Insiders Guide to Biggest Week in Medical Education: the First Friday Match Day

Match Day 2011 fell on St. Patrick's Day

This post was updated for Match Week 2012 – starting on Monday March 12th 2012.  This year, for the first time, Match Day is on a Friday.  See below for some of the reasons why…  

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 for the first time falls on a Friday breaking tradition.  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, 4th year students receive emails from the National Resident Matching Program letting them know if they matched.  For most students who receive the coveted “Congratulations, you have matched” email from NRMP, there’s nothing to do but attend Friday’s festivities – see below.   However, for those students that find out they didn’t Match – there is much to do before Friday.

This new process is dubbed “SOAP” (Supplemental Offer and Acceptance program).  The SOAP was created due to the chaos of free-for-all Scramble, and hence it is sometimes called the “managed scramble” as applicants will have to apply through the Electronic Residency Application Service (ERAS).  Believe it or not, one of the main ways unmatched applicants would transmit their application to programs that are unfilled was using a fax machine!   In any case, the list of unfilled programs will be released ONE HOUR after students find out they did not match and students can start “applying” via ERAS to the unfilled programs.

This process will still be stressful as students have usually never visited the program and maybe even the city that they will be considering.  Moreover, the programs listed may not be in the specialty that 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).

This year, one interesting thing is that programs can ‘contact’ unmatched candidates who applied to their program in the SOAP to discuss the program or ‘interview’ the candidate.   One key change from prior is that the program MUST initiate contact to the applicant, not vice versa.

Tuesday – Unfilled programs begin ranking the unmatched applicants – Programs with spots to fill can start officially entering a list that ranks the unmatched applicants who have applied to them.  Programs can continue to contact unmatched applicants who have applied to their program via SOAP.

Wednesday and Thursday – Unfilled programs submit final rank list and SOAP offers made.  Candidates will be notified which programs have “offered” them a spot.  This process will occur in rounds, with the applicant will have 2 hours to make a decision, making it important to weigh the options carefully.  Some people have forecasted a continued decrease in number of unfilled spots available as the Match increases in size due to increasing US medical school size without a corresponding increase in residency slots.   Although the SOAP ends Friday at 5pm, the process may be over before it begins with many of the spots getting “sopped” up in the first or second round of the SOAP.  Since this is the first year of the SOAP, it will be interesting to see how it goes and is perceived by all those involved.

Friday –  MATCH DAY! – Most schools have a ritual or a party, including some really unique rituals like this one at EVMS!  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.

Following the Match, students often receive calls or emails welcoming them from their residency program leaders (Chief Residents or Program Directors).  Then, comes the Match Party – which could either be school-sponsored, or more ‘underground’ social event set up by the class.

Saturday – 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 4th years) to enter the residency application process!

The Future of the Match – Next year, we will probably have the biggest Match ever as the NRMP implements the “All -in” Match so that even International Medical Graduates MUST go through the match to get a U.S. postion. 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 doomsayers are saying even sooner!).   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.    More on history of the Match here.

–Vineet Arora, MD



  1. Thank you for wishing me well in the Match and for directing me to your site. I love that it mixes key information with a hefty dose of sanity and wish I’d discovered it sooner! I will highly recommend it to students in the classes following mine!

  2. Great post! Very informative and engaging. Helpful to pass along to non-meded people so they can better understand what we do and the moments that make it all so worthwhile.

    Congratulations of a successful entry into the blogsphere.

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