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What happens when you do everything right…
But the system still says no?
In this episode of the IMG Roadmap Podcast, I sit down with Dr. Christian Matishak, a Canadian IMG who scored 250 on Step 1 and 265 on Step 2 — yet still struggled to match into residency.
His journey includes:
Applying to general surgery
Matching preliminary surgery
Going through the Match three times
Being told he could not reapply to surgery because of visa rules
Pivoting into anesthesiology
Finally matching and becoming an attending anesthesiologist
This conversation is honest, raw, and incredibly important for IMGs who believe test scores alone will carry their application.
Because the truth is:
The Match is more complicated than that.
What We Discuss
Why high USMLE scores still didn’t lead to a surgery match
What IMGs often misunderstand about residency competitiveness
The mistakes he believes hurt his application
Why personality and presence matter during rotations
The hidden visa rule that prevents prelim residents from re-entering the match in some cases
Why he ultimately pivoted to anesthesiology
What a “suicide match” means
Life now as an attending anesthesiologist on a J-1 waiver
Key Lessons for IMGs
1️⃣ Scores alone are not enough
Even a 250/265 score profile does not guarantee a match in competitive specialties.
2️⃣ Clinical performance matters
Quiet students who do not speak up in the OR may be overlooked.
Programs want to know:
“Do we want to work with this person for 4 years?”
3️⃣ Visa rules can change your options
Some visa restrictions prevent residents from re-entering the match for certain specialties once they’ve progressed in training.
4️⃣ Pivoting is not failure
Dr. Matishak pivoted from surgery to anesthesia and discovered a career he genuinely enjoys.
5️⃣ Positivity matters more than people think
After two unsuccessful matches, he made one mental shift:
“Things are going to work out.”
That mindset changed everything.
Where He Is Now?
Dr. Matishak is now an attending anesthesiologist in Little Rock, Arkansas, completing his J-1 waiver while building a career that once seemed impossible.
Connect With Dr. MatishakInstagram : @CMATISHAK
LinkedIn: Christian Matishak
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