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This was an email. I read your article on Physician’s Weekly about unmatched MDs. I am a bit down and looking for advice. I graduated from a Caribbean Med school. I have failed attempts and many gaps. Academically I dug myself into a deep dark hole, but my desire to practice medicine kept me going. I recently took Step 3 and just received my scored (failed by 2 points). I do not know anyone in medicine that can help me get a residency. I know I will be a great physician. I am just a horrible test taker. I didn't apply for the match since I was told that I needed to pass Step 3 to even try to match which would still be almost impossible even with a good score. I know many people who have not matched and have just given up on it. I have so much debt and no way of paying for it. What do you suggest I do? A friend thinks I should just take it again and apply, but I no longer have the funds especially since my chances are so low. I wish there was something more for me. Any words of advice would be really appreciated. And this was a comment on the Physician’s Weekly post mentioned above. There needs to be a job market for med students having passed boards but not matched. A PA can work after just 2 years with far less knowledge. I’m a Caribbean grad, unmatched, in debt, depressed, and unable to find work even when leaving MD off my resume. I was top of my class when I graduated but took my Step 1 twice. Now I’m banished to a cave even though I know I would’ve made one hell of a physician. :-( It’s the reality. Five years have passed and I’ve given up. My poor wife works, and I do odd jobs. How sad. I regret I have no useful advice for both of them and the many others who are in the same situation. Retaking Step 3 is probably futile. The writer didn't say when he graduated from medical school, but the further away you are from clinical medicine, the less likely you are to match in any specialty. Even if you finally did pass Step 3, you probably would not be able to find a position. What can they do with an MD degree and no postgraduate training? What kind of job can they get that would enable them to survive while paying off a tuition debt of six figures? How many med school grads are facing this dilemma? Google “nonclinical jobs,” and you will get 12.8 million hits. But how realistic are the options? Maybe someone should start an organization to help these people. Readers, do you have any ideas?