Voices of Unmatched Applicants in Otolaryngology

Introduction: The purpose of this study was to understand how unmatched applicants to Otolaryngology navigate career planning and coping strategies, which may guide models for mentorship and mental health support for future students.

Methods: This is a qualitative research study conducted via semi-structured Zoom interviews. Individuals were identified after the 2021 and 2022 National Residency Matching Program cycles. Eleven participants were consented to participate in a confidential interview with a trained individual outside the Department of Otolaryngology. They were asked to reflect on their applications, contingency plans, barriers, resources employed before and after the Match results, and future plans.

Results: Prominent themes identified included strength of relationships with mentors, relevant and timely feedback, contingency plans ahead of Match, connecting in the virtual era, and dissociating identity and self-worth from a particular field. Participants had frequently been told by mentors they had a strong likelihood of matching throughout the application process. Contingency plans were applicant-initiated, and those with a plan reported benefits to overall anxiety, ability to seek guidance, and targeted decision-making that aligned with long-term goals. All participants pursued plans to reapply into Otolaryngology. Participants identified relationships with patients and loved ones as most valued sources of fulfillment should they not ultimately match into Otolaryngology.

Conclusions: Given the difficulty in predicting individual outcomes of the Match in recent years, destigmatizing conversations regarding the possibility of going unmatched and generating contingency plan flowcharts with mentors are necessary to better position applicants to achieve their career goals and cope with the outcome. Improved integration of mental health counselors with the Match process is needed to maximize their ability to support medical students.