The 2019 main residency match was larger than any that preceded it, according to the National Resident Match Program (NRMP). 

The total record-high 38,376 applicants submitted program choices for 35,185 positions.

According to data on the 2019 Match compiled by the National Resident Matching Program (NRMP), 47% of seniors from U.S. allopathic medical schools got the top choice on their rank-order list—the lowest figure on record—while 72.5% wound up in their top three on Match Day.

The number of available first-year (PGY-1) positions rose to 32,194, an increase of 1,962 (6.5%) over the prior year. That increase in opportunity reflects the growth in the number of osteopathic programs joining the Main Residency Match as a result of the ongoing transition to a single accreditation system for graduate medical education (GME) programs.

The number of U.S. allopathic medical school seniors saw a modest rise of about 100 from the prior year. The 93.9% match rates for such applicants holds with recent trends. Because of the shift in GME, the number of U.S. osteopathic medical school students and graduates who submitted program choices also hit a record high of 6,001, an increase of about 1,400 over last year. Among that group, a record 84.6% matched to PGY-1 positions, up from 81.7% in 2018.

But even that high match rate in 2018 left 1,171 individuals seeking an alternate way to advance their careers. Now everyone is encouraged to use soap. However, some will need to use SOPE-The Supplemental Offer and Acceptance program, while others will pursue non-clinical career opportunities

Here is some advice on what to do if you do not match and are interested in reapplying next year.

The status of more than 4,200 foreign doctors who were chosen to do medical residencies in American teaching hospitals — hospitals that will desperately need their help to cope with Covid-19 — is in doubt because the State Department has temporarily stopped issuing the visas most of them would need to enter the country, according to a group that sponsors international medical graduates.

he status of more than 4,200 foreign doctors who were chosen to do medical residencies in American teaching hospitals — hospitals that will desperately need their help to cope with Covid-19 — is in doubt because the State Department has temporarily stopped issuing the visas most of them would need to enter the country, according to a group that sponsors international medical graduates.

Here is some advice to medical student entrepreneurs who don't match and are thinking of a non-clinical career opportunity:

1. Do an internship with a startup this summer after you graduate. Here are some examples from medical student entrepreneurs. Take advantage of technology, online job searching, interviewing and remote working in the Corona economy.

2. Network as much as you can and find a mentor. A good way to do this is to join The Society of Physician Entrepreneurs and attend virtual (and face to face when they resume) local chapter meetings, connect to other members and get involved with other organizations in your local biomedical and clinical clusters, like biopharma, medtech and digital health organizations and accelerators.

3. Be sure to use social media aggressively to find like minded students around the world and create a ready for prime time profile.

4. Take advantage of free MOOCs being offered in bio-entrepreneurship, medical innovation and digital health. Attain the entrepreneurial knowledge, skills, attitudes and competencies you will need to succeed.

5. Identify others in your class who are interested in biomedical and health innovation and entrepreneurship and start a special interest group or student club and invite members of your local cluster or ecosystem to speak at lunch and learn sessions.

6. Focus on getting education, access to resources, networks and mentors and experiential learning. Find out whether your school offers bio-entrepreneurship workshops, courses or degree programs and rethink getting an MBA. You should also look into iCorps training.

7. Take the requisite tests to get your medical license.

8. Just as there are some states where it is "better to be a doctor", there are locations that have stronger innovation ecosystems with more opportunities. The list will be different depending on whether you are interested in biopharma, medtech, digital health or care delivery innovation and entrepreneurship.

9. If possible, reapply to the match and complete a residency and several years of practice to understand the problems beguiling sick care and possible opportunities to fix them. It's called physician entrepreneur for reason.

10. At this stage of the game, stay fixed on being a problem seeker, not a problem solver. Start by developing your entrepreneurial mindset and practicing entrepreneurial habits. Here are 10 crucial steps to becoming a "pre-entrepreneur".

11. Start to learn about the business of medicine particularly innovation, marketing, the use of health information technologies and business models. There are big opportunities in health IT and data science so consider additional training that does not require enrolling in another expensive, lengthy degree program.

12. If you are not internally motivated to do this for some time, then quit now and save yourself a lot of heartburn.

13. Renegotiate your student loans and debt obligations.

14. Take care of yourself.

15. Out yourself and seek help.

16. Identify were you can add value as the pandemic changes opportunities, the economy and business models.

If you fail to match, it is not the end of the world. There are many non-clinical career opportunities where you can still help patients without spending your career seeing them face to face, or , these days, online. It's your choice whether to use soap, SOAP, SOPE or SOPE. Just because you didn't match, it does not mean you have to wash your hands of medicine. Good luck in the match.

Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs on Twitter@SoPEOfficial and Facebook.