On March 19, thousands of medical students will log into Zoom, open emails, or pull up to drive-in gatherings to find out where they will be spending the next few years doing their medical residency training.
To continue their journey to becoming full-fledged physicians, graduating students must match with a residency program, where they will complete three to seven years of training (depending on their specialty). The process involves applying to and interviewing with multiple residency programs across the country. Ultimately, the residency program administrators rank their top choice candidates and students rank their preferred programs. Then, a computer algorithm sorts through all the preferences and matches students with the respective programs. Students don’t find out where they will be training until Match Day — which is March 19 this year — at a ceremonial placement reveal at noon.
It’s one of the most nerve-wracking and monumental moments in a physician’s life, and like last year, it will take a different form this year than the traditional crowded auditorium envelope reveals of years past.
But no matter how each new physician’s Match Day unfolds, it will be memorable.
Established physicians shared their memories with AAMCNews of the mixed emotions they experienced on their Match Days and gave their advice for this year’s matching class.
Ali Raja, MD, MBA, MPH, executive vice chair of the Department of Emergency Medicine at Massachusetts General Hospital and professor at Harvard Medical School
The night before his Match Day in 2004, Ali Raja, MD, MBA, MPH, stayed up late into the night playing pool and snacking with his roommate to calm his nerves. Neither of the fourth-year Duke University School of Medicine students had been able to sleep in anticipation of the day they would learn where they would be spending the next several years completing their residency programs.
Raja had his heart set on the emergency medicine program at the University of Cincinnati College of Medicine. He felt like he clicked with the people in his interview, but he hadn’t done very well on his board exams.
On Match Day morning, he went out to breakfast with several of his fellow fourth-year medical students, but they were all too anxious to eat.
Then came the big moment. At noon, Raja gathered with his classmates and opened his envelope. As it turned out, the University of Cincinnati had liked him too. It was a match.
“I got lucky,” he recalls.
He loved his time at the University of Cincinnati, but 17 years of experience later, he believes he would have been happy wherever he matched.
“The main thing I learned is no one decision — or no one outcome — defines the rest of your life,” he says. “Your medical career is going to be constantly changing.”
Raja sympathizes with the fourth-year medical students and interns who have had a particularly challenging year because of the pandemic.
“It’s been exceptionally isolating,” he says.
His advice for matching students is to do what they can for themselves in these final days before the Match® and to relax before starting their intern year this summer.
“Don’t try to learn all sorts of medical things you think you’ll need during your intern year,” he says. “It’s our job as residency programs to teach you. Focus on taking care of yourself.”
Megan Ranney, MD, MPH, associate professor of emergency medicine, assistant dean for digital health innovation, director of the Brown-Lifespan Center for Digital Health, and associate professor of health services, policy, and practice at the Warren Alpert Medical School of Brown University
In the days leading up to her Match Day in 2004, Megan Ranney, MD, MPH, remembers being frustrated with her lack of control over where her next several years of training would be spent.
As someone who took a few years off between college and medical school at Columbia University Vagelos College of Physicians and Surgeons in New York — and who also had recently gotten married — Ranney was used to making adult decisions for herself. It felt odd entrusting her future to the Match® algorithm.
“It’s such a weird, anachronistic process,” she says. “We just wait for someone to magically match us to somewhere we’re going to spend the next three-to-seven years of our lives.”
But she wasn’t terribly anxious. There were several programs she’d interviewed with that she was enthusiastic about, so she was more excited to finally have her future settled.
Still, her hands shook as she opened her Match® envelope alongside her friends.
“It was going to determine the trajectory of your future,” Ranney recalls. “Where you were going to live, who your friends were going to be for the next few years … and I had my partner’s happiness on the line.”
She felt a tremendous sense of relief to learn that she matched at her first choice, Warren Alpert Medical School of Brown University in Providence, Rhode Island, where she now teaches and leads the Brown-Lifespan Center for Digital Health.
But the emotions were mixed as she went around the room hugging her friends and learning their fates. Some were overjoyed; others were crushed with disappointment. And overshadowing the entire day was the reminder that they would all soon be separated from the friends with whom they had grown so close over the years of medical school.
Ranney acknowledges that this year’s matching class will have a unique level of anxiety, since they are likely to be matched at programs they’ve never even visited in person due to the pandemic.
“There’s a whole other level of nervousness,” she says.
But her advice is to take time to celebrate the past four years’ achievements and treasure these final moments with classmates.
“Enjoy it for a few days,” she says. “Everybody enters internship nervous, and you’re all going to be just fine.”
Drew Weissman, MD, PhD, professor of medicine at Perelman School of Medicine at the University of Pennsylvania and creator of the messenger RNA (mRNA) technology used in two COVID-19 vaccines
Drew Weissman, MD, PhD, is not the type to get nervous.
“I have kind of a matter-of-fact approach to things,” he says.
So he didn’t spend much time fretting about his residency placement in the days leading up to his Match Day at Boston University School of Medicine in 1987.
He remembers that, instead of the ceremonial envelope reveals that are common today, his class had to check a list that was posted in a central hallway near the campus mailboxes.
He and more than 100 others crowded around the list at noon and craned over each other to make out their own fate, printed in 12-point font.
“It took a while to finally figure it out,” Weissman recalls.
He was relieved to see that he had matched into his first choice at what is now Beth Israel Deaconess Medical Center in Boston.
His advice to students preparing to enter their intern year is to brace for what will be some of the most stressful years of their lives.
“You do what you’re told to do, you work incredibly long hours,” he says. “My biggest advice is: Don’t make any life-changing decisions during residency.”
One upside he sees is that he expects this year will be easier for students and interns than the past year has been due to the pandemic.
“I think you’ll look back at this past year and think, ‘I lived through it, I learned from it,’” he says. “Probably by fall, it will be back to normal.”
And that “normal” will be, in large part, thanks to the mRNA technology Weissman has spent much of his career developing that was used in the two leading COVID-19 vaccines by Pfizer and Moderna.
Justin Dimick, MD, MPH, Frederick A. Coller distinguished professor of surgery and chair of the Department of Surgery at the University of Michigan Medical School
Justin Dimick, MD, MPH, found out where he would be spending his residency years while parked on the side of the New Jersey Turnpike.
Instead of staying with his peers at Johns Hopkins University School of Medicine on his Match Day in 2000, he decided he wanted to share the life-changing moment with his family back in Vermont. So, he threw a basket of laundry and a textbook (Greenfield’s Surgery: Scientific Principles and Practice) in the back seat of his car and hit the road.
Dimick was nervous about his potential placement. He’d received a B in his core surgery rotation, prompting many faculty to advise him against applying for a general surgery residency.
As he was driving, he decided he couldn’t wait until he got home to find out his match. He pulled over on the side of the road, took out the first cellphone he ever owned, and called the dean’s office.
He had matched at one of his top choices: the surgery program at the University of Michigan Health System.
“I was just really excited to know where I was going to live for the next seven years,” he says.
He had been drawn to the University of Michigan because of its collegial atmosphere at a time when civility among surgeons was not where he thought it should be — an issue that often persists today.
Dimick recalls looking at the textbook in his back seat — which he’d been waking up every morning at 5 a.m. to read — and realizing that he would soon be working under the surgical faculty at the University of Michigan who edited the text.
“I thought that was kind of cool,” he says.
But it’s also not the end of the world not to match at one of your top programs.
“No matter where you end up, it’s the right starting place,” Dimick says.
His key advice to rising interns, wherever they end up, is to be intentional about the kind of culture and environment they promote in their residency programs.
“From day one, you have a tremendous responsibility to support the safety, education, and well-being of the people around you — that is called leadership,” he says. “Eventually, you will own the culture of your program. My advice is to start owning it on day one.”
Bob Wachter, MD, professor and chair of the Department of Medicine at the University of California, San Francisco, School of Medicine and the “father” of the hospitalist field
Bob Wachter, MD, and 10 of his best friends strolled into a Philadelphia auditorium at what is now called the Perelman School of Medicine at the University of Pennsylvania on their Match Day in 1983 dressed to the nines.
They picked up their sealed envelopes and then went out to the chauffeured limousines they had hired to take them to their favorite bar.
Gathered around a table together, they all opened their envelopes.
Wachter was surprised to see “University of California” written on his. It took him a moment to realize that he got into his first choice at the University of California, San Francisco (UCSF).
The celebration quickly turned melancholy as the friends realized that they would soon be going their separate ways.
Wachter remembers second-guessing his decision to list UCSF as his first choice.
He’d spent his whole life living on the East Coast and surprised himself by wanting to go across the country to California.
“I wondered whether I would have been better off closer to home,” he says. “I thought it would be a three-year interlude in California and then I’d move back to the East Coast.”
Now, 37 years later, he’s the chair of the UCSF Department of Medicine.
He has seen firsthand how the COVID-19 pandemic has disrupted the medical school experience, not only for his students at UCSF but also for his daughter, who is a third-year medical student there.
In some ways, it reminds him of his own residency training, when AIDS was a new and mostly unknown disease.
“It was scary, it was tragic, and it felt a little bit like it was all I was learning about,” Wachter says.
But his experience with the epidemic during his medical training shaped his formation and impacted his approach to his career. He believes COVID-19 will have a similar impact on today’s medical students and residents.
“I’m guessing they’ll look back — not fondly — but recognize they’ve learned some life lessons that they wouldn’t have learned otherwise,” he says. “These experiences are hard, but there is a richness to them that is unmatched.”