Unmatched US MD Seeking Opportunities

[u/theraygerfromthedark]

Hello r/neurology members, I am a recent US MD Graduate who failed to MATCH into Neurology as well as unable to acquire a PGY-1 preliminary year position during SOAP. (Edit: I did not fail any STEP exams, medical school pre-clinical courses, or any clerkships, and had 6 interviews).

I am reaching out to this subreddit at this time, to see if there are any paid or unpaid opportunities in neurology (which has so many) that anyone may have come across or know personally. I am located in California but willing to relocate for an ideal opportunity that will help provide me with additional relevant experience whether it be clinical or research. I have always had a passion for neurology so like any unmatched applicant I am quite disappointed but more so due to the fact I do not have a preliminary year position to continue moving forward.

I would tremendously appreciate any concrete opportunities directly involved in neurology, as I have done significant amount of job searching in "medical consulting" "pharma" "medical writing" and simply put I am not qualified for any of these jobs despite many people in medicine always recommending this route. They do not want to hire someone who has no experience doing what they are interested in just because you are MD/DO.

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[u/PadfootMD]

There was something glaringly wrong with your application (ie likely letters) if you are USMD, no failures) that applied to every program and only got 6 interviews. 

You must have the biggest inflection on what you can do in the next year. Strongly recommend talking with your Med school on how they’ve helped former students in the past - whether that means delaying graduation for a research year to recoup and reassess (likely meaning applying for fields like FM who has countless openings).

You could likely find a program (not in neurology tho) that has open spots they can still fill out of the match/SOAP process but they are likely still Single and ready to mingle for a reason (same as yourself - beggars can’t be choosers)

I say none of this to disparage you, but for your own sake for your progression in medicine 

[u/theraygerfromthedark → u/PadfootMD]

I appreciate the feedback and in no way took it disparagingly as this post is intended for thoughts and interpretations....interestingly enough that you used the word glaringly wrong because last Friday my Dean and PD met and agreed there were no glaring red flags which I actually was scared he was going to say there was (makes it more confusing)

I don't know where you are in your career but unfortunately SOAP and post-SOAP there are virtuall NO spots for TY , IM, and some FM. IT is getting crazier and crazier every year and that'smy biggest program/

I don't know how to find a position or opportunity in the interim

[u/Futurebraindr → u/theraygerfromthedark]

No prelim IM spots? Also were your deans able to read your letters and confirm they weren’t the cause?

FYI I also applied this cycle from a T20 MD school and fell to #13/15 out of mostly mid to lower tier programs.

[u/theraygerfromthedark → u/Futurebraindr]

Could you elaborate on what you meant by that the Dean reading letters of rec? I could ask the PD but my Dean said you wouldn’t have gotten 6 without good letters which I don’t really believe…in your opinion or experience what would a bad letter be ? Just weak or generic?

[u/unsureofwhattodo1233 → u/theraygerfromthedark]

Surprisingly enough. Back in the day when I was in match….. we had 2 people in our class who were applying NSG who the PD went out of their way to tell those students he would write a letter for them (and proceeded to shit on them in those letters… dude was a gigantic asshole as you can imagine). Obviously neither matched. The first found out during an interview, where another PD violated rules by telling 1 guy exactly what was written verbatim. LOL

People are cunts. To be honest, I knew the students and they were sort of assholey. Then again what NSG isn’t ?

[u/Futurebraindr → u/theraygerfromthedark]

Like is the dean assuming the letters were ok? Or is there some way for you to get feedback from someone who has actually laid eyes on them? I never understood how people that claim their letters sunk their app were able to find out for sure what was written in them

Idk I’ve only just applied once! But I would think bad letter<<<generic<good. Also relative to other strengths in your app.

And to clarify, you applied to EVERY neuro program in the country? Or just in the area? If so, how many?

[u/PadfootMD → u/theraygerfromthedark]

Then it’s something you might be able to work on - the next most likely option is you came off poorly during interviews

[u/theraygerfromthedark → u/PadfootMD]

Yes two people said that’s the last thing to point towards which I am not defensive of, just surprised because I always thought the on paper stuff was the issue and that I’ve always been a personable person and easy to talk to but yeah

[u/HealthyFitMD → u/theraygerfromthedark]

i am sorry to hear this op. could it have anything to do with your letters of rec? you sound like a great candidate

[u/theraygerfromthedark → u/HealthyFitMD]

I don’t think so I would think interviewing over letters of rec. but what IS considered letters being an issue. This didn’t get brought up much until this post I feel like the people who wrote them weren’t random people and I chose wisely

[u/HealthyFitMD → u/theraygerfromthedark]

i don’t know because i am not there yet but from reddit posts and speaking to one doc, it sounds like the letters have to really point out how you stand out but not in a generic way that sounds like every other letter.

[u/theraygerfromthedark → u/HealthyFitMD]

Thank you

[u/HealthyFitMD → u/theraygerfromthedark]

i hope you find a great opportunity op

[u/peanutneedsexercise → u/theraygerfromthedark]

There was a lot of FM spots open in soap. The FM program at my place had 3 open spots. My friends IM program in Mississippi was unable to get 3 ppl to fill their open spots so now their class has to start with 3 less ppl…she was saying their class is gonna get screwed by coverage and call.

[u/I__run__on__diesel → u/theraygerfromthedark]

Tl; dr -- Perhaps it would help to spend some time revising your essays?

This person is trying to help you, and so am I. Let's look at the grammar and sentence construction here.

I appreciate the feedback and in no way took it disparagingly as this post...

I appreciate the feedback ^{comma or em dash here OR rewrite the rest of the sentence to accommodate a semicolon} and in no way took it disparagingly ^{comma or em dash here to match the one earlier in the sentence. If em dash, delete the "as"} as this post...

...interestingly enough that you used

... ^{ellipsis not appropriate. Start a new sentence} interestingly ^{commonly misused adverb; "interesting," would be technically correct, but is kind of clunky, so would change to something like "what interests me".} enough ^{enough for what?} that you used ^{replace with comma; there is some debate over whether the word "that" as used here is grammatical or stylistically ideal.}

I want to sink my teeth into the arbitrary use of "glaringly" and why "wrong" is incorrect here ^{sorry, couldn't resist}; however, editing is my job, and this is the extent of the free work I can offer you.

[u/theraygerfromthedark → u/I__run__on__diesel]

My friend this is Reddit, of all the feedback I received this is a poor example of n=1

I typed the response on my phone without editing it in a rush, my personal statement was fine tuned. I use commas and semi colons very well and am big on grammar as well. Thank you though

[u/doc_aardvark]

keep your chin up, i didnt match my first cycle. soapd but finally matched second time around. you ll get there

[u/theraygerfromthedark → u/doc_aardvark]

I appreciate it, I have hope, it’s really the immediate / now part of having something to show for — really difficult to find unpaid / paid research nowadays and it feels like anything clinical related I’m not appropriate for in someway

[u/memepajamas]

I’m hearing more of USMD/DO not matching neurology recently. I’m wondering what’s going on….neuro is historically not competitive

[u/Meerooo → u/memepajamas]

In general, neurology is becoming more competitive as there was a sizable increase in applications this year. The top programs are pretty competitive which is where most USMDs apply and want to match to.

[u/theraygerfromthedark → u/Meerooo]

^Was going to say this. But I applied to every program and got zero bites for interviews in Midwest (despite medical school being in Illinois) or east coast or south

[u/Meerooo → u/theraygerfromthedark]

I'm not going to lie, that's VERY surprising. There are plenty of programs in the Midwest with a good portion of FMGs/USIMGs that would not have hesitated to send you an interview, even if you had red flags.

I'm sorry to hear that things didn't work out but don't let it define your path. So many talented folks go unmatched every year for reasons that aren't always clear. I'm confident you WILL match in to a program where you belong. You 100% got what it takes so don't lose sight of it.

[u/theraygerfromthedark → u/Meerooo]

Thank you I appreciate it I'vealways remained resilient its more so not having that prelim year to show for , being from SoCal makes it difficult to get any interviews ( i did not receive even 1 from my hometown LA -- not shocking though) however was surprised even with tagging Midwest as a geographic area it made no difference

[u/tobrittany → u/theraygerfromthedark]

Why did you apply to EVERY program? You must have been aware of something concerning on your app to apply to that many programs? Feels like you’re leaving something out here. Usually qualified candidates apply to like 25-50 programs, not >100

[u/theraygerfromthedark → u/tobrittany]

Because everyone says to apply broadly. And on top of that being from CA with all those competitive programs won’t provide favoritism, I applied to 75 programs as i want to make the most of first time applying. even if I was a top candidate I see no reason to not apply to as many as possible. That if anything seems arrogant / cocky if I did that.

[u/My_Stethi]

Maybe signup here just in case. It’s free.

[u/theraygerfromthedark → u/My_Stethi]

Thank you I just did!

[u/DiscussionCommon6833]

how was your step 2 score OP? i fell to the bottom of my rank list despite getting glowing evals from multiple aways as a DO; i had no fails but only a 220s step 2. it's rough when more people are applying.

[u/MehFooL]

I'm a USIMG from Fremont that went unmatched last year in Neuro/Psych due to late Step2 failure. My local hospital opened a sleep center and I looked for jobs at it. I eventually ended up in a 2-week $3000 A-STEP program and then ended up climbing the tiers of Sleep Technologist towards a RPSGT position. The job was chill, working 12-hr shifts 3x/wk that mostly consisted of watching patients sleep. Because of this experience, lots of program directors commented how I really stood out from other applicants. Sleep Medicine fellowships exist for Neuro/Psych/FM/IM and it's called a "one month program that lasts an entire year" and literally no sleep is taught in MD curriculum. I got several extremely prestigious interviews in Neuro/Psych and matched at my #1 psych program.

DM if you're interested in this job because I made a large network of connections that would employ unmatched MDs, but before anything else, make STEP3 your number one priority. Also, use a tutoring service like AceMedBoards to help you apply for next cycle. my old PS were so shit in comparison to the ones their tutors helped me draft.

[u/theraygerfromthedark → u/MehFooL]

Thank you DM’d

[u/Southern_Drink8602]

Apply to neurology pre-residency spot there is spot @ university of New Mexico , st.Louis university and BMC

[u/theraygerfromthedark → u/Southern_Drink8602]

I interviewed at UNM I will follow up thank you. I thought those are only for IMG

[u/SurfingTheCalamity]

As a first year DO student that wants to do neurology… I’m scared. 😭

[u/theraygerfromthedark → u/SurfingTheCalamity]

Geography matters so much. California does not favor home town people much

[u/peanutneedsexercise → u/theraygerfromthedark]

I don’t think it doesn’t favor hometown people as much as there’s just SO MANY California applicants trying to come back to their home.

There’s also a bunch of Cali ppl who are California or bust and ONLY apply California. I mean, even in med school California residents were the second highest population compared to instate ppl. There’s just a lot of people from California and they all wanna go home.

[u/SurfingTheCalamity → u/theraygerfromthedark]

I did hear that, which makes sense, but anywhere? I would’ve thought you’d be competitive at least somewhere. I’m so sorry you’re going through this by the way, I can’t imagine. Best of luck to you and I hope someone here has good advice!

[u/DiscussionCommon6833 → u/SurfingTheCalamity]

don't bomb step 2. i had double digit interviews this cycle yet fell to my bottom rank. i had a step 2 in the 220s. get 240+ and you should be more than good to go

[u/giovanotto0]

Op this is all very confusing to hear. As a DO we had to play the vsas and away game very heavily and I spent the end of my third year and 3/4 of my 4th year doing aways in my home state (CA). Did you do any aways?

Fwiw I matched in state to my 1/16 program. I had a clear goal of where I wanted to end up and beelined to that program.

[u/Own-Account3098]

What were your Step 2 score and clinical clerkship grades?

[u/tejiteji]

Apply peds then do child neuro

[u/theraygerfromthedark → u/tejiteji]

I applied to the available ones!

[u/tobrittany]

How many years post graduation are you? Why didn’t you apply in the traditional timeline?

[u/theraygerfromthedark → u/tobrittany]

I did apply in traditional timeline. I was a January 2025 graduate with a medical LOA

[u/Own-Account3098 → u/theraygerfromthedark]

Was the medical LOA considered a red flag by the deans? If the rest of your application had not red flags, assuming step 2 within national range and no failed clerkships, you should have matched somewhere.