Support Systems and Advocates for the Unmatched Medical School Graduates


 Author: Treven W. Cade


Continuing Germane Solutions’ discussion of unmatched graduates, we wanted to highlight the advocates and support systems that are in place for graduates who are not matched within the National Residency Matching Program (NRMP) process. Our discussion will begin with the Supplemental Offer and Acceptance Program (SOAP) and legislative efforts that can benefit graduates that were unable to find a residency. Then, the organizations that explicitly support unmatched U.S. medical school graduates will be articulated, as they support a number of these legislative efforts. Outside of these articulated systems and organizations, unmatched medical graduates can often work within a hospital with a non-clinical or administrative role as well. In short, while not matching into a residency program can cause an initial pessimistic outlook, there are many venues or state initiatives that can help one develop in the medical field.

The SOAP, in essence, gives unmatched medical graduates a chance to be placed in a residency program by utilizing a pool of unfilled residency positions and is perhaps the most well-known, structured, and utilized support system for unmatched graduates. However, a MATCH applicant must be eligible for SOAP: an applicant needs to be registered with NRMP by the Rank Order List Deadline (March 2nd, 2022), eligible to enter a GME program during the start of the academic year (July 1st); and the last eligibility requirement is dependent on whether the applicant is a graduate from an international or U.S. medical school, where an applicant’s USMLE scores must be registered a week before MATCH or an applicant’s medical school must clear their graduation requirements, respectively (“Are You Eligible . . .”). If your program has unfilled positions after the MATCH process, you can find additional information on the SOAP process  here , and if you are an unmatched applicant, you can view additional sources  here .

Moving forward with legislative efforts: in essence, legislation that helps unmatched graduates is legislation that increases the number of residency positions (this could be seen from the implemented Section 126 of the Consolidated Appropriations Act of 2021 or the unpassed Resident Physician Shortage Reduction Act), which decreases the number of medical graduates that are unable to fit themselves within a program. Although other legislative efforts exist that could allow medical graduates to practice without a residency. Germane has briefly  discussed these  efforts, notably a Missouri initiative that provides an Assistant Physician license to unmatched medical school graduates to work under the supervision of a physician. Similar measures have taken place in Utah and Arkansas, the latter state passing an initiative that “allows a ‘one-year transitional training permit’ for unmatched medical graduates” (Barker). With the experience medical students have, if they do not find a residency, they can pursue an Assistant Physician license and get clinical experience under the supervision of a physician, which will work to decrease the care needs and shortages of these states.

A few organizations exist whose mission is to lower the number of unmatched graduates and help the graduates through the difficulties of being unmatched, most notably, the Alliance of Medical Graduates (or the Unmatched and Unemployed Doctors of America) and Doctors Without Jobs. These organizations have very similar objectives regarding unmatched graduates, and the goal of the former, in particular, is to “ensure that every medical graduate residing in the U.S. who has passed their required United States Medical Licensing Exams is able to occupy space as a physician” (“About”). More so, the Alliance of Medical Graduates provides mentorship to unmatched graduates as they pursue developments in their careers. Both organizations have shown support to the Resident Physician Shortage Reduction Act and would without a doubt support the initiatives that allow medical graduates to garner clinical experience without a residency, as a residency is the most prominent bottleneck in becoming an independently practicing physician. Regarding the legislative initiatives that would increase the number of GME positions, they support those efforts because, with an increased amount of residency positions available, it would be more likely for larger groups of medical school graduates to match into a program. These two organizations believe U.S. medical school graduates should be prioritized in the MATCH process; therefore, they have been affiliated with anti-immigrant groups, which has caused some unmatched medical graduates to not follow these organizations (Knight), but Doctors without Jobs and the Alliance of Medical Graduates continue to pursue their mission on assisting U.S. medical graduates to pursue physician employment.

If a medical school graduate is unmatched immediately after graduating, there are many support systems that exist to provide them with guidance and extra opportunities to fit into a GME program—this is not to mention that one can reapply into the MATCH in a future year. The SOAP is the most prominent first step unmatched applicants take to be placed into a residency program; although some states have implemented the Assistant Physician license, which does not require a residency, that will in time most likely become more prominent to combat America’s physician shortage. More so, Doctors Without Jobs and the Alliance of Medical School Graduates continue to provide mentorship and guidance to unmatched graduates, while supporting legislative efforts that would increase the number of residency programs. All of these assets, in culmination, have the ability to provide direct support to unmatched medical school graduates and indirect support, such as supporting legislation that aims to mitigate their plight.

Works Cited

Knight, Victoria. “Two Unmatched-Doctor Advocacy Groups Are Tied to Anti-Immigrant Organizations.” Kaiser Health News, April 30th, 2021, Two Unmatched-Doctor Advocacy Groups Are Tied to Anti-Immigrant Organizations | Kaiser Health News (khn.org).

“Are You Eligible for the Post-Match SOAP?” Match a Resident, February 8th, 2016, Are You Eligible for the Post-Match SOAP? | Match A Resident.

“About.” Alliance of Medical Graduates, About – Alliance of Medical Graduates (wordpress.com).

Barker, Josh and Brooklyn Roberts. “States Help Solve the Physician Shortage Crisis.” American Legislative Exchange Council, August 5th, 2021, States Help Solve the Physician Shortage Crisis - American Legislative Exchange Council (alec.org).

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