For most people the third Thursday of March is just another day. But for medical students across the country, it is Match Day. Match Day for medical students not only determines where they will complete their residency after graduation, but what kind of doctor they will become.
Damien Ihrig, coordinator of match day events at The University of Iowa Roy J. and Lucille A. Carver College of Medicine, talks about a March Day:
How many medical students will be graduating this year from the college of medicine?
We will have 132 graduates this year.
When does each medical student start the process of determining where they would like to do their residency and what specialty they may want to be trained in?
Some of our students decided what they wanted to be when they were 5; but for most of our students, the process really begins in their third year of medical school.
The first two years of undergraduate medical education focus on what we call the basic sciences, where we stress both factual knowledge and key skills, such as critical thinking, establishing rapport with patients and colleagues, and conducting medical histories and physical examinations.
The third year students transition to the clinical setting by rotating through clerkships in the primary care areas; such as family medicine, pediatrics, internal medicine, and other specialties in the hospital, such as anesthesia, orthopaedics, or psychiatry. They're exposed to a wide variety of medical diagnoses, procedures, and specialty areas. This exposure then helps them to narrow down what kind of doctor they want to be. In the first half of their fourth year, they pick a specialty and begin the match process in earnest.
Do they apply for positions at medical institutions in a specialty they prefer or do medical facilities recruit particular students to their hospital?
There are two steps to the match process:
- The application/interview step
- The ranking match step
Except for three particular specialties and the military, the first step is handled by an online program called the Electronic Residency Application Service or ERAS. This program facilitates the connection between students and residency programs. Typically, students only apply in one specialty area, but there are some who are still deciding and may apply to more than one.
Students build a profile in ERAS starting in July of their final year; submit their application materials to the programs they're interested in; and starting around October, programs invite students for in person interviews. The interviews are important because each program has a slightly different personality and both the student and the program are looking for a good fit.
Depending on how competitive the specialty area is and how strong the student is, the student may end up traveling all over the country to dozens of interviews. Between the fees for ERAS and the cost for travel, most students spend somewhere around $3,000 for the entire match process.
Is the same process going on with every graduating medical college in the country at the same time?
Yes, even around the world. The National Residency Matching Program, or NRMP, was established in 1952 to provide the same start date for positions in graduate medical education, or what we call residency. Each year about 16,000 U.S. medical students participate in the residency match and compete with another 20,000 independent applicants for around only 25,000 available residency positions. Independent applicants include former graduates of U.S. medical schools, U.S. osteopathic students, and graduates of foreign medical schools. But the application deadlines, match notification date, and residency start date are the same for everyone.
Who determines which newly graduated doctor is placed in what residency program?
Through the National Residency Matching Program, students rank the programs they want to match at and programs rank the students they want as residents. This is the second step in the matching process I spoke of before.
Rank order lists from both students and programs are due to the NRMP by 8 p.m. CST on the fourth Wednesday of February—no exceptions. The NRMP then uses an algorithm to optimally match each student and program, and these matches are considered binding contracts and both parties are expected to meet their obligations. There are penalties for students who refuse to go to their match program; that's why we counsel all of our students to only include on the rank order list those programs they will be happy to attend. We only want to see happy faces and tears of joy.
How will students learn where they match?
Every school does it a bit differently, but it's always at the same time and it's always a great celebration. Exactly at 11 a.m. CDT on the third Thursday in March, our students are handed an envelope listing where they've matched.
This year the Student Government Match Committee will put a fun spin on it to help reduce some of the nervousness. We'll randomly draw students' names and have them drop a dollar in a pot and the last student drawn gets the pot—so a nice going away present. Then the students will celebrate with family and friends with a meal and other fun activities. Most of all, we get to learn what our graduating students will be doing for the next three to six years of the medical education; and overall it's an exciting day for all of us.
It sounds like all of them will get matched somewhere, although it may not be their first choice, but I'm sure they're all pretty happy to get to that point anyway.
Yes, they're all obviously happy to find out what they're doing and it's true that there's a chance that not all of our students will match into a position, but we have very talented students who have received great training at a world class medical institution and the vast majority of them will match somewhere. In fact last year we were fortunate enough to have all of our students who wanted to match secure at least a first year position. We look forward to seeing where our 2010 graduates end up. |
