Nine Times Unmatched: What I Learned on the Road to Residency
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By Caleb C. Atkins, MD
When I graduated from St. George’s University School of Medicine in 2013, I expected to begin residency and continue along the traditional path toward becoming a practicing physician. Instead, I went unmatched. Then I went unmatched again.
Over nine Match cycles, I learned lessons I wish someone had shared with me at the beginning.
Like many applicants, I was advised to “cast a wide net.” At first, that seemed logical. But applying broadly is expensive. I personally know applicants who have spent approximately $10,000 pursuing residency in a single year, with no refund if they do not match and the same expenses waiting the following year.
It also makes it difficult to approach applications thoughtfully. I eventually became more strategic, focusing geographically and on programs where I had connections or a genuine reason for wanting to train. This allowed me to better research programs, personalize my application, and demonstrate genuine interest.
The most important piece of advice I can give is to stay involved in patient care. During my years outside residency, I worked in clinical research, taught anatomy and physiology, volunteered at a free clinic, worked through Missouri’s Assistant Physician pathway, and completed additional postgraduate clinical training in Puerto Rico. Of everything I did, returning to direct patient care mattered most.
I will always remember my first day at the Mary Rose Free Clinic in Oneida, New York. After being away from clinical practice for so long, I questioned how much I had lost. Caring for patients again felt like a 10,000-pound weight had been lifted from my shoulders. I remember thinking, “I still have it. I can do this.” That experience restored confidence I had gradually lost during years of going unmatched.
Clinical experience also builds relationships. Physicians you work alongside can provide meaningful letters of recommendation, help evaluate your application, brainstorm opportunities, and use their connections to help open doors. For graduates seeking clinical opportunities, the National Association of Free & Charitable Clinics maintains a searchable directory at https://nafcclinics.org/find-clinic/.
In 2020, I founded the Alliance of Medical Graduates (AMG), a nonprofit created to advocate for residency expansion and support unmatched medical graduates. The physicians I met through AMG reminded me of my worth when the Match process made it easy to question it. Their encouragement was pivotal in pushing me outside my comfort zone, helping me see new possibilities, and giving me the motivation to keep trying.
In 2022, nine years after medical school, I matched into Family Medicine at Samaritan Medical Center and completed residency in 2025. Today, I practice at Samaritan as a family medicine physician and part-time hospitalist, precept residents, serve as one of the Medical Directors for the Watertown City School District, and serve as President of the Jefferson County Medical Society. I am also working with my hospital to become a collaborating physician so qualified medical graduates can work in collaboration with me to care for patients, gain meaningful clinical experience, build professional relationships, and strengthen their applications while continuing to pursue residency.
I now try to pay forward the support I received by mentoring other graduates through AMG and continuing advocacy with colleagues through AMG, NYSAFP, AAFP, MSSNY, and the AMA. AMG welcomes medical graduates seeking support and physicians interested in helping: https://allianceofmg.wordpress.com/join-us/.
I am grateful to MSSNY for the opportunity to share my experience, for providing an outlet for advocacy, and for its meaningful work on behalf of physicians and patients across New York. There are talented medical graduates still waiting for an opportunity. Each of us can make a difference through mentorship, clinical opportunities, connections, and advocacy, but by working together, our impact can be exponential.
