If You Play With Matches You’re Gonna Get Burned: Part 1

Editor’s note:  This two part series is brought to you by none other than the talented and fabulous Dr. S.  Many of you will remember Dr. S from our wedding, as one of MB’s oldest and dearest friends.  Dr. S is graduating from The University of Pennsylvania Medical School in a month {!!} and has an interesting story about the tortuous thing they do to medical students, when they are just about to see the light at the end of the tunnel:  Match Day.  Enjoy!

Before starting medical school, I had heard rumors of some bizarre holiday within the medical student community called “Match Day.”  Unlike other traditional holidays, we wouldn’t sing festive songs, eat chocolate or gather around a tree or menorah.  Instead our families and loved one would gather ‘round “The Envelope”—the almighty No. 10 sized receptacle of every fourth year medical students future.  And on March 18th, 2010—the medical student receiving her envelope was me.


The process leading up to “Match Day” is one that confuses most people, myself included.  Beginning this past August (beginning of my fourth year of medical school), I started work on my ERAS (electronic residency application service), which is the electronic residency application sent out to all the residency programs that I wanted to which I wanted to apply (for a per application fee, of course).  After concocting a personal statement and selecting my list of 18 programs, I  then spent most of November through early February traveling for my own personalized East Coast Hospital Tour 2010!  Really, its even less exciting than I’ve made it sound.  I was lucky in that all the programs I was interested in were within a bus or train ride away. Many of my friends spent hundreds to thousands of dollars traveling to 20 or more different hospitals.  Some applying in competitive specialties like dermatology applied to more than 50 programs in the hopes of finding one that would work out in the end.

All of this interviewing then led to the submission of “The Rank List.”  The Rank List is a personalized list of programs, submitted in the order in which you would like to attend them.  I could list as many programs as I interviewed at or I could choose to leave some off, knowing that if I listed a program that I didn’t like, there was still a possibility that I could end up being bound to attend. However, not listing enough programs meant risking not getting a job at all.  Oh, decisions.

To clarify: Yes—the Match is binding.  This means that when you are a matched a program, you are obligated to attend, although no one will send you to jail if you decide you don’t want to be a doctor anymore (or at least I don’t think so?).  There is no real option of “Thanks but no thanks” as exists in most other realms of academia and real life.  Since residency programs range in length from three to seven years, the order of The Rank List is life changing in terms of importance since ranking a program #2 vs. #3 can turn out to be quite important.

While I was making my list and checking it twice (actually about 20 times to make sure I wasn’t listing the Hospital of the University of Pensacola #1 by mistake), all of the residency programs were making their own Rank List of applicants.  After all of the lists are finalized, applicants and program lists all go in to the big residency match supercomputer housed by the all-powerful NRMP (National Residency Match Program).  Yes.  A computer run by some unknown algorithm mastermind (or as im convinced mystical wizard), will come up THE MATCH.  In other words, each student gets matched to one program off of their list.  There is no “acceptance” and then you decide later.  The computer is your decision maker.  No exceptions, so rank wisely.

However, the true madness (you thought it was already crazy?) begins on Match Week Monday.  On this day, every applicant receives the “Did I Match?” email.

While thankfully, my email started with a “congratulations” this is sadly not the case for everyone.  If you do not match you are subjected to the next ridiculous part of the process:  THE SCRAMBLE.  And no, I am not talking about something off of the Food Network. To scramble is a med student’s worst nightmare and is thankfully one that I was lucky enough to avoid unlike some of my other classmates.  If you did not match and thus have no job lined up for the following year, you can choose to frantically “scramble” for whatever unwanted jobs are left.  Usually these jobs are unwanted either because they are in the middle of Idaho, are in a less competitive specialty (i.e. not plastic surgery or radiology, for example), or are at a lower quality program.  If you decide not to scramble, most people will take a year off and reapply again, hopefully this time with a stronger application or more realistic set of goals for their career.

After “Did I Match Monday” and “Time to Scramble Tuesday”, Wednesday is Match Day Eve—the true height of anxiety before Match Day Thursday.  Match Day Eve brought about many feelings from me ranging from excitement to nausea.  The “I want to vomit” was a common status of friends on facebook and I think we all could have benefited from a strong drink and a mild sedative that day. I chose to spend Match Day Eve with friends, having a calming beer as we all tried to ignore talking about the topic that permeated all of our thoughts.  “Will I get my first choice?  What if I get #10?  Where will my friends end up?  Will I like my future colleagues?  What if I have to move?” And the list went on.

Did she match at the right school?!  Do we find out the meaning of life?!  Oh where will she be?!?!?  Stay tuned!

Did YOUR graduate school put you through the ringer right before graduation?


3 thoughts on “If You Play With Matches You’re Gonna Get Burned: Part 1

  1. Pingback: If You Play With Matches You’re Gonna Get Burned: Part 2 « I Now Pronounce You Wife & Blog

  2. I happened on this site because my husband is going through the match process right now, which confuses and bewilders us both. However, I’m an engineer and I noticed you characterized the match algorithm as an unknown algorithm mastermind. It’s actually common in math and based on the “stable marriage problem” if, for some reason, you’re interested. That’s the only part that really makes sense to me in this process.

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