Wednesday, June 2, 2010

List Day- My Fate in the Hands of a Computer Algorithm

Today I finalized my rank list for fellowship on the NRMP webpage, one step in the marathon journey of applying for a Hematology/Oncology fellowship program. (If fellowship application is a marathon, then going through all of medical education from med school on is definitely an ultramarathon: long, painful, and one constantly questions "Why am I doing this?") For those less familiar with the absurdities of the job application process for medicine residencies and fellowships, let me briefly explain.

During the last year of medical school, students start to apply for residency programs in the specialty in which they are interested (Internal Medicine, Surgery, Psychiatry, Pediatrics, etc). This long, drawn out process involves writing an application including essays, letters of recommendations, outlining EVERY SINGLE activity/extracurricular since the beginning of college, and providing a sample finger-painting from our kindergarten days (okay, okay, not the last one, but it sure feels that way!). When the application is uploaded to a special website, the med student can specify which programs can "see" the application. Depending on the competitiveness of the specialty, students specify anywhere from 5-30 programs, I think I did 10 because after 10 you have to pay extra, so that seemed like a good stopping point. Then, students get interview invitations and travel the country (on their own dime) to interview at programs. After 5 months of interviews, students input a list on the NRMP website of the programs they would like to attend in the order they liked them (#1 is top choice, etc.). At the same time, the programs enter the students' names in the order they liked them to the same website. Then 2-3 weeks later, there is Match Day. The 'matches' are chosen by some computer algorithm that puts together students and programs based on their mutual preferences.

Ah, Match Day. Match Day for residency is probably the most important/dramatic/stressful day of a doctor's career. Match Day is the day when all the graduating medical students in the country get together with their classmates and find out where they will be spending the next 3-6 years of their lives. We all find out at exactly 12 noon EST. Of course there is a lot of hubbubaloo before hand, in which the med school deans tell us how great we are (we know!) and how hard we've worked (we definitely know!) and that we'll all do great in the match (we sure hope so!). Then the envelopes containing our match results are dramatically handed out. Mine is below.

Then, exactly at noon we all open the envelopes. This day is stressful because our results are legally binding. We have to commit ahead of time to EVERY SINGLE program on our list so there's no turning back if you don't like your match. Some folks are elated, some are devastated, some are relieved. Then we celebrate the rest of the day, then scurry home because, at that point, we have to move to this new place and be ready for residency within a few short weeks.

Some of my friends and I waiting for noon in our Match Day t-shirts:

Pre-Match emotions range from, well, fishy (?), to excitedly nervous, to annoyed and tired, to blank stares to 'hey, I'm always up for a chance to make funny faces at the camera':

So the above process explains residency match. The process is essentially the same for fellowship, with a few exceptions. Here's the fellowship match timeline that I've been dealing with all year:

August-December 2009:
Complete application including yet another personal statement, letters of recommendation, etc

December 2009-April 2010:
Interview invitations come rolling in. I only interviewed at 5 places since I know I want to stay in the Midwest and Heme/Onc is only moderately competitive. I have friends matching in Cardiology who flew all over the country to interview at 30 places. Remember we have to foot the bill for all this! It's not uncommon to spend $10,000 on this process.

1/6/10: On-line Match officially begins

4/7/10: Rank order list opens

6/2/10: Rank order list closes

6/16/10: Match day

So, now, on 6/2, my list is in. Now I wait until 6/16 to find out where I match. There's no big party for fellowship match, I hear it's all very anti-climatic (exactly the opposite of resident match) but, to be honest, I really hope that I match where I want/expect to so anti-climatic is exactly what I want! Wish me luck!


  1. Good luck, Val! This was so interesting. I'm glad you typed it all out because I never really understood the whole process. I can't wait to see where you are matched.

    p.s. I love the part about having to turn in a sample finger-painting piece from kindergarten - ha!

  2. Look. This is all very interesting, but VERY silly. I think the med schools are causing more trouble than it is worth. But that is just my opinion. There are so many easier options that are based much more on ability as a person than an interview process. Kind of a load of crap. As I'm sure you already guessed, the obvious solution is to do it like "Hands on a Hard Body." All the programs could just slate how many slots they are giving to, say, University of Chicago. Then put them in a GIANT envelope. And all the candidates could stand around it until there are only a few left with their hands on the prize. Boom. Problem solved. Oh, and as a huge bonus, my way doesn't cost the indentured med student anything but time...

  3. Thanks for the comments guys! Kris- yeah, it's quite the craziness! GT- Love it! Hands on a hard body it is! Of all the solutions us residents have discussed, someone that one never came up....but you better believe I'll start suggesting it!