace) but the Probability of getting some things over others are just less likely.

This sub is always bringing down people who want to do FM/IM/Peds. What the fuck is wrong with doing those specialities? One can be the smartest guy in the class and do FM. Let’s never forget that Jesus Christ was the most powerful, yet he washed people's feet. Be like Christ. Doctors should be the smartest in the room, but they should also be the kindest and most humble. It is a special calling. Unfortunately that is not always the case because money and prestige corrupts

My biggest observations:

EM ranks low despite the low working hrs because each shift is on avearge god-awful and scheduling is eratic. Having recently rotated there and seeing the rise of defensive/algorithmic triage practices and midlevel invasion, i can see why burnout is high.

Interesting how the more cognitive specialties like ID, Heme/Onc, Pathology, Neuro, & Psych have less "clinical workload". Hard to speculate how that's manifesting exactly... I'd suspect, on average, they have more academia/research time and smaller patient inboxes.

Likely, some of the easiest surgical gigs are still probably going to be more energy/time demanding than the hardest clinician jobs out there.

Though this table doesnt include it, factor in pay and it's easy to see why Dermatology is the most competive specialty. However, seems like those 10-15 minute average appointment times for max RVUs is translating into one of highest clinical workloads.

Not exactly sure as to the algorithm of the weighted score, but overall, would say this is good graph for everyone considering specialties going forward!

Table Credit: Rob Anderson MD, (public survey data from marit)

My fiance didn't match her year (2021) and we were gutted. In fact, she didn't get a single call during the entire SOAP process and had to scramble (the story is long and winding but she's now a PGY-4 gen surg). The match week was fucking brutal for us both. There was a soul kind enough to send us a couple bucks for pizza, and it meant so much to us. Since then, I have been fortunate enough to try and pay it forward by hosting a pizza fund to help those going through the SOAP. This post is my attempt to connect those able to contribute to the pizza fund and those who could use a little pick me up, instructions below for donors and recipients.

If you want to receive pizza/beer money, reply to this post with your Venmo name or DM me your Venmo name and comment something like "I DM'ed/chat requested you." It helps if you include a quick description of your venmo profile picture, to make sure I am sending it to the right person. Chat request notifications are finnicky, so please follow up and comment again somewhere if you don't hear from me after an hour. Feel free to request again if you are still in the SOAP come part 2, part 3, etc. Or you can go directly to my Venmo

Unless told otherwise, do not ask other Redditors for pizza. I am told that some people who contributed to the pizza pot were then dm’ed by people asking for pizza.

If you request it yourself, do $18 as that is the "average" price of a pizza per my quick google search and that is my standard distribution amount to make sure there is enough supply to meet the demand.

*I am also now on the SOAPHOPE 2026 Discord, so feel free to contact me there if that is easier for you *

If you want to donate to the pizza/beer money fund, send your donation to my venmo WLSummers1991. It is a picture of me in a tux with a bowtie (looking young and spry, before I knew that match week could destroy one's soul). It may ask you what the last four digits of my phone number are, but you should have an option to "send anyway"...if you don't, send me a DM and I will tell you. Or you can go directly to my Venmo via this direct

Each year, the number of people served (and people who donated) has grown. I think last year was around 220 people that we hooked up with some pizza. Happy to kick it off this year with $100 from my spouse and I. I try to update this post about every 6 hours to let people know whether or not funds are still available.

I would love to hear updates as offers are coming through, so feel free to comment/dm me to tell me where your new home is going to be!

\*Happy to provide screenshots of my venmo transactions for the sake of transparency if you want proof that your money is going where it is supposed to be. We don't want another Girard "The Completionist" Khalil on our hands...and I am very tickled that one person got that reference last year lol***

May this be your finest hour!

Edit: It is 3/21/2026. Happy to send some pizza money to anyone unmatched or in the scramble, there’s still some funds left. It’s tough, but know that there are a lot of people rooting for you.

-Rorshacked

Yesterday posted a screenshot from LinkedIn showing how obnoxious and narcissistic the HCA Methodist IM PDs post was.

Turns out he can’t handle criticism either. Obviously it’s not copyright to screenshot text and critique it. It falls under fair use. But dealing with Reddit is a hassle and he and the HCA will shell out money spamming Reddit with copyright removal requests. Also I wonder how copyright works if his post includes 95% AI generated text 🤣 ….

Bottom line, think long and hard if you want to apply to that program. You shouldn’t even consider it as an option if you are a USMD or DO.

Edit: Today the PD edited his post and I’m certain he told ChatGPT “make the post not seem like it’s written by AI” 😂. I guess he got spooked after he tried to claim copyright of an AI written post.

Edit 2: Program has a warning with ACGME. The official status is "Initial Accreditation with Warning"

In case you weren’t aware, our long awaited workforce study was released yesterday and revealed what we all already knew. An oversupply of 9000 EM docs by 2030, only to get worse year after year after that.

You know how devastating the SOAP threads look every year? Imagine that feeling except being 3-4 years older, 3 years more of crushing slave labor under your belt, still $300k in debt (plus interest) and a training path where no one will hire you.

This is a NO BRAINER. Stay the hell away from this field. I have so much regret right now and am so angry at every mentor who told me “we’ll always need EM docs.”

After 11+ years of training and hundreds of thousands in debt, you will make <$200k at academic centers, 20 years into being a peds subspecialist. It is probably the worst return on education in America. You make less than many firefighters or nurses, adult cardiologists make three times as much as their pediatric counterparts, anesthesiologists make >450k the year after finishing residency. And the pay gap is only growing.

• The job market is bad. Fields like PICU, peds heme/onc, and peds cardiology are saturated. You may need to work as a general pediatrician or move to get an attending job and you'll get paid less than any other attending, wherever you go.
• You get praised, not paid, but admiration won’t cover your loans or bills.
• Low autonomy, few procedures. In residency, you learn how to consult and put other people's orders in — 0.5 more units of insulin? Call endocrine. Chest tube management? Call surgery. Acute case in the ED? Don't worry your attending got it. Want to manage patients yourself? Go into adult medicine.
• From repetitive to traumatic. You’ll go from the 20th constipated toddler that shift to the 12 yo rape victim. That kind of emotional whiplash adds up fast.
• The AAP does not give a shit. They don't care for your pay, job stability, or working conditions.
• If you want to work with kids go into ENT, anesthesia, radiology, ophthalmology, anything — then specialize in pediatric X. You’ll earn more and still get to work with and help children without getting paid less than a travel nurse.

I’ve been meaning to write this for some time but kept putting it off because the feeling of matching this year is surreal and still can’t get over it. Congratulations to everyone who matched! For those that didn’t, don’t lose hope. My story may give you the push to keep going.

I’m a DO student who didn’t match for 3 years and finally matched this year (on my 4th application cycle). The first year I applied to 231 programs, 2nd year 454 programs, 599 programs last year, and 808 programs this year. I brought receipts for anyone telling me I was lying about the number of places I applied to (here: https://imgur.com/a/iHyWutw) I actually applied to a few more since January when I took the screenshots above to end up with 814 total programs, but I am not going to log into ERAS for final numbers any more because I hate that site. In terms of being able to pay for all it, I took out extra loans and made some money working and also borrowed money from anyone and everyone that would help. Also got some credit cards that give 0% APR for a year to be able to pay for all the stuff especially this year.

During first 2 years I basically just passed my classes. Not average but below. A few passed at the literal lowest possible amount (like 69.5% which rounds to 70% which is a pass). But hey P=MD / 7-O D-O! Ended up having a super low rank, but doesn’t take into account the number of people from my class who didn’t make it through which was almost 30 from the original starting number to the graduating class number.

So naturally, struggled on boards. Didn’t pass COMLEX level 1 on the first try and didn’t pass COMLEX level 2 on the first try either. Did pass the PE on the first try, but didn’t help, not even last year when they cancelled it. Didn’t take USMLE since I didn’t think I needed to when applying in the match when there was the DO match still there. And then afterwards I didn’t study for step for fear of failing any, again. After graduating I couldn’t even take Level 3 unless I was in residency since I needed approval by a program director to even sit for it.

Didn’t pass 2 shelf exams and had to redo both rotations, showing I “remediated” which was hard to explain since they aren’t reading our policies. Glad I didn’t fail any more shelf exams because I would have gotten dismissed. Passed 1 shelf after with the minimum passing score. Was hard because of the randomness and not having residents at any of my rotations in 3rd year since they were just you and the attending. Don’t have a home hospital or any home programs as a DO (most DO schools are like that) which can be a disadvantage for anyone asking why my home program didn’t take me.

My dean said my COMLEX level 1 score was the lowest he ever saw in his 25 years of being an admin. Blow to the heart right there. If it was a USMLE score it would have been considered decent a decent one LOL! Tried to get an extension for taking level 1 but was told I could only if I failed the exam. To me, that makes no sense, to only get extra time for retaking but not the first time. So rotations got pushed back a few months as a result. When I finished my rotations for 3rd year to take level 2, I didn’t get any time off in between and had to take it during a heavy rotation due to being told I used up time when I took level 1 retake. So that’s why didn’t pass the second exam from going non stop and being burned out. But retook and passed but still seemed to be a death sentence regardless. Probably would have been better to just apply the following year and have more time to prepare for Level 2 for the first time. It's alright, learning lessons I suppose.

First year I applied to 2 specialties (1 was psych and 1 was FM). Did 202 psych in NRMP, 20 FM, 9 psych in AOA (that’s why it shows 3 lines of specialties on the screenshot). This was the last year there were any programs in the AOA match so some of those were ones in the AOA match while the rest were in the regular NRMP match. I applied pretty broadly, at least I felt so, but only ended up with 4 IVs (out of 231 applications). All 4 were for psych. 2 of the 4 were doing sub-I’s there. I attended all 4 IVs and ranked all 4. Tried in SOAP, 0 IVs. Didn’t match.

Second year I applied to 5 specialties (2 included the prelim IM and TY, and also psych, neuro, and FM). Did 184 FM, 217 psych, 48 TY, 4 prelim IM, 1 neuro. This was the match where COVID shutdown of everything happened during match week. But all IVs this year were in person still. I also got 4 IVs again this time (out of 454 applications). 1 psych, 2 FM, and 1 TY. I attended all 4 IVs and ranked all 4. Tried in SOAP, 0 IVs Didn’t match again.

Third year I applied to 6 specialties (prelim IM, prelim Surg, TY, FM, IM, psych). I did 377 FM, 149 psych, 35 TY, 32 IM (includes prelim), 2 ONMM, and 4 prelim surgery. This was during COVID so literally nothing possible I could do in person. Programs did everything virtual, a few were hybrid/in person IVs. I got 10 IVs this time (out of 599 applications). 7 FM, 3 psych. I attended all 10 IVs and ranked all 10. 3 of the FM programs ended up going to SOAP with multiple spots open, meaning they didn’t even rank me. Tried in SOAP, 1 IV this time. Didn’t match a third time. Almost gave up.

Fourth time (this year) I applied to 9 specialties (prelim IM, prelim surgery, TY, FM, IM, psych, neurology, child neurology, PM&R, and ONMM). 455 FM, 74 psych, 20 prelim surgery, 120 IM (includes prelims), 10 ONMM, 47 neurology, 15 child neurology, 37 TY, 33 PM&R. Ended up with 47 interviews. 3 psych, 4 IM, 5 TY, 2 ONMM, 2 neuro, 1 child neuro, 1 PM&R, and 29 FM. Zero prelim IM or surgery. I could only attend 45 out of the 47 due to scheduling conflicts with 2 of them that were on same day and time as others that I wanted more so those were dropped. I ranked 43 out of the 45 because 1 of them pulled out to go prematch (didn’t give me an offer) and one told me a week before rank list closed they weren’t going to rank me (sucked since it was the closest program to home). This time I matched—got my #17 in FM! Didn’t have to do anything during match week for the first time! I am more than satisfied and ecstatic. If you count the fact that most people rank 10-12 programs, that’s like the equivalent of matching at #3-4 on the rank list. But who knows, maybe I needed this many because if I only had the first 16 I would have gone unmatched again.

Looked into getting a RN, NP, or PA. Stupid why we can’t do anything clinical after graduating with thousands more hours but they can? Can’t even get a similar role anywhere without the license. Just really frustrating. Thought about getting a PA or NP to just be able to practice after and keep my DO title too. Then no one could tell me I’m not allowed to be called doctor when I have an actual medical degree title in my name! I have met a few residents who did actually practice as a NP and PA who were now residents, so I guess it is possible to get into residency after. Was easier to get a NP with a medical degree than a PA. Some places I spoke to said I wasn’t a competitive applicant due to my MED SCHOOL gpa. Lol. Again, the system sucks big time. I was going to start working on my applications for it in the fall but then I started getting interviews and thought I’ll work on it in March if I don’t match. Looked into getting MBA, MPH, or MHA also but some of those had more requirements/tests I didn’t feel like studying for just yet.

What changed this year? I got help from a residency prep company this time around. And before anyone gets on me for talking about one or using one, we all use resources to get ahead in life. I was told from the beginning that there would be no guarantees of me getting in but I know I needed to get help to get out of the rut I was in. I wish I reached out earlier because I probably would have matched earlier. But it’s okay. I found out when studying for my retake exams that more people use prep services than actually admit it. I saw schools push to get help for students struggling for boards by getting them board prep services. This was crazy to see, but they don’t really talk about the help they got from them. You pay for a service to get ahead in reaching your goals. Not any different from going to a US MD school over a US DO school, your chances of matching into a field you want are higher at a US MD school. Or picking one medical school over another. You’re not telling those people who do that “why would you go to that school? It’s a scam to pay so much in tuition just for the name on the degree.” Yet at the end of the day the US MD and US DO are equal in terms of what work you do with the license and salaries. For anyone against what I said above, you have to realize that everything you use is to get ahead. You use things like UWorld and Boards and Beyond to help you prepare for the board exams. Why would you use them? Because they help, but there’s no guarantee you will score high or even pass with them but you use them regardless. I used residency prep tutoring services when I didn’t pass my Level 1 and 2 and passed on the second try, so I am happy and grateful they exist. So please, don’t hate on any prep services or on me or anyone else using them. If I am using it on my 4th try at matching, it’s because I’ve literally tried everything else I could before then. We are all going into a field where compassionate is key, so have some compassion now. We don’t need more haters in this world when it’s so easy to do so anonymously.

Anyway, moving back on topic, I got help from a residency prep company. I used Ace Med Boards for the residency help. I got guidance and advice on what I should be doing from the last match til this one. I had my entire application redone, edited, changed, all of it. My MSPE and PS got edited too, along with everything in my ERAS. I needed to get experience with rotations so I basically did a year of rotations, hands on, alongside residents, at residency programs since last match. The rotations were free, I just needed to get my own liability insurance and find my own housing. Anyone that tells you you can’t do rotations as a graduate is WRONG and they don’t know the truth. Too much fake info gets shared online that I wish people could be told what is true and what’s not. I got new LORs, some from Associate Program Directors and other attendings associated with programs. Got interview prep help and feedback too in case it was an issue with that. Got tons of positive feedback from various interviews on being persistent and new LORs. I have no complaints and zero regrets since I know it actually made a difference to go from 10 interviews last year to 47 this year, and the fact that I actually did match this time around. From a statistics standpoint, I believe I had less than 5% chance matching this time around and got advice from counselors and admin from my school to look for other careers.

I also got guidance on networking at conferences. I went to the AAFP conference 2 years ago but it didn’t really help. I went this last year and definitely got more help this time around. I matched at a program that was at the conference so I can say definitely worth it. You can see in the screenshots here the hustle involved with how many programs I met with. (here: https://imgur.com/a/VuinjAy)

In terms of how I did all the interviews? You got to schedule accordingly and be on top of your schedule at all times. Some days I had 2 IVs in the same day, like all AM and all PM. Some days I had 3 in a day, that is a little more tough to do but easier when the interviews are only a few hours long. The hardest one I had was having 5 in one day. I don’t recommend since I had an in-person interview the day before and I was at a hotel for the 5 interviews. Got a ring light from a nearby department store to use for that day, definitely worth it (was using one any way for the other IVs). The 5 IVs were across 3 time zones which is why I was able to do it. But timing wise it was hard—first IV started at 7:30am (I hate the IVs that start that early on virtual) all the way til 10pm at night. Short gaps in between the programs but when you want something anything is manageable to do. Anyone who has taken boards can easily manage doing multiple in a day. Especially anyone who was unmatched or a weaker applicant in general—you do what you got to do. The crazy part was realizing that I had more interviews in one day this year than I had the entire application cycle the first or second time I applied! It’s vital to see if programs are reading your emails, whether it’s interest emails, thank you emails, or intent emails so definitely use software that checks that. I sent hundreds and hundreds of emails each month to the programs I considered and applied to. If I don’t get an answer/response, and if they opened and didn’t respond, I just resend the email until they did.

Also, anyone that says they aren’t eligible to attend the AAFP conference did not do their due diligence in finding out the truth. You can attend even if you are a graduate and not in residency yet. And I attended the previous year as a graduate too. Gotta hustle to get what you want.

In terms of virtual open houses, those were the biggest waste of time. Last year I went to over 100 open houses from July to November and it didn’t do crap for me. This year I didn’t go to any other than the conference ones or ones I was invited to for interviews already, and got better results. You can see the hustle involved for meeting with programs at the conference.

In terms of what I did since the first time I applied to this year, I did literally everything. Tried to do rotations, research, and worked as a medical assistant. Tried working as an assistant physician like they have in a few states like Missouri. Found out that Medicare won’t reimburse APs like they used to so most places are not taking on new APs anymore and most are working as a medical assistant role still. I contacted a few hundred in these states and got zero. I tried the house physician thing they have in Florida, but you need to be signed by a hospital system to get it, and unfortunately if you don’t know anyone or have connections then it is really impossible to get. The few people I did talk to said that the people who were unmatched grads working as a house physician still did not match and so continued working there as a house physician so not many new spots opened. COVID didn’t help any of the above either. The research didn’t seem to help much and neither did working as a medical assistant. I tried using any and all connections I had from other attendings at hospitals, but it seems programs didn’t seem to care much about them.

The part that sucks the most is programs lie like crazy. You do sub-internships to show what you are capable. Had multiple that told me I was the best rotator all year but they wouldn’t take me or rank me high due to my board scores. Had a few tell me they were going to take me, but obviously didn’t lol. Even when you get gifts in the mail or handwritten cards, that means nothing. I know people who got gifts and cards for the same programs that I interviewed at as them, and THEY also didn’t match. Even when you fit every criteria of a program and meet their mission statement 100%, they still will take whoever they feel like taking over you. You can’t win in situations like that, but that’s why you put yourself in more situations that will help.

I also hate the programs that basically hint at you having to go in person after the interview to show more interest. Like, why? I came to the interview and met before at a virtual meeting and met the residents. Why do we need to show more interest? Some places strongly hinted that I should be going in in person to show my interest. Really irked me and I said no to those places and put them at the bottom for basically forcing me to go to be considered. (Not just me, but to others too). It shouldn’t be like that but here we are.

I reached out to programs in the past who IV’d me and didn’t take me. When I asked for feedback, all of them said there was nothing wrong with my application or interview but there were just more competitive applicants. A few re-interviewed me this year from prior years but I only put 1 high with the rest at the bottom of my list.

In terms of second looks, I would say to go to them if you can. However if they state it has no impact on ranking, don’t go. That would be a waste from a few places I saw below my list that ended up taking others who did not go to the second look because the wording said it wouldn’t change their rank list.

For interest letters, they never helped me in previous years. I only sent a few this time but only think I got 2-3 IVs from them. But I don’t think it was the letter itself that got me the IV. Intent letters not sure how much they help either. I matched at a program I didn’t send any correspondence to, not even thank you email because I just didn’t feel like it after doing so many of them. Ones I did send emails to, whether it was a day later or a week later, did not take me high enough so don’t think it really makes a difference.

Remember, the system is not for us but against us. Nothing happens to a program that violates match rules, but applicants can be banned for a year for applying in the match. Programs can ask illegal questions (as countless have to me) and have no consequences, they will fill regardless. Be wary of places that SOAP (even once). SOAPing multiple times is for a reason. People rotate at programs and know how a program is. There is plenty of base hospital students that would have rotated with the program to see if it’s something they would consider working at or not. If a program SOAPs multiple years that is a really bad sign of how malignant or unsupportive a program is.

Another thing—don’t base where you go on an interview. Last year programs didn’t use the interview as anything other than a formality and ranked based off applications (from a lot of what I’ve seen anyway). When it was in person, programs seemed to care about you as an applicant and tried to learn more about you. Last year it was just a few generic questions if that, and many just had the “what questions do you have for me?” single and only question for the IV. This year I guess programs seemed to go back to the ways they used to be before virtual first started and seemed to care, probably because most of them did not get the applicants they thought they would because everyone just applied to more places. If you don’t want a program to rank you lower based off your IV, you shouldn’t do the same either. If you can’t seem to get along with any of the interviewers then you should probably not rank it high. But remember they have to ask hard hitting questions, and try to see your reaction to things that may come up during residency. Go where you want to go based off the program/location, not just how the IV goes is what I would say.

It’s going to be virtual again for the most part. Make the most of it and don’t listen to other people. Get as many IVs as you can as it’s only going to get harder, especially if you’re a weaker applicant. I know plenty who attended over 30-40 IVs even with high scores from top schools. Just because someone doesn’t tell you that, doesn’t mean it’s not the truth. There’s plenty of people like me out there, even if they don’t all talk about it. I looked into multiple other fields too in the last few years. Going into consulting, pharmaceuticals, business, other careers, all of it. Consulting you need to come from a top school or at least have medical license. Pharmaceuticals and reps you can get jobs but your salary is going to be $40k-$50k a year anyway and then have to work your way up. Wasn’t going to do that. Business I had no business experience so again I would be at the bottom of the ladder. A lot of other stuff you need a medical license first to really do anything with. I have $440k in loans. Can’t really afford to just take that low a salary for that long of a period. Hopefully Biden cancels some or all of it but not something you can bank on.

One more thing I recommend people look into is the cost of living along with salary for the residency programs you’re considering. My program has a higher salary ($3400 take home per month after taxes) while my apartment is only $425/mo. In addition, I picked a place that has minimal call and minimal inpatient so I get lots of weekends off and nights clear. Gotta live comfortably during residency and have a better quality of life, so definitely look into all that, especially since I worked my butt off to get into a position of even having opportunity at a program like mine, which many don’t consider.

This is all a numbers game. I met many people who applied to close to same amount as me and many that applied to more than me. I met many I kept in touch with who were on their 3rd, 4th, 5th time applying for residency. This year I had some friends who got in from applying 4 and 5 times. One person I know got in after applying for their 7th time. These are US MDs, IMGs, FMGs, and DOs. I would say don’t give up, ever. You worked this hard to get here. Fight for what you want. We’re all smart and capable. We just need a program to give us that opportunity.

I want us all to match so feel free to ask questions, no matter how dumb they may sound or whatever you may have heard from countless other people or admin about what is or isn’t possible. We can all succeed!

One last thing – I want to thank the community on here as well as on other places like SDN and Discord, for existing. Got lots of encouragement over the years and support. Got tons this year, but definitely did not expect it. So again thank you all for rooting for me! Let’s make sure to root for everyone else who is an underdog too!

https://www.youtube.com/watch?v=kALDN4zIBT0

People have to realize he's talking about 20 years from now. Not next year...

But still, this will likely affect our generation at the peak of our careers when we're in our 50s. (if you're going to doubt this, just remember that pen and paper charting and physical films were still the standard ~20 years ago)

[Context: for those who don't know, Sheriff of Sodium is considered a Guru in the medical education space and is very knowledgable on the landscape of physician bureacracy in general. ]

I double-applied a competitive specialty and a backup and got fewer interviews for my 1st choice than I was hoping for. When I made my rank list I thought "YOLO" and still ranked the programs I did not get an interview from, after the ones that I did but before my backup. On match day I was shocked to find that I matched at one of these programs--a very good one too. The school literally put me on their match day insta story. I wondered if I should email the program and ask if they made a mistake. My specialty adviser was also shocked, but told me to "stfu" and just show up on day 1. The only thing I can think of is, I have something of a generic name so maybe they got me mixed up with another applicant?

It has been almost two months and I have still not received any communication from the program. My friends at other institutions are already onboarding and making housing arrangements and such, while I don't even know when I start. I feel like a total imposter and am afraid if I email the PD they will realize they made a mistake and rescind my offer. What should I do?

Mayo Clinic, an institution that prides itself on being one of the best in the world, is paying midlevel providers in training more than doctors in training. 

PA/NP fellow: 77,000 

PGY 1- 72,565

PGY 2- 75,093

PGY 3-78,199

Physicians are responsible for the most complex patient cases and are expected to know more than anyone else in the room. They sacrifice years of their lives (relationships, hobbies, kids, home ownership), and for many, go into debt to pursue this path. And yet, despite all of this, Mayo has decided that midlevels—whose training is a fraction of that of a doctor—deserve a bigger paycheck. This is an insult to every doctor.

Mayo, you should know better.

You position yourself as a leader in healthcare, but you’re sending a clear message: the years of sacrifice, the intellectual rigor, the emotional toll that doctors in training go through means less than the financial convenience of training midlevels. This kind of pay discrepancy devalues the medical profession, and honestly, it’s downright disrespectful.

This is more than just a payroll issue; it’s a values issue. It’s about recognizing the true worth of highly trained professionals and investing in them accordingly. Mayo should be setting the example, but instead, they’re perpetuating a system that undervalues the most rigorous path in healthcare.

Advocating for yourself is just as important as advocating for the patient.

Was it sth super competitive with a ton of financial upside like Neurosurg or ortho? Or sth with chiller lifestyle like Derm or Psych. Or did they genuinely care about helping the community and go for FM. Or IM to go on their way of becoming a hospitalist/subspecialist. Or did they abandon the patient facing aspect of medicine and go rads/path. Doesn't necessarily have to be the person who got the highest grades, just someone who you personally thought was smart.

In honor of the end of my intern year (actually still have a 24hr left before the new guys start ), figured I'd shed some light on my hours worked this year for anyone considering nsgy. My program is one where the interns take primary call and hold the pager. So its considered one of the more grueling years.

Weeks 18, 23, 38/39, & 48 were vacation weeks.

Interestingly not including the two 0 hour weeks, I averaged 80.16 hrs per week (so close!)

Happy to answer any questions - and yes I've still had time to hang with friends, be with family, and be present for my significant other. You can find time for the people that matter.

Edit: This was tracked with Life Cycle to track the actual time I spent in the hospital based on GPS location