Unmatched.com

Medical students have a lot on their minds these days and, like all sickcare providers in training, they have had a tough year. In addition, their anxiety levels about passing tests, paying off their student loans, getting high marks in clinical rotations, and matching into the residency of their choice seems to be higher and happening sooner. At least that is my impression based on volunteering as a mentor to some medical students and recent reports about student depression, anxiety and burnout.

They have good reasons. A medical student who, three decades ago, would have appeared to be among the most competitive applicants would now be closer to average, according to data about the Match process.

In total, over 21% of all applicants in the 2021 cycle did not match into a residency program, forcing thousands to balance crippling debt and dwindling career opportunities with the stress, trauma, and hopelessness borne of becoming a doctor during the COVID-19 pandemi c.?

Consider these metrics:

• The average scores on the medical student portions of the United States Medical Licensing Examination (USMLE)—Step 1 and Step 2 CK—have risen significantly over the past three decades. A Step 1 score that would have put a student in the 75th percentile of test takers in the early 1990s would put them somewhere between the 10th and 25th percentile today. (The Step 1 is?going pass-fail in January 2022 .)
• In certain specialties such as neurological surgery, dermatology and radiation oncology, the number of abstracts, presentations and publications among matched applicants is in double digits. That work is in addition to a normal course load.
• The number of residency slots available through the Match has not increased at the rate of applicants. Since the 1990s, the process has included more applicants than positions.

More drop out docs are becoming entrepreneurs and forgoing a residency. But, it's called physician entrepreneur for a reason.

The primary mission of every medical school is to educate and train students to take care of patients. Few, if any, have as their mission to train graduates for non-clinical careers.

Unfortunately, if, after graduation, the student, either by choice or by chance, does not match into a residency training program, either in the location or the specialty of their choice, then they may not practice medicine at all, or, they will have abbreviated clinical half lives if and when they get a license to practice. Adding to their confusion and anxiety is that most are not aware of non-clinical career options or how to pursue them. Their primary source of misinformation are other fourth year medical students who have matched.

Here is a resource for medical school graduates who did not do a residency.

We should provide more comfort to medical students beginning in their first year by:

1. Providing biomedical and clinical innovation and entrepreneurship education and training .
2. Requiring courses in digital health, data literacy and personal financial planning
3. Making them aware of campus, system and regional ecosystem resources by creating an asset map
4. Insisting that every student have a personal and professional development plan and help with achieving their goals
5. Providing students with reliable, credible and data driven advice about matching into a particular specialty residency and the likelihood that they will succeed given their competitive status. Despite being $150,000-200,000 in debt, some students are so afraid of not matching, or have unrealistic expectation about getting into highly competitive residencies, they are spending even more money applying to every residency in the country in their specialty of choice, spending unnecessary time and effort on externships that won't improve their chances of matching or submitting a back up matching application in a specialty where they have had , literally, two weeks of exposure during medical school when they applied.
6. Preparing them to deal with the possibility that they might not match and connecting them to others who have moved on and prospered
7. Helping them get resources, networks, mentors, peer to peer support and career guidance
8. Helping them develop the soft skills they will need to surthrive as a sickcare corporate employee practicing CorporateCare.
9. Teaching them the business of medicine
10. Engaging their spouses/partners in the process and support them, much like what the military does with families of soldiers and sailors on active duty.

Here are 3 sickcare entrepreneurial paths as career options.

The future of medicine will depend on how we create and treat the trainees who will eventually treat us or help add value through the deployment of innovation in a non-clinical way. Stop frying them.

Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs