Thursday, March 16, 2006

The Match

Smell that?

That combination of fear, panic, 22nd guessing, hope, and feeling like 24,000 people are about to enter into a 1-7 year (or more) arranged marriage come the last week of June?

It's also the smell of impending relief as finally, the whole damn kiss-ass, put-your-very-best-face-on, snow-all-and-sundry (from the receptionist, to the program chief, to that asshole chief resident who led the tour), god-I-hope-I-got-in-to-one-of-my-top-three-choices-please-please-please process is about to be over in a few hours and, well, at least you will know!!!

It's Match Day!

Ever wonder how the hell you get from medical student to that spot as an intern? You though it was just like many other things? Throw out applications, interview, sort through offers, choose that spot in Honolulu over that one in Bismarck? (Or vice-versa, depending on presence or absence of frontal lobotomy.)

Nah. Much more dysfunctional.

First, you send out your requests for information to different internship and/or residency programs (an intern is a first-year resident). You leaf through the slick folders, much like you did for college, grad school, med school, law school, and everything else you've done. Then you fill out the application, again, as you've always done. So far, just tedious. You send them out and buy a suit (or suits, if you have a sugar daddy or a partner who is gainfully employed above the minimum wage level), several pairs of nylons, a pair of shoes that you can tromp through airports and hospitals for hours on end in without sobbing (no scrubs or tennies allowed). The offers for interviews at awkward times are received and you scramble to schedule them in clusters to diminish the travel costs. Perhaps your partner can go with? (A huge bonus to provide prospective when visiting strange cities, as they will likely be living there, too, won't they? They can check out the local flavor while you are grimacing in your suit. Plus, it is nicer to not drink alone in your motel room, staring and muttering at the peeling, flowered wallpaper each night.)

You then return from your trip(s), broke and broken, needing to list all the programs who have interviewed you in order of preference. Who had the least-worst coffee? Who had the most elective time? Which program had the least-bitter-looking residents? Did any of the programs actually let you see any of the other residents? Even away off in the distance? Then you close your eyes and point, as it is as good a way as any, and submit your list (then it was a mailed-in #2 pencil bubbled form, now it is online). The programs do the same. ("Hey, which was the one with the legs, Bob?")

Then all is sent in to the National Resident Match Program. (Somewhere along the line, probably early on, you sent in fees. Can't do anything without sending in those fees. Fees for everyone!) Everything is fed into a database and, magically sorted, so you are matched with the program that wanted you ahead of someone they wanted even less than you.

A Match made in mediocracy.

The results are announced on Match Day.

Match Day is sacred.

Actually, today, with the internet, I think it is a bit different. It seems you can look up your results online, rather than waiting for what ever ritual your particular school had. I actually hope some of the schools found a way to continue the traditions. My favorite was the one (with many variations) where students were gathered in an auditorium (say a main lecture hall) and one by one, the names were called and the envelope with their fate was handed off. As each approached, a dollar was deposited in a hat or something, and the one who was called last got the consolation of getting the Kitty in dollar bills.

For our class, we met in a plain room in the one dorm on campus. (Most of us did the apartment thing.) We gathered, almost completely silently. The envelopes were distributed, and we opened them together. Nobody said a word for a bit, then, almost like at a funeral, we sought each other out, in ones and twos, exchanging the news of where we would all be going. Some were very pleased, some (most, probably) relieved, a few in silent tears.

Lord, it was weird and surreal. Your whole life for the next year or decade or whatever the length of the program, decided in one fell swoop. The thing was also binding. Pretty much no getting out of it without much legal wrangling and more money.

So, what if nobody wanted you? Well, the day before, you sat by your phone, waiting for the dreaded call from your school, telling you that they had been notified that you HAD NOT MATCHED (not uncommon in highly competitive fields like ophthomology or orthopedics) and giving you info on programs that had not filled. You then got the hell on the phone, in a panic, calling all these places and trying to get in somewhere, anywhere. Fortunately, the programs were also desperate to fill, as not filling is a terrible black mark, (and, hey! any tepid body is worse than no tepid body, right?) Some very good graduating classmates didn't match, many because they didn't rank enough programs or were trying to match with partners, (so they could stay in the same city) and the partner was trying to get into a highly competitive program.

Then, it is all over and there you are. Your foreseeable future laid out in front of you. Now, you have about 9 weeks to finish your classes, go through graduation (usually early June) and get your self moved and settled so you can start working for real, usually starting the last week of June with orientation and various life support certification classes; your first day on the wards--July 1st.

What ever you do, don't get sick and in the hospital the month of July.

Man, I don't miss that.



Blogger listmaker said...

Wow; that's weird and you're right - surreal.

"What ever you do, don't get sick and in the hospital the month of July."

I'll definitely keep that in mind.

9:48 AM  
Anonymous Anonymous said...

this is why I went to school for nursing. I don't think I could handle the pressures and the hours residents have to put in. It's crazy!

10:51 AM  
Blogger Teri said...

We'll save the blowing-appendages-off-with-firecrackers accidents for August 4th, then.

Makes me wish my father-in-law was still alive so I could ask him what it was like for him.

2:09 PM  
Blogger brooksba said...

That gives me more respect for the ordeal that medical students go through to become doctors. Just wow.

4:28 PM  
Blogger Rozanne said...

Where did you end up "matched"--if that's the correct usage of the term? Was it one of your choices or not?

I'm sure your nails were bitten down to the quick by the time you got notified.

4:49 PM  
Blogger Diana said...

Listie- At least avoid all teaching hospitals in July. Yikes.

Amy- You know, it really wasn't as bad from the inside. Like lots of things, you just put your head down and trudge ahead. Had I matched with a program that was horribly malignant, I'm sure my views would be different. As it was, my fellow residents (Hi, Honey!) and I pulled each other along.

Teri- Wise choice. An August resident is much more adept and less likely to sew both thumbs onto the same hand. Or worse, put a nose in place of one.

Beth- The thing of it is that it was so different from what we'd been doing for the the whole of med school, which was basically schlumping through huge piles of shit, literally and figuratively. (Like what Johnny is going through, but with just one species of creature. Well, make that 2: child and adult versions.) You have to go all business-interview from coast-to-coast and then it's like a lottery (not actually, but that's what it feels like) to see where you are indentured to for a long period of time. It's probably the most efficient way, but horribly stressful.

4:54 PM  
Blogger Diana said...

Rozanne- Gah. I was sort of sick, as I recall, walking down with my best friend at the time. I matched my second choice (Providence), which in retrospect should have been my first choice as the only time (aside from the 2 months of insane ICU intern rotations--call every-other-night makes me intensely depressed in keep-me-away-from-all-weapons way) I was unbearably miserable was during the 3rd year when I spent a manditory rotation at the VA, which was where I'd have spent most of my time, had I gotten my first choice (the smaller OHSU/primary care track). Third choice was OHSU as well, but the larger 'regular' internal medicine program, with less of an out patient emphasis. Basically they were the same except the one had extra time in the out-patient clinics, as I recall. There was a lot of back-stabbing and one-up-manship that I witnessed there that we just didn't have at Prov.

5:12 PM  
Anonymous Anonymous said...

One thing I love about your blog is hearing about the things you couldn't talk much about to your parent at the time you were living through them, but are now able to share. Thank you.


3:36 PM  
Anonymous Leigh-Ann said...

I'm embarrassed to admit that the first time I read this entry, I couldn't get past the first paragraph. "24,000 people entering into an arranged marriage? Is this some weird Moonie thing?" I sat and thought about it for quite some time until it occurred to me to keep reading. Ahem.

7:09 PM  
Blogger Jamie said...

OMG. Am forwarding link to this entry to my brother and his wife, who are new doctors embroiled in their residencies.

What insanity!

10:54 PM  
Blogger Diana said...

Mum- Poor Charles bore the brunt of those years. When I look back it really does seem a bit insane.

Leigh-Ann- I like your take on it. Hey! That could be some sort of sit-com where the whole program not only trains together but is married together. Moonies meets 'Scrubs'. (I've probably offended many just now.)

Jamie- Now I have the song 'Tradition' from 'Fiddler on the Roof' in my head, as so much seemed to be Tradition. I'm very curious to know how things are done, 15 years later. How has the internet changed things? I'd love it if you let me know.

8:04 AM  
Blogger CarpeDM said...

Boy, am I glad I didn't decide to become a doctor.

Okay, the chances of this were very slim since I'm pretty sure you have to understand math and not throw up when someone else throws up in the same area. But still, I'm glad I didn't.

Yes, please, I would love your recipe for granola. My email address has changed a bit, just instead of Thank you!

10:21 AM  
Blogger Diana said...

Dana- You got it babe!

4:47 PM  
Blogger buffaloon said...

Wow. I had kinda forgotten all about that day. In a kind of repressed memory sort of thing. It WAS very surreal. The pressure of it all, the anticipation, then going to room where we had NEVER been. No comfort of horrible lecture halls or any of that.
Hmm. Very strange in deed.
(Thanks Honey!)

4:48 PM  
Blogger Diana said...

Hi Honey- You hit it on the head. Not the familiar comfort of the concrete walled and floored lecture hall. I remember you sitting on the ledge by the window and being very glad that we had matched together, along with F, J, and L. (Have you heard from anyone lately? Got a Christmas card from F. She's doing well, of course.)

6:15 PM  
Blogger Cagey said...

I remember Match Day! The Guy Who Would Have Been My Brother-n-Law Had I Married A$$hole #1 went through it. We waited with baited breath because we so desperately wanted him to live near us.

4:35 PM  

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