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This is one in a series of occasional updates on the lives of people featured by STAT during our first year.

They have MDs to their names, but they can’t treat patients. Now Dr. Heidi Schmidt — and others like her — are heading to nursing school to fulfill the dreams that were quashed when they failed to match with a residency program after medical school.

Schmidt, who’s 47, is one of thousands who have graduated from medical school yet failed to match with a residency, the post-graduate training doctors need in order to practice medicine in the United States. STAT wrote about her in March, when more than 29,000 applicants matched to a residency but 8,640 applicants failed to get an offer through the main matching process. This number includes hundreds of students in their final year at US medical schools, as well as foreign nationals and US citizens from international medical schools.


Many failed applicants reapply after spending a year doing research or a fifth year in medical school. Others join the “Dropout Club,” a group for doctors and scientists who leave their intended professions for alternate paths.

Though they have medical degrees, doctors who don’t do residencies can’t treat patients, or even work as nurses or medical assistants, without further training. Some in the medical profession say that’s a good thing, because there’s a reason — such as poor performance on board exams — that these new MDs didn’t make the cut. But others call it an outrage that doctors’ skills are going to waste amid a shortage of primary care physicians, just because there aren’t enough residency spots to go around.


Schmidt, who graduated from American University of the Caribbean School of Medicine in 2010, had been hoping to take advantage of a 2014 Missouri law that will allow unmatched medical school graduates to work with a collaborating physician in medically underserved areas. But implementation has dragged: The Missouri Board of Registration for the Healing Arts doesn’t anticipate accepting applications until early 2017, according to a spokesman.

Kansas and Arkansas have passed similar laws — over the objection of groups such as the Association of American Medical Colleges, which contends that it’s not safe to let doctors bypass the traditional residency, which lasts at least three years. Kansas, whose special permits are restricted to graduates of the University of Kansas School of Medicine, has not had any takers so far. Arkansas, which limits applicants to those with ties to the state, just issued its first two special permits in October.

Schmidt isn’t waiting around. She is back studying chemistry 101 and human anatomy, as she begins a three-year journey to become a nurse practitioner. She has been accepted into a bachelor’s of nursing program in Indianapolis, where she lives, and plans to use loans and scholarships to pay the approximately $140,000 in total costs.

Volunteering in a free medical clinic in Indianapolis has rekindled her passion to practice medicine, she said.

But Schmidt said she’s frustrated that there isn’t a faster — and less costly — track from an MD to a master’s in nursing.

“My schedule is insane,” she said. “I stay up half the night taking online classes.”

    • Just to put things in perspective people:

      Passing the usmle exams is getting above a 192 out of a total score of 300. Would you want someone as your doctor if they passed or would you want someone who scored really high. It is those that just barely pass that dont get residencies.

      Btw, the usmle tests medical knowledge.

  • I’m a near ten year Chlamydia patient, a “Reiter’s Disease” patient, and have been through like 30 PCP’s, 15+ Infectious Disease Specialists, Urologists, Dermatologists, Rheumatologists, Gastroenterologists, and at this point am still being denied proper treatment with the antibiotics because I’ve failed to produce a positive diagnostic sample, (regardless of the fact I’m thoroughly complicated, have a serious mistreatment history, and everything supports my original diagnosis of Chlamydia)…”

    • “Though they have medical degrees, doctors who don’t do residencies can’t treat patients, or even work as nurses”

      As a nurse practitioner with bedside experience, this is insulting. Physicians have little to no idea how nurses are trained or what nurses actually do on a day-to-day basis. They have no idea how to work as nurses. Stat should be ashamed of themselves for even printing this and conflating two very different professions.

    • That’s not a fair question, because it assumes that one who have had “proper training” don’t screw up despite the many lawsuits that are successfully filed against said “properly trained” MDs.

      This lady is well within her right to use her degree designation in in academia, research, and in literature; neither of which requires a residency.

  • If an MD graduate doesn’t match up to a residency, it’s the same as a pilot, who can’t get a flying assignment. It’s about capability, class rank, etc. To that end, notwithstanding the “MD” designation, one should not use it if not practicing in that capacity.

    • She earned that Degree. That’s a degree designation only. It can be used wherever on wishes as long as it’s not used in an instance where she is working in a another healthcare role…

      I still used it in general, but I don’t use to sign charts when I’m working as a CRNA, because that is illegal.

    • I’m interested in which path you took. I have wanted to be a crna. I’ve finished my medical degree but couldn’t get into residency. I would be grateful if you can guide me through this process

    • Albert, I also went through a similar ordeal, and I am currently enrolled in a BSN program following the exact path you did. Would you be willing to chat outside of this blog ? It would be nice to talk with someone who has been in the same boat.

  • Why can’t they open more residency spots rather then opening new medical schools, even if they open training programs for free( instead of payed residency programs)and do not pay the residents they will be happy to learn rather than getting waisted

    • To be brutally honest, this isn’t a problem of a disparity of residency positions. This woman went to a Carribean school. Those schools are notorious for high drop-out rates, and low residency matches. It’s not like the risks of an island school were unknown to her.

      I would be far more interested in factors that would lead to a graduate of a traditional, US based school to fail a residency match.

  • It’s so sad and tragedy for medical graduates that they not only can not get into the residency programs where they could get proper medical teaching from their mentors but they have to restart school from scratch if they want to work as a Physician assistant or Nurse Practitioners. All our knowledge goes to drain. Not passing the exam with first attempt could be due to some family issues or some people are not good exam takers but know their stuff lots better than good exam takers. It’s very unfair

    • Coffee Pot AUC, the school she went to is part of the acreditation system of US medical schools, 3 in the Carribean are LCME schools hence equal to US schools, Puerto Rico is too. She was given same US student loan money as everyone else and now cannot repay.

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