Monday, March 8, 2010

The Final Countdown / Mysteries of the Match Revealed

In a shade over 169 hours I will be frantically logging on to a website to find out if I "Matched"*

It feels surreal that all of the work and sacrifice leads to this one moment next week that will determine the rest of my career. But, I suppose that life is just a series of these moments. I am strangely calm at the moment but my serenity is occasionally punctuated by brief moments of sheer terror. Stiff upper lip and all that..

* I have received a bunch of questions about the whole match process so I have decided to include a overview on how this whole thing works. I hope this helps.

Every year medical students graduate from medical school and subsequently begin their Residency training. 

Residency is where physicians complete several years of training in their chosen specialty. This training, is for instance, where family doctors become family doctors, surgeons become surgeons, and psychiatrists become weird. (I kid because I love!) Prior to residency, we are all pretty much the quintessential lump of clay which requires a great deal of molding (preferably by a scantily clad Demi Moore while Unchained Melody plays in the background...but I digress...)....where was I ?  Oh, yes- molding- right. In order to become anything resembling useful physicians we need residency training.

So how is it decided who will become surgeons and who will become OB/Gyn etc. ? (fighting the urge to do a 'head-injury' joke here) Well, we get to choose. 
Sort. Of. 
After doing some soul-searching (no offense meant, surgeons) each one of us decides which area of medicine we would like to pursue and then we apply to residency programs in said specialty. For some, deciding on a specialty is one of the hardest steps in this whole process-  lifestyle, salary, work environment, patient population, competitiveness of the applicant, and about a million other factors must be carefully weighed so each student can figure out which specialty suits their preferences best.

The Process
Step 1 : Drowning in a sea of paperwork (July-Sept)
The July of medical student's 3rd year they begin working on their applications to residency programs. Transcripts, Letters of Recommendation, personal statements etc. are all gathered and submitted to ERAS  a central web-based application service. Beginning in September, applicants choose which programs to submit their applications to. This is a fairly simple matter of selecting programs from a list within your specialty and clicking on a box. ERAS takes care of the rest (transmitting all of your application info to each program). 

Step 2: Waiting is the hardest part
After an applicant's applications are sent out, begins the waiting phase. Each program has its own unique timetable to do things so this is an anxious period. Programs review applications and based on what they are looking for choose which applicants to invite for interviews. 

Much angst surrounds exactly how programs choose which applicants to interview. Is it test scores- is there a cut-off number? What about personal statements? What about my letter of recommendation from my High school guidance counselor/ Psychic/ Oral Hygienist? If you are looking for a great source of entertainment hang out in the cafeteria in September and sit at a table full of Medical students. You will learn that, "according to my friend's girlfriend's roommate's uncle- who is the program director's gardener...." that the actual process used by programs to select applicants to interview is a proprietary blend of alchemy, remote viewing, dark magic and the use of a random number generator. Good Luck!

Step 3: 12 cities in 9 days? Sure I can do that! (Sept-Jan Interview Season)
Once applications are submitted, slowly but surely (hopefully) invitations for interviews will start rolling in. This is an exciting time- you have at least  "made the cut" and the program has an actual interest in meeting with you. Applicants will begin traversing the country in a whirlwind manner and doing their best to make great impressions with each of the programs they interview at. This is the opportunity for each applicant to see the program up close and personal, kick the tires, talk to the current residents, and see if they would like to spend the next several years there. The flip side of this, of course, is that from the program's point of view it is a chance to discover the hidden sociopathic pathology that your personal statement glossed over. I was actually told on an interview, "We just want to make sure you're not a douche."

Step 4: I like a friend
After all of the interviews, each applicant has an idea of which of the programs they liked the best and begins to formulate a list of their top choice, second choice etc etc. Using another web based computer system, the National Resident Matching Program, NRMP, each applicant actually submits their Rank Order List, ROL. In turn, each program will similarly rank each of the applicants it has interviewed. Yes, they actually rank in order the applicants they have interviews in order of preference. This year's deadline for submitting your ROL was February 24th. 

Step 5: THE MATCH.....The answer is: ...... 42
The last step is the most exciting. Armed with each applicant's ROL, and each program's ROL the NRMP computers follow an algorithm  to "match-up" applicants with programs, hence the name. For those who will be applying next year, do yourself a favor and check out the link explaining how the algorithm works- this is another one of those pet topics that medical students seem to have nothing but  misconceptions about. (For the last time, spelling out obscene words using the fist letter of each program on your ROL will NOT GUARANTEE YOU A SPOT at John Hopkins Dermatology!)
This year on March 15th at 12:00 noon EST the results of this Matching algorithm will be made known!
Sort. Of.
March 15th each applicant will find out IF they have matched with a program or NOT. Applicants will not find out WHERE they have matched until March 18th.
Why the built-in days of agony? The interim period is known affectionately as The Scramble- this is an opportunity for those applicants who have not matched to a program to have access to the still-unfilled spots at various programs and serves as a last ditch effort to secure a residency spot. 

I hope this helps to clear up some of the questions regarding this whole process, like: 
"Have you mathced yet, Vince?"
"Where are you going to be working, Vince?"
"Why are you curled up in the fetal position, Vince?"


Rogue Medic said...

"We just want to make sure you're not a douche."

This is like a wallet lying on the sidewalk under the piano being hoisted to the 4th floor. This is like the free offer to get you to come to the dealership. This is like the respectful email from rich Nigerians relying on my excellent reputation to straighten out their finances.

Someday one of your kids will come home and explain how they will retire within a year on their Amway pyramid money, or the profits from the Glengarry Glen Ross leads, but by then you will be in a seminary, working on your doctor of divinity. ;-)

I suppose the answer is that you do not have that swan-like neck, which they had to observe in person, therefore you are not a douche?

Vince said...

@ Rogue Medic,

Obviously they cannot fully assess 'douchery' with any sense of completeness. One can however, spot douche-like characteristics @ 60 paces. I believe his point was that they have a pretty good idea of the candidates they are interested in based upon the application; and the interview is just there to catch any major red-flags / personality clashes that would arise. This sentiment seems to be echoed among many physicians I have spoken with.

As for me, no- I have no swan neck ;-)

I am glad however, that I decided against the Balsamic aftershave!

Arjune Rama - 4th Year Medical Student said...

Easily the best explanation of the match process. I especially appreciate how you have answered the questions I get almost daily from non-medical friends.

Vince said...

Thanks Arjune,

I posted a link to your blog- so maybe 1 of my 3 readers will stumble by and say hello. ;-)

Anonymous said...

O.K. I think I get it now, so...
"Have you mathced yet, Vince?"
"Where are you going to be working, Vince?"
"Why are you curled up in the fetal position, Vince?"

Ray M.

Vince said...


Trixie the Pixie said...

I am so happy you have returned to the blogging world! I'll just ignore those surgeon comments :)

Best of luck -- let us know how it all pans out.

72ish hours to go. I'm about ready to bust down the doors at NRMP and demand to know. And I'll bring Chuck Norris with me.

Vince said...

Thanks Trixie,

Good luck to you too!

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