So, what does all of this mean? For all of those who are in the medical field & have been through this process, you fully understand the joys of the match - so you might want to stop reading now & switch on the TV or find another blog to read; for the rest of you, here is a brief overview of the "Match."
1. The Match is the process by which graduating medical students are placed in residency programs. No, graduating medical school doesn't make you an instant doctor; you still have to go through a very long, strenuous residency training program, before you can practice on your one & make a decent living. Residents work 60-80 hours a week and earn 46-50K a year. Sad, isn't it. And, you don't just get to pick which type of doctor you want to be; you have to apply to a specialty & go through the match & hopefully get a spot in the specialty you select, or you end up doing something else. So, the saying "What do you call the person who graduates last in her medical school class?" has a totally different meaning once you have made it into a medical school class. This year, I think they are calling them "pediatrician, or family medicine doctor;" but, that seems to change with which specialty is popular at the time. My mother still says, "at least you will be a doctor." I just roll my eyes & laugh! To 4th year medical students going through the match, that is the worst thing you could say. The results of the match can turn a person who wants to be a neurosurgeon into a proctologist....
2. Early in 4th year, graduating medical students fill out a very detailed application on ERAS (Electronic Residency Application Service). This application is torture; it requires test scores, very detailed personal information, recommendation letters, and a personal statement explaining why you want to be the kind of doctor that you want to be. The personal statement is the hardest part for most students; some even hire ghost writers to help them with theirs. These writers charge around $250 to write a statement for one student. Some examples of personal statements can be seen on this site: USMLE Web.
3. A few weeks later the application process actually opens up & allows students to apply to residency programs all over the country. ERAS has a list of all of the programs who are taking applicants & the student clicks on the programs that they want their application sent to. Keep in mind that none of this is free. I can't remember the exact fees, but I know that you can apply to 10-12 programs in one specialty for one fee and then each additional program in that field is another charge & each additional specialty is an extra fee also. It usually runs another couple of hundred dollars.
4. A month or so later, students start receiving emails through their ERAS account inviting them to interview with programs or telling them that the program is not interested in interviewing them. Some programs never respond to applicants at all. Once the student is invited to interview, if the student accepts the interview they are responsible for all of their travel expenses and must wear a suit to every interview. This is where the match starts to get pricey. I know students who have spent 10-12K traveling to interviews. I, myself did not spend that much!
5. The interviews go a little something like this:
1) the night before the interview there is a dinner where you meet the residents and sometimes the staff who are involved in the program. This is suppose to be a casual affair, where you can feel comfortable asking the residents whatever you want "off of the record." However, I can tell you that it is rarely comfortable & everything that you say to a resident is "on the record."
2) the next day you put on the suit and head to the hospital. You are interviewed by anywhere from 2-10 program members; they could be residents, staff physicians, nurses, or secretaries. The interviews can be very informal, or incredibly stressful. Most of mine were very laid back, the people just wanted to know if they could stand being around me for the next few years. However, one of my interviews was super stressful. I was asked to talk a surgeon through an entire surgery from start to finish; he wanted me to explain the first time that I met the patient, how they presented & exactly what happened in the OR. He even wanted to know which areas were prepped & how long the case took. The same interviewer asked me how many friends that I had on facebook!
3) Sometime during your day of fun at the hospital you are given a tour, fed, given some papers, and given one more opportunity to talk to the residents.
4) at the end of the day, you are exhausted & run home to write down everything that you can remember about that program so that you can rank it properly when the time comes. Well, that is what you are suppose to do, anyhow...
6. At the end of interview season, which is usually early February, students are asked to submit a "Rank" list. This list is compiled of the programs that they interviewed & lists them from the student's #1 choice all the way down to their last choice. It can ONLY list programs that the student actually interviewed at. The programs also submit a list of the candidates that they interviewed and are willing to have attend their program. Some students end up on a DNR (Do Not Rank) list, and some students place programs on a similar list as well.
7. Once the lists are turned in the students start to worry. We worry that we ranked the programs in a good order, we worry that we won't match, we worry that we chose the right specialty and on and on and on.....Finally, on March 12th (or thereabouts) the initial rank has been computed by some high-tech algorithm & students find out if they matched. Like I said they find out IF they matched, not where they matched.
8. If a student matched into a categorical (full) program then they wait until the 16th to find out where they matched. If they matched to a non-categorical program (a program that starts with post-graduate year 2 training, or something like that; I won't get into all of this in-depth stuff, because it would take me another hour to explain it) or if the did not match at all then they enter the SOAP. The SOAP use to be called the scramble, because unmatched students scrambled for open spots for 4 days. They changed the name this year; but I am not going to get into that either, because it is a long story & I don't want to type all night!
9. The SOAP: unmatched students are given access to a list of programs with unfilled positions. These programs are located all over the US and are in many different specialties. The applicant then fills out another application and submits it to the programs that they are interested in. I think you are limited to the number that you can apply to, but I haven't read the entire SOAP rules (YET). The programs then interview selected applicants via phone, skype, or in person if they are in the same area. Then on March 16th, at the same time as the rest of the students, the SOAP students are notified as to whether or not they will be participating in a residency program next year & if so, which program.
10. So, what happens to people who don't match at all? The answer to that question is "I have no idea & I don't want to find out." Unfortunately, there are a lot of graduates who do not match; I am currently praying that I am not one of them.
So, there it is, the match in a nutshell. I hope that gives at least a decent overview of how doctors become specialists & can give a glimpse into what makes medical students so stressed out.
Here I sit, at 12:25am on March 12th, blogging about an email that I have been thinking about for 4 long years; an email that will change my life forever; an email that will be in my inbox today at 12:00 EST; an email that will either cause me to go into SOAP mode or introduce me to 4 more days of waiting.....
*If you are really interested click here for more information on the match from MomMD, or search the web & find all sorts of information on the subject!
....68 more days until graduation!!!!
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