I actually worked a fair bit during the first 2 years of medical school. I kept some contacts from my former employers a did a few sub-contracting gigs that I was able to work on remotely. I probably averaged ~10 hours a week or so. I 've kept some sort of side gig running during med school and residency from engineering work to tutoring to driving for Uber. So, it’s definitely possible to bring in some sort of income during the process.
The first 2 years of med school do throw a lot of information at you, and the biggest challenge is to figure out how to study effectively. It took me about a semester to get a good system down. I tried my best to do school from about 8a-5p on weekdays and to limit studying outside of that timeframe and I was able to more or less stick to that unless I had exams the next week or something. But if you stay on top of your studying and are efficient with your time, then you’ll be able to find time for other endeavors.
Not matching was exceedingly difficult. I was interested in going into Emergency Medicine. I did not match through the traditional process. That was pretty heartbreaking, because I had come into medical school with the idea of doing EM. In 3rd and 4th year of medical school I liked most everything. There were aspects of IM I didn’t care for, but I liked the hospital work. When I didn’t match, I knew I had to find some kind of job for the next year, so I went through the scramble/SOAP process to secure a position.
For those that don’t match, there is the SOAP process where unfilled spots in the regular match are open. The SOAP is a very stressful process as it all happens over the course of about 3 days where you find out you don’t match on Monday morning, have applications submitted to open positions by later that afternoon, then have a series of phone interviews over the next few days before they allocate SOAP positions. I applied to open Emergency Medicine, Internal Medicine (categorical and preliminary) and Family Medicine positions. My thought with selecting those specialties were that if I came out of it still interested in doing Emergency Medicine that I could pivot to EM through those routes (there are some informal IM->EM fellowships and the like, for example).
As to why I didn’t match, I never got a great answer. My grades and board scores were good. I got good clinical evaluations as far as I knew. I think being a little older, and some aspects of my personality (I’m fairly introverted by nature) caused me to not mesh as well with the EM residents. EM is tough as a medical student as the faculty and residents change everyday when you’re on a rotation, so you don’t get as much opportunity to build more longitudinal relationships that you would versus say being on an internal medicine wards team where you’re working with the same residents and attending for 2 weeks in a row.
I got into a preliminary internal medicine (intern year) position through the SOAP and came into it with the initial intention of applying through the Match again for EM. I came into my intern year and really threw myself into the work and apparently impressed the right people. As it came time for me to apply for the match again, I went to talk to my IM program director and he asked me if I would consider completing residency with them. They also told me that I could probably get into their combined IM/EM program as well. It was a really tough decision, but the possibility of going through the process and not matching again was still out there and not matching twice in a row would have likely made working as a doctor very difficult. Plus, what I was being offered would cut a year off my training as they were going to credit my preliminary year. So, I was looking at 3 options: 1) completing an additional 2 years in IM; 2) completing an additional 4-4.5 years in EM/IM; or 3) applying through the match again for another 3-4 years of EM (or some other) residency with the possibility of not matching again.
I ended up taking the IM option and am glad that I did. I like my program and my colleagues, I enjoy hospital medicine work and am looking forward to making a career of that. I’m completing residency earlier than the other options that I had (which means I start making real money sooner). Plus, while I liked EM as a med student, I wasn’t crazy about the month I spent in the ED as an intern (ED is part of our required IM rotations), and the job market for EM is pretty terrible right now. So, I think it’s all working out in the end.