Next steps

The news is very belated but I SOAPed "successfully" a couple of weeks ago into a general surgery preliminary position. "Successfully" is an optimistic term because I can't bring myself to be too excited about a one-year position, and thus another year of uncertainty about my future. But I'm fortunate to have a job and to be moving forward with my life and career, so there's that.

I'm not even close to being over the fact that I didn't match ortho. Some days are better than others, but most days involve tears, and I'm not generally a crier. I'm also finding it hard to be optimistic about my future, at this point wondering if I can even manage to match general surgery next year and thus have any sort of career.

I've had a lot of lows in medical school and in life but I can safely say that this is the worst I've felt in a very long time. The little amount of confidence I had going into the match has completely evaporated and I've lost most of the hope I used to have in the medical establishment and more specifically, ortho program directors. I was told that crushing away rotations by busting my butt and being personable would help me secure a spot at a program, and I was too naive to believe that. In the end, I played the game wrong because no amount of hard work can overcome test scores from two years ago.*

I don't know what the future holds for me, and that's really unsettling. I vacillate between feelings of "I got this. I'm totally getting into ortho next year," to "Fuuuuuuuck. I don't think I even have a shot at general surgery." It doesn't help that the stats are not in my favor. The chairman at an ortho program I did an away at said I have a 3% chance of matching into ortho next year. That's very scary.

Everyone tells me I need a backup plan if I don't match again, with the most likely one being categorical general surgery. While there are parts of gen surg that I honestly do enjoy, I'm still repulsed at the thought of operating on bowels for 30+ years. I'm trying to keep an open mind because that seems like the most likely outcome and it's not a bad one. But I want ortho SO BADLY that not being able to do it is devastating.

I'm also somewhat regretting taking the prelim position. My Achilles heel was my Step 1 score and there's absolutely nothing I can change about that. I'm much better in person than on paper and in theory I'm really good at winning people over.** That's where the suggestion for the prelim position came into play. What I didn't think of was delaying graduation to do more away rotations and some research. It would've given me exposure to the program where I did research as well as my away programs. This way I'd have 4 chances to win people over instead of the single one I currently have.

I keep reminding myself that the prelim spot is the best path for me, but that doesn't say much considering it's the best option out of a bunch of really shitty options. On the plus side, with the prelim I have a whole year of the ortho department getting to know me instead of a month. I can prove without a doubt that I'd be an awesome resident (instead of a program having to extrapolate from my performance as a 4th year rotator). I can also slide into an ortho spot if any resident decides to quit. So there are positives...if it all works out. If I fail again, I'll always wonder, "What if?"

I wish I could end on a positive note but there's not much positivity in my life right now. My dean tried to cheer me up by saying I was ranked in the top 10 at my top program, but they just didn't go down that far this year. From talking to the PD, it sounds like they went to number 6 or 7 on their list (they take 5 residents) so I was 3-4 people away from matching. I know this information was meant to make me feel better, but it has the opposite effect. It hurts that much more knowing how close I was to being an orthopaedic surgeon and now I'm scrambling for any sort of career at all.

I know life isn't fair and in the end, I'll be alright. I'll have a good degree and I'll probably be able to get some sort of categorical residency position. But I (most likely) won't get to do what I set out for when I quit my previous career to go to medical school. It sucks that the dream I've had for 6+ years was crushed because of bad luck (and poor pre-clinical study skills).

---
* This came out whinier than anticipated. I take full responsibility for not matching. I knew what I needed to do to be competitive (crush Step 1) and I didn't deliver. But ever since that test, I've worked really hard to do everything right, crushing Step 2, honoring most of my rotations, and kicking butt on my aways. I also know people with my scores who got terrible feedback after their aways ("none of the residents want to work with you") but managed to match because their orthopaedic surgeon father made a phone call for them. Like I said, life isn't fair and I knew this was coming. It doesn't make the outcome any easier to stomach.

** So I was told. See previous paragraph about losing faith in people.