Your DrSpouse is just about to finish up a very long, challenging residency. It meant 80+ hour work weeks, a tight budget, and little time for family.

As if that wasn’t torture enough, you guys just committed to additional training by doing a fellowship. This means going through the same thing for another 1-4 years.

So you apply to a bunch of programs and hope and pray that you match.

But instead of rejoicing when you open up the Match email, you feel the horror when it says:

“You did not match.”

Thoughts race:

What did you guys do wrong??

How could this have happened??

Were all those years of sacrifice not enough??

As you think of all the Plan Bs, the one you’re most scared of is the one where he “settles” and doesn’t enjoy his career for the rest of his life.

Here’s what you should do:

  • Don’t flip out ‼️
  • You didn’t get this far in life to hit a brick wall. It will require a ton of sacrifice but you can overcome this.

Let me share with you our personal story.

Our Story Of Failing To Match And Then Finally Matching Into Fellowship

Our personal story goes like this:

At the end of Internal Medicine Residency, my husband became interested in Gastroenterology.

Normally a person would know if he or she wants to do a fellowship pretty early.

Dedicing on one medical school or intern year? Reasonable. ✔️

Deciding the last year of residency? NOT reasonable. ❌

My husband was just a late committer…

I tried not to be upset with this. As his wife, I know him better than anyone else. And I KNOW that he takes TIME to make major decisions.

(It is the same man that was sure he wanted to marry me from Day #1 but took four years to ask me to be his wife!)

The problem with our situation was in order to sub specialize in GI, residents are required to publish strong GI-specific research. Well, by the time he applied to GI programs, his CV didn’t have that!

So we got the email that he didn’t match.

It was an incredibly hard time for us. We had many sleepless nights together strategizing our next move. As dawn came, we came up with several ideas and brought them to his Program Director and Mentors for him to consider.

It was ultimately up to my husband to determine what he wanted to do and how he was doing to do it. He had my support no matter where he would take us.

We eventually came up a battle motto for our family:


Thankfully, he did eventually match into GI so nobody had to die 😝

I’ll share everything we’ve discovered on this difficult time of our medical journey. I hope some of these gives you tips so if you are going through the same thing, you can also successfully match as we did.

3 Options To Take In Case Your Dr Spouse Does Not Match Into A Competitive Fellowship

1. Do A Sub-Fellowship

Doing a sub-fellowship is a great strategy. Examples of sub fellowships are Critical Care, Clinical Nutrition, and Hepatology.

These fellowships don’t have to be accredited.

Pros: If that institution has an in-house fellowship program, he would have a leg up as an internal candidate.

Drawback: Your DrSpouse’s salary will be similar to when he was a resident, which is about $55,000-60,000. It’s a big sacrifice to be making training salary when he COULD be making 4-10 times more than that as an attending.

2. Work As An Attending And Do Research

Working as an attending is another strategy. If your DrSpouse does this, he should choose an employer with the following criteria:

  • Has an in-house fellowship. (Internal candidates typically get preference over external ones.)
  • Is a program where he has a reasonable chance of matching.

(Tip: If your DrSpouse is IMG (international medical graduate), shoot for a program that has a record of alums of the fellowship program who were also IMGs.)

While an attending, he CANNOT coast. He must do research with a well-established attending. The more famous and well connected this attending is, the better.

Pros: The attending he does research for will see your DrSpouse’s performance and vouch for him with the PD through a letter of recommendation and phone calls.

Drawback: Most PDs like to ensure that candidates still have a training mindset. They want to avoid candidates who are used to being the end decision-maker and is harder to teach new tricks. This is likely one of the reasons why we see that the longer a person is out of training, the less likely he or she is to match.

3. Pursue Unique Opportunities Designed To Prepare For Fellowship

There are programs that are specifically designed for those who didn’t match and are preparing for fellowship.

They’re rare and hard to find, though.

One program I know of that combines hospitalist work with a mentor doing research is NYU’s Hospitalist Scholars Program. Another is the VA Quality Scholars Fellowship Program that also offers research.

So there’s two to check out 😀

Pros: These programs specifically makes sure you get research opportunities, especially if your DrSpouse is painfully shy and not the kind to seek these opportunities out.

Drawback: Not every PD is familiar with these unique programs. Having this type of experience might make your DrSpouse look super interesting, or he might be looked over because he looks very different from the rest.

Which One Of These Strategies Is Best?

Each specialty and program is different. I can’t give exact advice, only guidelines for each strategy.

My best advice is have your DrSpouse ask his PD for guidance for his situation.

What My Husband Chose

My husband chose the first option and did a sub-fellowship.

Instead of entering the workforce as a Hospitalist straight out of Internal Medicine Residency, he did a Clinical Nutrition Fellowship.

A ton of sacrifice were involved for our family:

  • It meant earning a training salary instead of the attending big bucks.
  • It required a whole new world of logistics as we moved to another city and sold our home.
  • It made family life harder. I gave birth to Baby #3 ten days after we moved and went back to work full-time six weeks after giving birth. We also raised 3 kids who were aged three and under (who are all very active) while away from family support.

But we believe by putting our family though all this, that’s how he was finally able to match into GI and reach his dreams 🎉

Let’s Review

  1. Do a sub-fellowship. (The one was what my husband did.)
  2. Work as an attending and do research.
  3. Pursue unique work opportunities designed to prepare for fellowship.

In Summary

If your DrSpouse doesn’t match the first time, it is not a dead-end!

The road will require a detour and there will be tons of sacrifices. But if you work hard together, you are sure to make it.

Then you can smile when that email finally says:

“Congratulations, you have matched.”

I am hugging and supporting you, friend ❤️

To strong medical families,


Your Turn

What helped your DrSpouse strengthen his CV for fellowship?