From Surgery to Anesthesiology: Dr. Christian Matishak’s Journey Through the Match (IMG Roadmap Series #129)

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Most IMGs believe one thing:

If you score high enough on the USMLE, everything else will fall into place.

But reality is more complicated.

Dr. Christian Matishak scored 250 on Step 1 and 265 on Step 2 — scores many applicants would dream of.

Yet he still didn’t match into general surgery.

Not once.

But twice.

The Caribbean Route

Originally from Vancouver, Canada, Dr. Matishak attended St. George’s University in Grenada, one of the top Caribbean medical schools with a strong track record of matching graduates into U.S. residency programs.

Like many Caribbean students, he knew one thing early:

USMLE scores would be critical.

So he focused intensely on preparation.

His strategy included:

Heavy use of UWorld
Dedicated study periods
Study partners for discussion
A personal USMLE tutor

The result?

A 250 on Step 1.

Then a 265 on Step 2.

On paper, he looked like a competitive surgical applicant.

The Shock of the Match

Despite those scores, he only received six interviews after applying to nearly 200 programs.

And he did not match.

The experience forced him to reflect on what programs were really looking for.

His conclusion?

Residency selection is not purely academic.

Programs are asking something else:

“Is this someone we want to work with for the next four years?”

The Prelim Surgery Route

After the first unsuccessful match, he secured a preliminary general surgery position at UT Southwestern, one of the most respected surgical training programs in the country.

He believed this would strengthen his application.

But the following year brought another surprise.

Despite strong letters and a prestigious training institution, he still did not match into categorical surgery.

The Visa Rule That Changed Everything

During his second year of preliminary surgery, he learned something many IMGs never hear about:

Because of J-1 visa rules, he could not re-enter the Match for a PGY-1 categorical surgery position.

Doing so would count as regressing in training, which violates visa progression requirements.

That meant his options were limited:

Find a surgery position outside the match
Or switch specialties

The Pivot to Anesthesiology

Fortunately, one anesthesiologist had planted an idea early during his ICU rotations.

“Have you ever thought about anesthesia?”

At the time, he brushed it off.

Later, that suggestion changed his career.

After speaking with mentors and connecting with the anesthesia department, he applied to anesthesiology.

But even then, nothing was guaranteed.

He ultimately ranked one program only — UT Southwestern.

A decision sometimes called a “suicide match.”

It Worked

He matched.

He completed his anesthesiology residency.

Today, he practices as an attending anesthesiologist, performing advanced cases including cardiac anesthesia while completing his J-1 waiver in Arkansas.

The Mindset That Carried Him Through

What changed between match attempts?

Not his test scores, but his mindset.

After years of frustration, he made one decision:

“Things are going to work out.”

That shift changed how he approached rotations, interviews, and opportunities.

And eventually, the right door opened.

The Real Lesson for IMGs

Residency is not a straight line.

Even high-performing applicants face setbacks.

But persistence, adaptability, and mindset can make the difference between quitting and succeeding.

Reach out to Dr. Christian on Instagram @CMATISHAK and LinkedIn at Christian Matishak.

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