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On Monday, Kaitlyn Thomas, a 25-year-old fourth-year student at Lake Erie College of Osteopathic Medicine in Pennsylvania, was devastated after learning she hadn't matched to a residency training program.

She immediately turned her attention to the Supplemental Offer and Acceptance Program (SOAP), desperately hoping to secure an unfilled position. While spending as many as 12 hours a day on the phone being interviewed by prospective programs, and drinking protein shakes instead of eating actual meals, she made time to log on to social media.

Thomas is one of a growing number of applicants taking to social media to help normalize not matching.

"I think really it can happen to anyone," she said. "I don't have a red flag on my application."

The idea that she wouldn't be able to do the thing she has spent her whole life trying to do was "devastating," Thomas added. But during an interview with 麻豆传媒 on Wednesday, she remained hopeful that a SOAP offer would come through.

She credited the support and positive words she had been receiving on social media, including Twitter, for helping her through a difficult time. And she felt compelled to do the same for others in sharing her own experience with a situation that can take an incredible toll on mental health among those who went unmatched in recent years.

"We have to worry about whether people are going to hurt themselves because they didn't get a residency training position," Thomas noted. Overall, she worries the process of matching has become a broken system.

Normalizing the Process

Mahad Minhas, MD, who now works in the radiology department at the University of Texas at San Antonio, knows all too well what a difficult process not matching can be.

After not matching in 2020, Minhas accepted an offer for a general surgery preliminary year at the University of Michigan. After he didn't match in the 2021 cycle either, he was able to secure a residency spot after shifting his specialty to radiology through SOAP.

Speaking with 麻豆传媒 about the support people are showing others online during the 2022 cycle, Minhas noted that the thousands of applicants who go unmatched every year is a growing problem.

He too has been offering guidance and support on social media to those who didn't match, including retweeting what many of the #unmatched have publicly shared.

"I did not match in ENT, for the 2nd year in a row. Did everything by the book and 'exceeded all expectations' but still ended up without a match. I'm devastated but appreciate any and all advice," Duaa Kuziez, who graduated from the Saint Louis University School of Medicine in 2021.

Another applicant, Margaret Elizabeth, , "So happy to see all the positive news on my news feed. Unfortunately I did not match, but this is not the end for me. I will become an orthopedic surgeon, just gotta take a different path than I planned."

There has definitely been more support via #MedTwitter, Minhas said. "I think it's because it's just becoming more normalized to ask for help."

It can be "so embarrassing" and "so shameful," he added, when "after all your hard work, you get nothing. It takes a significant toll to go through this, and it's so costly too."

Not Enough Spots?

"I think overall in the match, there are not enough spots for the number of medical students there are," Thomas noted, adding that student loans are looming.

"I think it's really essential that, if we keep increasing the number of medical students ... we have to increase the training spots that we have," she argued. "Otherwise, this is going to keep happening."

It's important to highlight the problem against the backdrop of the COVID-19 pandemic, said Minhas. "We're obviously short on doctors. And despite being short, why are all these doctors going unmatched?"

It's "perplexing" to see applicants with "amazing CVs" get nothing, he added, pointing out that some applicants who could help address the need for more physicians end up turning to other work outside the field of medicine.

More Resources

In the meantime, Thomas said that she has taken the words of support she's received via social media to heart, noting that she believes more mental health resources and counseling on navigating the process would be helpful to applicants.

She described the SOAP process, which starts right after many applicants find out they didn't match, as incredibly overwhelming. It's difficult to "know if you have to make a decision tomorrow, what it is going to be," she said.

Thomas has pushed through the process in the hopes of receiving an offer, even switching her specialty from general surgery to emergency medicine, which had a relatively high number of unfilled positions. Though some applicants aren't comfortable making that change, she said she felt it was the right move for her.

After reflecting on the original application process, Thomas said she wasn't sure some of the programs were really hearing her when she expressed a strong interest in health policy and advocacy. Thankfully, with her SOAP interviews, the response has been different, she added.

On Thursday, Thomas tweeted, "" She told 麻豆传媒 that she accepted a SOAP offer for an emergency medicine position in Pennsylvania, in a hospital where she had completed the majority of her clinical rotations over the last 2 years.

Amanda D'Ambrosio contributed reporting to this story.

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