Mentoring the Un-Matched: Clinical Externships Can Provide a Needed Boost

One of the most difficult experiences for a graduating medical student is going through the rigors of the complicated residency match process and finding out on match day that you have not matched. After all the preparations, expense, and hard work comes the disappointment and the likelihood that you will have to wait another year to repeat the whole process with no assurance that the outcome of next year’s match will be different.

This year, about 10,000 medical school graduates—including 2,200 U.S. medical graduates, 2,143 U.S. citizens who graduated from international medical schools, and 5,730 non-U.S. international medical school graduates failed to match. If they decide to apply again for next year, how can they improve their chances of matching into a residency program? What are the opportunities available to them to create an edge in their resumes?

I have been reflecting on my experience as an unofficial mentor to two residents who happen to be twins, Drs. Adrienne and Andrea Saldana. Both started their residency matching journey in 2017 and unfortunately did not match that year. They reached out to me to discuss what they could do to improve their chances of getting matched.

I recommended that they take on clinical observerships with psychiatrists whom I personally knew, practicing in various settings. They did this the next year, and the number of interviews they were offered increased; however, they still did not get matched.

It was then that I remembered sitting with a colleague in the APA Assembly who struck me as a good mentor and educator—Dr. Rahn Bailey. I knew he wrote books and journal articles and took a chance and asked him if he would take Adrienne and Andrea under his wings to mentor. Without hesitation, he agreed and offered to have them do an externship with him. Dr. Bailey also had other externs working with him who in turn welcomed Andrea and Adrienne into their community of externs.

Externship with Dr. Bailey was an enriching learning experience for Adrienne and Andrea. Through Dr. Bailey’s mentorship and guidance, they read a number of books, journals, and other official publications but their confidence really grew by learning how to write and edit a scientific paper. They were immersed in major issues in psychiatry and were learning about the social determinants of mental health. They were also able to network with other externs who shared resources with them. Perhaps most importantly, the externship program gave them hope.

Adrienne and Andrea are two of the most hard-working, motivated, and smart young doctors I have met, and their inability to match initially does not in any way reflect on their capabilities and skills. Adrienne has just completed her first year of residency at Brookdale Hospital Medical Center in Brooklyn, N.Y., and she was recently awarded the Most Outstanding Intern of the Year. Her sister, Andrea, is going to start her residency at Brookdale in June.

Dr. Bailey and I are proud to see them accepted into residency training, and we look forward to seeing them achieve greater heights. Their story is one of grit, determination, and motivation. It is our hope that more psychiatrists will be open to mentoring medical school graduates who did not match into a residency and provide them a bridge to their dreams. ■