FutureDocs

Match Day 2011 falls on St. Patrick's Day

This coming week is Match Week – the culminating event of the residency application process for all senior US medical students (and many international medical grads too).  Many people have heard of Match Day, but may not realize the carefully orchestrated and at times chaotic events in the week leading up to Match Day, which this year is on St. Patrick’s Day- so hoping everyone is lucky.  Here is a guide so you can congratulate all the future doctors in your life.

Black Monday – As ominous as this day sounds, most students receive the good news that they did indeed match.  At 11am CST/ 12pm EST, 4^th year students receive emails from the National Resident Matching Program letting them know if they matched.  For most students who are notified that they matched, there’s nothing to do but attend Thursday’s festivities – see below.   Those students that find out they didn’t Match will be entering the dreaded ‘Scramble’ on Tuesday.  If you are advising or supporting one of these students, its good to talk with them about their priorities – what residency programs would they be interested in?  where in the country would they want to look first?  It’s also important to be realistic since there is very little choice in the Scramble.

Tuesday – The ‘Scramble’ is as chaotic as it sounds and also ominous.  In fact in 2011, it also happens to fall on the “Ides of March” , which marks the very day Julius Caesar was killed in the famous conspiracy.  Residency programs find out that morning (10:30am CST/11:30am EST) if they did not ‘fill’ their slots.  At this time, they know they have spots that will be listed in the Scramble.  Half an hour later (11am CST/12pm EST), the Scramble officially starts when unmatched applicants can see the list of unfilled positions and can start to call / email / fax / or apply via the Electronic Residency Application Service (or some combination of the above) to programs.  Programs are able to decide whether to accept a student, wait for another one, or to leave the spot unfilled.  Of course, the spots tend to go quickly as some programs decide to go unfilled that year or pick up an unmatched applicant.  Students have usually never visited the program and maybe even the city that they will be considering in the Scramble.  Moreover, the programs listed in the Scramble may not be what the student even applied for.  For example, in the competitive specialties (Dermatology, Radiation Oncology, etc.), there are no unfilled spots.  This is in contrast to 1 year preliminary programs in general surgery which constituted and Family Medicine which accounted for most of the unfilled spots.  (NRMP houses data from past Matches here). 

Wednesday – The Scramble continues as students who were not able to ‘pick up a spot’ on Tuesday continue to contact programs.   Residency programs find out who they actually matched into their program and start to think about planning for their new intern class.  Next year, the process of the Scramble may get less chaotic as the NRMP implements the “Managed Scramble.”  There is a lot of concern about for-profit organizations that are preying on students that did not match.

Thursday -  MATCH DAY! – Most schools have a ritual or a party.  Some schools make students stand up and read where they are going to their classmates and faculty so that students are literally reading aloud their surprise.  Other schools may think this may be a bit cruel and unusual and opt for passing out envelopes with simultaneous opening of envelopes for a big frenzy.   Other schools, like ours, have their own ritual:  

Bag of money awaits as Dr. Abelson hands out envelopes on Match Day

The Pritzker Ritual  Prior to calling names to retrieve envelopes, every student puts money into a bag.  Once the envelopes are presented, they put on a table in the front of an auditorium and tossed around so they are in no particular order.  As envelopes are drawn from the pile one at a time, students names are called to come down to retrieve their envelope.  Everyone returns to their seat to wait  patiently since  the student who is called last wins all the money!  Then, everyone opens their envelopes at once and massive celebrations ensue.

Friday – REST!  The students need to rest up for their upcoming internships.  The faculty also need to rest since a few weeks later, they will be busy preparing the current third years (rising 4^th years) to enter the residency application process! 

The Future of the Match -  With medical school enrollment rising and new medical schools opening, there will be increasing numbers of students who go through the Match. Without increased positions, the number of medical graduates will exceed available first-year residency positions by 2016 (some even say 2013!).   You don’t need to be a math guru to know that we need to increase the numbers of residency positions to make sure that future medical students can enter residency training.   Most recently, there is a proposal on the table for the “All -in” Match so that even International Medical Graduates MUST go through the match to get a U.S. postion.  More on history of the Match here.

–Vineet Arora, MD