Residency Interviews: Answering Why You Didn’t Match Into Residency?

Many interviewers will suspect you didn’t match based on your CV, even if you don’t tell them outright.

by | Aug 15, 2022

Any time you are applying or re-applying with a gap since medical school, interviewers will be curious about your career decisions.

Whether you didn’t match into residency or chose not to pursue residency for some reason, you’ll be expected to provide some answers.

Your interviewers will be interested in understanding how committed you are to residency — and how prepared you are to be successful.

This is true for all applicants, but a gap in time may raise additional questions because you didn’t take the most traditional route to residency.

You Are Not Alone

Re-applying isn’t unusual.

There are many reasons why a strong candidate might fail to match. The matching process is extremely competitive, in some specialties even more so than others.

Every year, thousands go unmatched. In fact, almost 20% of applicants fail to match each season!

And yes, sometimes it’s a poor performance in residency interviews that takes a candidate out of the running.

But the good news is that many of these unmatched candidates dust themselves off, put in the effort to improve their applications and their interview skills, and match when they re-apply.

When you’re ready to turn your disappointment into redemption, we’re here to show you the way. Let’s get to it!

Why Didn’t You Match?

You have undoubtedly spent time wondering about this question and have a sense of what you could have done differently.

Use this new opportunity to reinforce your continuing commitment to medicine and to your specialty.

Let’s take a moment to talk briefly about the most common reasons for not matching beyond the competitive nature of the process.

You’ll want to think about which of these issues were factors for you — and which ones you want to discuss in your interviews.

You don’t need to be 100% candid if you’re concerned some details could reflect poorly on you. The main goal is to demonstrate that you learned from the experience, are working on your weaknesses, whether real or perceived, and are now even more prepared to excel as a resident.

Often, those who don’t match can’t pinpoint one clear reason why. It may have been a combination of factors.

So if you’re not sure which to talk about, focus on issues you’ve been able to actively improve upon since your last interview.

Let’s go through some possibilities.

1. Weak supporting documents

Maybe your supporting documents — like your personal statement, or letters of recommendation — were not compelling enough.

Perhaps your personal statement was not well-written. More commonly, some people have decent personal statements and letters of recommendation, but the documents are too general. They don’t convey the applicant’s passion and ability.

Don’t be afraid to write passionately in your personal statement. Your interviewer and the program directors want to know beyond a doubt that you have the drive and passion it takes to excel as a physician. Leave them without any doubts.

For example, you could start your Personal Statement with a commentary on how your passion for music led you to learn an instrument and practicing taught you life lessons you needed throughout your school career.

“I can’t remember a time when I wasn’t moved by music. As soon as I was old enough, I began taking piano lessons. At first, my hands were clumsy, and the notes fell flat. Fortunately, my parents were patient and allowed me the time I needed to practice and improve. My teacher encouraged me to set daily and weekly goals for myself. This habit soon found its way into other areas of my life and still helps me today. Each time I accomplished a goal, I felt proud and my teacher and parents would celebrate with me. It helped me charge on towards the next goal with determination. In my life as a medical student, I find myself still charging towards my goals with that same fervor. I can’t wait to see what’s next.”

2. Application strategy

Some people apply too late because they’re waiting for scores or other issues. Some don’t apply to enough programs to give themselves good odds. And others don’t apply to the RIGHT programs — they aim too high or don’t look closely enough at the fit.

Be sure to stack the odds in your favor by doing your research into programs to find the ones that will most likely be a good fit for you. Apply to more programs than your top three picks to increase your chances of a match. And apply as early as possible so you don’t miss deadlines!

3. Weak interview skills

Many of you are reading this because you suspect your interview skills were part of the reason you didn’t match into residency. Most applicants don’t prepare properly for residency interviews because they don’t have much interview experience and don’t fully understand how the process works until it’s too late.

The interview is the final hurdle in the race to your perfect match.

A good interview separates you from all other candidates with solid scores and a great CV.

The good news is that weak interview skills can be improved much more easily than most other issues. With practice and the right feedback, you can be on the right track to interviewing success in no time!

4. Lack of U.S. clinical experience

For International Medical Graduates, it can be a challenge to gain enough U.S. clinical experience to demonstrate your comfort with the U.S. medical environment.

Limited U.S. clinical experience can lead to doubts about your abilities and comfort level, even if you’ve got great clinical experience in your home country.

If you suspect this was an issue for you in a prior match, you’ve likely been working on gaining more experience since then. You want to make sure you talk about this additional experience in the interview — emphasizing the value of any observerships and other U.S. experience you’ve acquired.

If you haven’t participated in an observership yet, it is highly recommended that you do prior to a residency. Doing so will allow you to gain valuable experience and develop relationships with physicians who can be used as references later in your career.

5. USMLE Exam scores

You already know that exam scores carry a lot of weight when applying to residency programs. Programs often screen for minimum scores before they even review other application materials.

In January 2022, Step 1 of the USMLE changed from a scored test to a pass/fail exam. If you took the test prior to this change and have a score, your interviewer is unlikely to care much about it since those scores are no longer in play. As long as you passed, that’s all that matters.

Step 2, CK (clinical knowledge) of the test is scored with a minimum passing score of 209. The minimum requirements for different programs and specialties vary. For example, in Family Medicine the minimum score may be 200, while for diagnostic radiology it may be 230.

Step 3 is a final exam and is a computer-based case simulation, which tests you on your ability to handle real medical cases without supervision. The minimum passing score for Step 3 is 198.

Obviously, you won’t be chosen to interview if you don’t meet the minimum requirements for the program. But that doesn’t mean you should ignore the fact that you barely met the minimum test score requirement, either.

The best way to combat low scores is to make sure your evaluations, Personal Statement, and references are outstanding. If you can hit those out of the park, program directors and interviewers will be more likely to overlook lower scores.

6. Choice of specialty

Some specialties have special requirements, and some are more competitive than others. If you applied for an especially competitive specialty, you may have lost out even as an excellent candidate. We have seen this a lot with surgery — orthopedic surgery in particular.

Some candidates are strategic enough to pick a backup specialty but have difficulty “selling” their interest in their Plan B in their interviews. No program wants to be your fall-back option.

These are all common issues that can lead to a failure to match.

How to Answer the Question “Why Didn’t You Match?”

If you didn’t match into residency, you should be prepared to talk about it.

Maybe they won’t ask, but there’s an excellent chance they will.

It’s a tricky question because it requires you to talk about failure and weakness.

Not only is that difficult to do for anyone, but it can also be risky. If you reveal too much and come across as too negative or self-deprecating, it can raise red flags with your interviewer.

Remember: You want to come across as confident and committed.

Here’s a basic 3-part approach to help you address this awkward question:

Part 1: A concise explanation of why

Be prepared to briefly describe your thoughts on why you didn’t match into residency. Keep the language and delivery neutral and not defensive. You don’t need to go into a laundry list of every possible reason, but you want to show some self-awareness.

As discussed earlier, the best approach is to focus on something that you’ve been able to improve in. This allows you to demonstrate your ability to persevere and overcome.

Part 2: How you’ve been improving

Discuss how you’ve been improving and becoming a stronger candidate. This demonstrates initiative and dedication.

But what about things you can’t improve — like exam scores or a weak clinical rotation grade?

You can still talk about making an effort to improve your overall experience to make you a better candidate. This helps to show that the score or grade wasn’t fully representative of your abilities.

Part 3: Close with confidence

Wrap up your answer with a confident statement of your readiness for residency. You can acknowledge that you were disappointed not to match previously, but you are now a more qualified candidate.

Sample Answers for Why Didn’t You Match?

Let’s go through this approach with some real-life examples.

Part 1: Explanation of why

Unfortunately, I didn’t match into residency last year, and I suspect it was due to my limited U.S. clinical experience at the time.

As I mentioned, I completed my medical training and two years as a family medicine doctor in India. My clinical skills are strong. However, since coming to the U.S., I have been focused on preparing for U.S. residency to continue my education and medical career.

I prepared for and passed my exams and had a great experience in my observership at Memorial General. However, I know that I did not have time to gain as much U.S. clinical experience as many other applicants.

Why we like it: This is a thoughtful and self-aware description. But it’s not defensive or self-deprecating.

Part 2: Improvements made

That’s why I immediately set about lining up my externship, which has been an amazing experience for me over the last 7 months and has helped me develop my clinical skills and understanding of the US healthcare environment.

Why we like it: She has been proactive about gaining more experience to prepare for U.S. residency. She takes initiative and is persistent.

Part 3: Closing

I have learned a lot over the last several months and feel confident I am ready for residency. This program, in particular, is a great fit for me due to my strong interest in community medicine…

Why we like it: She sounds confident and ready. She also takes the opportunity to reinforce her interest in this particular program.

This is just one example. You can use a similar approach for your answer.

What If They Don’t Ask?

If they don’t ask you this question outright, should you volunteer the information?

Sometimes, it can help you to bring up this awkward topic. If you feel it’s obvious that you are re-applying and you have made significant improvements in your application since last time, it can be helpful to draw their attention to your additional experience and dedication.

Some interviewers have a negative bias against those re-applying, even if unspoken. They may wonder if there’s something “wrong” with you — this is unfair given the competitiveness of the match, but it happens.

If you can explain well and speak eloquently about how you’ve become a stronger candidate, that can calm many unspoken concerns.

There are some other common residency interview questions that provide good openings to bring up how you’ve improved. Keep in mind you’ll need to be strategic about how you discuss the reasons why you didn’t match into residency in a previous season and ways you’ve become a stronger candidate.1. Weakness questions

Variations of questions asking about your weaknesses include:

  • “Tell me about a weakness.”
  • “What is your greatest weakness?”
  • “What is the weakest part of your application?”
  • “What could you improve in?”

See our blog post on discussing your weaknesses which talks about which weaknesses to bring up and how to talk about them.

2. Behavioral questions

There are a number of common behavioral questions that could be asked of you, including:

  • Tell me about a time when you failed.
  • Tell me about an obstacle you had to overcome
  • What was the most challenging part of medical school for you?
  • Tell me about a mistake and what you learned from it.

Behavioral questions are often the most challenging to answer. Practicing your interview skills and getting feedback on your habits is the best way to improve fast. Big Interview Medical has the perfect tools to help with that!

What if You Don’t Match?

Some interviewers like to ask about what you would do if you didn’t match into residency.This comes up for those going through the match for the first time — and even more frequently for those re-applying.

This question can throw you if you haven’t prepared for it. Nobody wants to think about not matching — especially if you’ve already been through this disappointing experience.

So why do they ask the question?

They’re probably interested in evaluating your confidence and dedication.

This is particularly true for those who have taken some time off after medical school before applying or re-applying for residency.

They want to understand how committed you are to a residency at this stage. Do you have the drive needed to succeed in your residency program?

Your answer should reflect confidence in your readiness and also clearly demonstrate your commitment.

So perhaps say something like:

“I would be very disappointed if I didn’t match because I am eager to begin residency and I am confident I am ready, after spending the last several months focusing on gaining more research experience to make me an even stronger candidate.

However, I would certainly not give up, as I am passionate about pursuing a career in neurology. I would analyze where I could improve and focus on making those improvements as well as gaining even more research and clinical experience to prepare me for residency.”

That sums up everything you need to know about discussing re-applying and failure to match in an interview.

It’s a sensitive topic and one that comes up fairly frequently. But if you’re prepared, you can address it with confidence and even use it to highlight your drive and commitment. We’re rooting for you!

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