Thursday, March 24, 2011

match (day) madness: backstory

Here's your relatively boring backstory. If you want the rainbow, you gotta put up with the rain, right?

I complain a lot about being a penniless freelance writer, but compared to the life of a penniless fourth-year med student?

My life's cake.
Funfetti cake.
Funfetti cake with gold dust sprinkles.
Funfetti cake with gold dust sprinkles, unicorns, and sparkly fountains that spew forth rainbow sunshine, good will, and cheer.

My life.

Let me tell you about everything I've witnessed Derrick go through in his 4th year. Without a word of complaint, I might add. (But you know what, kids? This is my blog, and I can complain about anything I damn well please)

Besides all the stress, exams, essays, letters of recommendation, presentations, call nights, 6 PM-3 AM shifts for four nights out of the week, rapid-fire examinations, 6 week-late disbursements from an incompetent financial aid department, massive student loans, and the whole "watching patients die or telling patients they're ABOUT to die" part...'ve got to get into a residency program, where you'll spend the next four years of your life.

Getting into a Residency Program: It's Like Prostitution, But With More Diseases

To get into a residency program, you also have to pay an obscene amount of money to submit your application--which you've spent a three months completing-- to various programs who will then contact you and offer you select dates to come interview. Some of these programs will offer you just one interview.

Naturally, this date will conflict with three other residency programs who have also offered you that one date.
That one date will probably also be on a previously scheduled exam date, your birthday, or Christmas.
Yep. That stressful.

As a med student, you're not getting paid to spend your nights in an on-call room or work twelve-hour days. In fact, you're paying hundreds of thousands of dollars in student loans JUST TO GO TO WORK. Now you get to pay even more to travel around the country and put on a smiling song-and-dance routine for each residency program. We're talking flights, hotels, food, the whole nine, kids. You can sit at home, smirk, and say "but he's going to be a doctor! They're practically millionaires!" Sorry, dears, that's an outdated misconception. Derrick's so deep in all kinds of debt right now that it's going to take him about twenty years to claw his way out. Fan-bloody-tastic.

It's Like 19th Century Courtship from a Laura Ingalls Wilder Book... or Maybe a Complicated Mating Ritual on Animal Planet

I didn't have a picture of a Laura Ingalls Wilder book on my hard let's just pretend this is a complicated mating ritual, shall we? For all I know, it is one.
The song-and-dance residency routine goes like this: you wake up at the crack of dawn and put on your best business attire. You sit through 8+ hours of interviews at each program where you get to explain exactly why you want to go to their particular program, and you have to pretend that program is drastically different than any other program in the country.

Spoiler alert: their program isn't drastically different than any other program in the country.

So you learn quickly to analyze the literature they provide in abundance for buzzwords. You slip in phrases like "diversity," "research opportunities," and "state-of-the-art technology." You smile a lot. You sell yourself. Meanwhile, your residency program is trying to sell their own program and convince you to go to their program. Then you get to repeat the whole damn process again. And again. And again. Rinse, repeat, smile and shake another hand.

It's a pretty sick-and-twisted form of courtship. You're each trying to convince each other that you're the hottest girl at the bar. In other cases, you're trying to convince each other that while there are certainly hotter girls at the bar, you're at least a better candidate than the one-eyed fat girl in the corner. The residency program buys you shots in an effort to convince you to go home with them:  a mini-box of chocolates, a gift box of tea packets, a free backpack with the school mascot on it.

But the truly twisted part is still yet to come.

After the whirlwind interview process is over, you go home and you rank the programs. The residency programs rank you. You go up your list, they go down theirs. The NRMP uses a complicated algorithm to "match" you with a residency program.

"If the Millionare Matchmaker can do it, why can't the NRMP?" you ask. "How complicated can it really be?" Well, here's the "simple" explanation on how the Match Algorithm works.

(You got to the first set of charts and closed the link, didn't you? Yeah. So does everyone else.)

Here's the most horriblest, terriblest, awfulest part of it all:

Every soon-to-be doctor learns where they're going on the same day. At 1 PM EST, every 4th-year med student in the country opens up an envelope and discovers where they--AND their families-- are contractually obligated to go for the next three to five years of their life.

No choice. No choosing between three offers. No negotiation. If it was on your list, you can go there. If you ranked eleven schools, you're going to one of those eleven cities.

And you have no idea where... until 1 PM on Match Day.

This concludes the backstory behind Match Day hear the rest of the story, which involves zany costumes and heavy drinking before 9 AM, you'll just have to hang in there. Tomorrow: Part One-- the Scramble. It's kind of like eggs...if the eggs are med students being scrambled in the burning fires of hell.


  1. This is the most brilliant analogy for Match Day that I have ever seen. And bloody hell, are you so right about doctors not being zillionaires. Shocking as it likely is, I'm in medicine and the only doctors who are driving Lamberginis are plastic surgeons. The oncologists drive Volvos.

    I love real life irony.

    I think that I'd like to go on a residency interview pretending to be a med student, and then give them The Face.

    *pulls another 'rita from the cooler and waits patiently (get it???) for Act II*

  2. This is a little like the education profession these days. There is little respect given from those in charge, lots of buzz words that don't really mean much in practice. But what this really shows is the misconception out there about what doctors have to go through. As a teacher, all I see is misconception in the media about what we're expected to be able to do. I await the rest of your story.
    It Just Got Interesting

  3. See the thing I really don't get is, there's a severe lack of good doctors and doctors are a precious resource. We need them. We cannot survive without them. Yet we make it so damn hard for anyone to become one. Years and years of school and learning, more years of no sleep and long days, lots of stress, lots of accountability, huge debts... it doesn't seem right to me. Surely these sort of professions should be government subsidized once proper candidates have proven themselves at med school. Everything after that needs to be made easier for them, for the sake of everyone. Or am I all idealist again? :)

  4. It amazes me that they have to pay to be a part of that program, but I'm kinda glad they have to work their asses off to get the privilege of poking and prodding me. :)

  5. OMG the "Doctors get Rich" myth is as prevalent as the "teachers are underpaid" myth. (Not trying to start a fight. . .it;s just that, well. . .nevermind)

    May I reccomend Dave Ramsey as soon as he lands? That way, he can get on the debt re-payment plan soooper fast and actually make his money work for him.

    If you wanted a man with money, you should have dated a plumber.

    Any residency in South Texas by chance??????

  6. Good lord. My coworker is engaged to a third year med student. This is what he's going to have to put up with next year?


    And I'm sorry for you, too. And him. And every med student/significant other of a med student that have ever lived.

    And you were wrong. I got to the second chart, and then I just switched tabs. I didn't close it.

  7. Dammit! You mean it isn't at all like Grey's Anatomy?? I've been duped.

  8. Kat- I didn't know you were in medicine! And I have to control my fierce urge to do The Face at EVERY job interview. I feel like it would really get me hired.
    Brent- You know, I would love to be a teacher. Absolutely ADORE being a teacher. One of the few professions where I'd spring out of bed each day to go to work. But I'm not willing to put up with the crap that you guys have to put up with. The paperwork, the parents, the standardized test scores...THAT part is not for me. I'd get burnt out in a year.
    Vegetable Assassin- That's exactly how I feel. Except way, way more eloquent. Thank you.
    Krissy - I hear you. I've seen just as many great doctors as I have horrendous ones. Including some awful OB/GYNs. SHUDDER.
    Mary- Sorry, darlin, I could never put up with the heat! No Texan residency programs. And I LITERALLY laughed out loud about the plumber comment. So I guess if there are any plumbers reading this that want to give me a call... (I KID!)
    Chanel- I'm so glad someone held out longer than I did. I actually looked at that page with my jaw And good luck to your co-worker! It's not a fun gig.
    The Onion- I was actually hoping it'd all be like Scrubs. But with more zany sound effects.


    Brilliant, Nicki-Bottoms. I, too, have watched my beloved, John, trail through 3 years of law school (he graduates in May - WHOO!)... I knoooow I'm not supposed to compare doc's and JD's, but let's face it: they run them both through the grinder unlike any other professional program. And they both come out with incomprehensible loads of debt. I have a few friends I watched go through the residency process (well, the med school process as a whole), and you're right - it IS sick and twisted.

    But you know what? In an even more sick and twisted way, I'm happy the docs taking care of me at the end of the day are the ones who survived this. If this was a walk in the park, we'd all be doomed because any crack pot would saunter into med school (and John would be setting up a nice malpractice law firm). In other words, it sucks hardcore now - but I KNOW the payoff will come.


  10. So I was so looking forward to reading what you've been up to. I didn't know you're going through something like this. So sorry.

    *stabs self*

    Hahaha. And yes, I closed the link because I didn't understand the chart. Whaaaat??? :p

  11. Crap...Is that what I'm going to have to go through for Pharmacy school? :/


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