The process begins in September with the submission of a standard application that includes the student’s education history, transcript, Board examination scores, extracurricular activities, personal statement, and letters of recommendation. (The preparation of the application begins months earlier.) Students submit applications to a varied number of programs. The number depends on the field to which the student is applying – how many spots are available nationally and whether it tends to be highly competitive – the strength of the student as a candidate, the student’s geographic preference, and just how worried the student is about securing a position.
After reviewing applications, programs issue invitations to interview between October and February. Traditionally, students accept every interview offered early in the season. Later, once they [hopefully] have the security of having garnered many interviews, they cull their schedules for the most desirable programs, cancelling their appointments with hospitals in which they have less interest. At the end of the interview season, students submit an electronic list of the programs that they have visited, ranked in order of preference. (They may choose to leave programs off the list, thereby guaranteeing that they will not train there.) Every program also submits a ranked list of the candidates whom they interviewed. A computer runs both sets of lists through an algorithm and spits out one program for each student. For some students, no program is assigned and they must then scramble to secure a position in a residency program that did not fill, often in a different state and even a different field than they had desired. The entire process, from application to algorithm, is known as The Match.
It’s a nerve-wracking process, this Match. There is the waiting for interview offers, and then the waiting to find out where you will train. But in between, there is the strain of not only putting your best self forward over and over again, but of trying to weigh the programs that are weighing you. Are the residents really as happy as they seem? Do the teaching methods favored by the program correlate well with your preferred learning style? Will you see a high enough volume of various diseases and patient populations? Does the program have a good track record of sending graduates on to fellowship training? How well is the program regarded in the field – how well will it prepare you for your career and how much strength will it lend to your curriculum vitae? What is the culture of the program and how closely do its values align with your own?
And which of these factors is the most important?
Early on in the process, I was awash in confusion. I had a clear geographic preference (New England, centered around Boston). There are a number of impressive pediatrics programs in the area, with wildly different reputations, and with reputations that vary depending on whom you ask. I wanted the best for my education. But after four years of largely unhappy grinding, feeling that what I want out of life was at odds with what was being celebrated all around me, I wanted a place where I would feel comfortable, where both my love of medicine and my loves outside of medicine would be embraced. After each interview, I reflected on everything I head learned about the program and tried to rank it with respect to the programs I had already visited. Tay gently pushed me to explain my rankings, trying to help me process my thoughts, and sometimes there was no clear-cut answer as to why one program stood out compared to another; it just felt better. Over time, the intangible qualities that I sought in a residency program evolved into something I called The Huggability Index. On the surface, it was a basic measure of whether or not I had felt the urge to hug anyone I met on interview day, and if so, how many people I had wanted to hug. (I didn’t actually embrace anyone; I just noted the feeling.) Some programs scored high. Others garnered negative numbers. Still others were somewhere neutral in the middle.
The program that I ultimately ranked the highest brought out a flood of emotions. When the program director addressed that day’s group of applicants, I immediately felt the urge to cry and then vomit. Cry because everything he said about why he had come to lead this program and the wonderful quality and balance of life that he found there were exactly what I had been seeking. Vomit because I realized that I had one chance to make a strong impression, to make it happen, and that chance was today. (Again, I held both of these urges in check.)
Throughout that day I wanted to hug an inordinate number of people: the director for asking about my writing [I had used my writing as the focus of my personal statement, as a sort of litmus test for the programs; would they still be interested in someone who didn’t submit a statement that was some variation of Why Medicine Is The Best Thing Ever? Would they be not only interested, but encouraging as I made it clear that I had no intention of putting my writing on hold during my training?] and for every thoughtful and huge-hearted sentiment that he shared about the patients he cares for, his enthusiasm for the colleagues he works with, and his philosophies about educating new physicians. I wanted to hug the residents for their enthusiasm, warmth, and candor; my interviewer for being the most laid-back yet respect-inducing interviewer I had ever encountered, and for having really cool music playing in the background while happily discussing both public health and the many wonderful reasons to call New England home; and pretty much the entire institution for being fantastically child-friendly. Yes, many hospitals are decorated with children in mind, but this one exudes a warmth that I have felt in few others.
In the end, my choice was easy. Waiting to find out the contents of the envelope with my name on it was excruciating.
But once I opened it, there were hugs all around.
I’m going to become a pediatrician, and I'm going to do so at Brown.
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