On February 23rd everyone across the world that is seeking a medical residency in the US had to certify their ranking list in the order of where they would like to to train for residency. It marks the end of a long residency application process, but now everyone is waiting in suspense for that mythical, March 17th ‘match day’, including me.
It began on September 1st when applicants sent out their ‘e-apps’ to all of the programs they were interested in. These things house at least 5 years of test scores, grades, people’s opinions of you, accomplishments, essays, and anything else you could think of. Applicants then sit around and wait for interview offers to come in. I have to say interviews that were granted to me appeared to follow absolutely no rhyme or reason. I realized trying to understand their offers/rejections was like trying to find the end of a black hole and I just took what they gave me.
Interviews occurred from Nov-Jan and were actually really fun. I flew all over the country, including trips to Seattle, Hawaii, Dallas, Boston, North Carolina, and Madison getting to see cool cities and meeting really awesome people on interviews. It was odd because I met great applicants and they were simultaneously my competition and my possible coworker since you don’t know how the match will shake out.
After my last interview on Feb. 7th, I started putting together a list of my favorite radiology programs (years 2-6) and favorite internships (year1). There was a lot of second guessing and alteration right up until the deadline for certifying my list this past Wednesday. I’m know proud to say I’m contractually obligated to go where I match.
The National Residency Matching Program (NRMP) began in 1952 as a way to fairly distribute labor (residents) to needy programs (residencies). The algorithm is favored towards applicants so if I rank a place #1 and I’m on their list I’m ‘tentatively’ matched there until/if a person with a higher spot on their list bumps me out. A detailed explanation can be found here. I found it interesting that the algorithm was developed by game theory economists who were struggling with a classic problem, getting a group of people to pair off in stable marriages! Here. Hall’s marriage theorem helps a group marry into the best possible combinations so that the most people will be happy. Why not leverage that, b-school (hugluk) style, to the residency match.
Anyway, the computer holds that information for three sweet weeks until the great unveiling on Match Day. Well technically, the big computer tells applicants who go unmatched the ‘good news’ 3 days early to try to allow them to fill open spots in the “scramble.” The “scramble” is handled more like a traditional job search, except it happens over the course of a week.
The NRMP holds a national ‘match’ for all of the available residency spots in the US where everyone in the world participating in the match finds out where they are going to be for residency at the same time. Individual ceremonies are put on at the different medical schools and can get really crazy given their set up. For example, at our medical school, all the people participating are gathered in a room at 10 am and told to try and socialize. You can imagine 220 type A people, on a 21 day ‘lack of control’ diet, trying to chit chat and hold liquor at the same time. Some do better than others. The pressure gets turned up when the ‘envelopes’ are passed out at 11 am. There will be shrieks of joy, blood curling screams, moans mixed with tears, just moans, or, hopefully, pure happiness that doesn’t embarrass you or your neighbor. I would say that at a US medical school its about a 70% solid happiness, 20% happy shrieks, 10% moan/cry/scream mix. Varies year to year and with the number of people forwarned that they’ve gone unmatched, relegated to scramble. Match day will be on Thursday, March 17th and I’ll be streaming it live from this blog site through a hidden webcam in my ‘kiss me I’m Irish’ button…….kidding.
And so I wait, stuck in varying levels of the unique residency purgatory. I am matching in radiology which offers another unique twist, the preliminary year. I not only ranked 20 radiology programs but also ranked 10 clinical internships in different places around the country. I could end up on Oahu for the first year and in Boston for the next 5 for my residency. On the other hand, I could be in Roanoke, Virginia for my first year and Los Angeles the next five for radiology. The amount of possible variability only adds to the waiting…
It’s all to be able to be elbow’s deep in that ‘sweet earthly paradise’ of 45k/year as an intern…
Check out the stats about successful matching below, from Wikipedia and from 2007. 30% of US MD applicants and 94% of DO applicants don’t match…It has only gotten more competitive as more and more people try to practice in the US. It can get stressful!
