It’s that time of year. Interviews have been completed and rankings have been submitted. The waiting begins.
For fourth-year medical students and their loved ones, the time leading up to Match Day* often brings a wide range of emotions and experiences. It can seem as if that one moment—opening the envelope—will reveal the measure of one’s life.
On an intellectual level, we know that’s not true, but stress disrupts access to the rational part of our brain. The greater we make the stakes, the more we “feel” about ourselves and the future.
While it might seem counterintuitive to many of the students who have planned for this day for many years (from selecting the “right” courses in undergrad, finding ways to demonstrate interest in health care and medicine, volunteering, working as a medical scribe or starting a pre-med interest group, “building a resume,” preparing for the MCAT and interviews), the way to get through the waiting (with reasonable worries and excitement) involves the opposite of planning. It is letting go of expectations and demands regarding the outcome.
While you have worked hard and tried to do everything you could to improve your chances of having the best options, the truth is hard: there are no guarantees, and the match process is imperfect.
But you do have power over your mindset. If you can focus on what residency actually is, and what you are there to do, you can connect with your values and ground yourself in what led you to consider a healing profession in the first place.
There are as many different stories about why someone chooses to become a doctor as there are students. Some of you grew up in families surrounded by parents or relatives who were doctors. Some of you are the children of immigrants who have been told that medicine leads to stable and respectable employment. Others became interested after experiencing their own health difficulties or those of people for whom they care. Some like the intellectual challenge of correctly diagnosing and treating a particular condition. Even a few might have been seduced by a medical series on TV. Hopefully, though, you are motivated by a desire to connect with others and to ease suffering. No matter where you match, that is exactly what you should be learning and practicing to do.
Of course, there are a number of personal and professional considerations when it comes to choosing a residency program: location, partners, and family obligations. Those things matter.
But the ranking of the program should not matter as much.
If you are committed to learning how to be compassionate, thoughtful, open, and curious about the “whole person” in your exam room, everything should fall into place.
If you can embrace humility and remember what a privilege it is to be with others at their most vulnerable, you will be well on your way to being a true healer.
But what do you do when you are sitting with the uncertainty of what will happen? Please consider the following strategies.
Set limits on the amount of time you spend talking with family, peers, friends, and mentors about the match. While we have gotten used to 24-hour news coverage and hours-long sports shows that offer predictions, speculation, and odds, constant speculation just isn’t helpful when it comes to Match Day.
If you find yourself discussing the worst-case scenarios or ideal situations over and over, notice that you are doing it, and gently remind yourself that no amount of thinking or conversing will change the outcome. Redirect loved ones from talk of the future to what is going on right now. You can communicate that you are stressed or worried, but try to ask for support and distraction. Let others know that you are trying to remember the big picture. Wondering where your CV stacks up in comparison to others? Compassionately remind yourself that it is normal to want to know, but that it is a futile effort.
Remember that there are too many variables to consider in the match process and you can’t control a lot of them. Different programs value different metrics differently. Your interviewer may be a sucker for an applicant who is a plumber’s daughter. One of the application readers might have been put off by a misinterpretation of something you wrote in your personal essay, while another one may have really “gotten you.” Some programs may assume you wouldn’t really want to go there and decide to rank someone they think would love to be there higher. There are TOO MANY VARIABLES!
Let me say that again: TOO MANY VARIABLES. And your journey was, and is, yours and yours alone. Maybe something tragic happened while you were in medical school. Maybe you struggle with assertiveness and confidence. As long as you care about people and are competent, I would want you as my doctor. Give me warm, authentic, and humble candidates over the top test takers or most prolific researchers any day.
Resist the (common and understandable) urge to compare yourself to others. Practice self-compassion. If you happen to be blessed with exceptional cognitive skills, good physical health, and need a ridiculously low amount of sleep (truly, not just depriving yourself and getting by), in addition to social and emotional intelligence, good for you. Don’t work too hard just because you can.
Everybody else: that person is a unicorn (and probably looks like that on paper but not IRL), and they do not have more value as a human being than you. In short, don’t compare! Congratulate yourself for getting through medical school with your well-being intact (or at least recoverable). At this point in your career and life journey, it’s common to question your choices and to rue your experience. Don’t do this to yourself. You will be starting residency soon. You don’t have time to deal with the effects of self-induced suffering. So please be compassionate to yourself, if only for future you.
Take a long view of things to reduce short-and long-term stress. There are lots of strategies to deal with stress in the short term: deep breathing, mindfulness exercises, progressive muscle relaxation, yoga, positive self-talk, and writing out your worries on paper and throwing them away.
Those strategies will work in the short run, but I hope you also remember that you will do well in the long run if you can embody the sense that you are an imperfect person just trying to get by. Bad stuff can happen, but you are a capable and worthy whole person who is lucky to have a job (intentional use of the word) that is challenging and gratifying in ways many others could not imagine. d
Congratulate yourself. Be kind to yourself. Be patient with yourself (and the rest of us).
If you find yourself extremely stressed by Match Day or for any reason at all, seek out guidance from medical professionals. The following list includes some key resources that are available to SOM students. You can explore all the resources available to SOM students (mental health and otherwise) on this page.
Behavioral Health Crisis Support Team. Connecting behavioral health clinicians with specially trained public safety officers to respond appropriately and effectively to those in crisis, seven days a week.
*Editor’s note: For folks unfamiliar with the term, Match Day is when fourth-year medical students who apply to the National Residency Matching Program are matched with the medical training programs where they will typically spend between three to seven years. It occurs on the third Friday of March. It’s a momentous professional and personal milestone for young doctors (and their families), as it can determine where they will work and live. The 2022 Main Residency Match had more than 39,000 participants; picture 39,000 highly motivated and competitive people waiting for and then learning important career news at the exact same time on the exact same day. All of these factors can combine to make Match Day itself and the weeks and months immediately beforehand a stressful season of life.