04 March 2017

Landing a Residency - Part I

Hope the first couple months of 2017 are off to a good start for everyone.  Been awhile here at Andrew Langfield Struggles, so thought I'd do a short series of posts concerning the residency match process.  Likely many of you reading are painfully familiar with The Match already, either from personal experience or from hearing me talk and talk and talk about it over the fall and winter.  But to those of you triathlon peeps to whom this is all quite foreign, thought it might be fun to shed a little light on the transition from med school to residency in the crazy world of American medicine.  I’ve been putting together a fun, photo-heavy entry with highlights from the interview trail, but first a brief intro.

The 4th year of med school is hilarious.  Sure, you have to do some tough rotations, keep making the grades and passing tests.  But for the most part, you really only have one job: match into a residency program.  “The Match” is actually an extended process, and it takes most of the year.  Start pulling your application together in late summer, get things submitted exactly on time on a very arbitrary day in mid-September (and if you don’t, you’re late), travel to interviews all winter, agonize over your rank list for a month or two, then sit around and wait for another month to find out if you actually landed a position.  And in some final, archaic ceremony, steeped in rich symbolism and pageantry, every graduating student across the nation actually opens an envelope and reads a form letter – that had to be physically printed, stuffed and sealed into said envelope by a human being – that tells you where you are moving to start the next chapter of your medical training.  And this happens at the same moment.  Noon eastern, to be exact, which is 9 am here in P-town.  Nobody knows why it’s done this way.  I think tradition, mostly.  The only redeeming feature: this year, Match Day falls on St. Patrick’s Day.  So that should be fun.

Don’t get me wrong, I think the match algorithm itself is genius.  Nobel prize worthy, even (and that isn’t just my opinion).  Plus, by going through this process, you do gain some fascinating perspective on how physicians are currently being trained and health care is being delivered in this country.  But for the most part, it seems like a system that ran off the rails a long time ago, forcing applicants and programs to spend exorbitant amounts of money to pair up.  Depending on the specialty, most applicants will apply to 30-100+ programs in the hope of getting 10-15 interviews to ultimately match at a single program.  And if you’re entering the Match as a couple – as Elena and I are – you basically just double everything.  It’s not easy for programs either, as they now have to sort through thousands of applications and interview hundreds of qualified med students to fill the same number of spots.  As one program director put it: “We still have the same number of spots in our program.  But since we have to interview 4 times as many applicants now, it just means each person we interview is only ¼ as likely to come here.”

All that said, if you can keep the right attitude about it, the interview trail is actually pretty fun.  When else do you have an excuse to travel to Burlington, VT and Albuquerque, NM in the same year?  I’ve been to places this winter I never thought I’d make it to.  And even more fun is imagining what life would actually be like in these new towns, and if you can see yourself living there.  Internal (and family) medicine residencies are typically only 3 years long, and I hear that time goes by pretty damn quickly.  It brings some levity to the process.

So there’s a little insight for ya, probably more than you’re used to getting here at Andrew Langfield Struggles.  Hope you aren’t feeling confused, angry or otherwise deceived.  Next up: adventures from the interview trail.  Then Match Day madness.  Stay tuned.


-A