- You submit your application to as many programs as you want in whatever specialties you want. The more programs you want to apply to, the more expensive it is to discourage people from applying to every program in the country. Most people only apply to one specialty, but some apply to multiple specialties if they're not sure what they want to do or they're concerned that one specialty is more competitive and they want a back up. Additionally, some specialties like anesthesiology, radiology, and (you guessed it!) dermatology require you to complete an intern year (or first year of residency) in one of the big basic medical specialties before starting a residency in that field. For example, I applied to intern years in pediatrics in addition to dermatology residencies.
- After any and all the interviews you may or may not have been invited on by various residency programs, it is time to compose something called a rank list. Every residency program creates a list of the people they want to come to their program in order of how badly they want them. Every applicant also creates a list of the programs they want to go to in the order of how much they want to go to them. There are a lot of rules surrounding this process to keep people from making false promises and intimidating applicants. These lists are submitted in mid-February.
- Between mid-February and mid-March, *~*something*~* happens with all these lists. I'm not sure anyone is really sure of exactly what happens. But as I understand it, this national organization goes down an applicant's list and tries to "match" them at their highest choice possible. This is only possible if a particular program ranked them high enough. If no program on an applicant's list ranked them high enough, that applicant does not match.
- On "Match Day", everyone who matched finds out where they matched. If you matched somewhere, that's a binding contract that you can't break without some pretty severe consequences. Tears are shed, both happy and sad, and it's a giant party. The end!
Not quite what my school's Match Day looks like, but similar energy.
I can't say I wasn't nervous going into this process. Dermatology is an extremely competitive specialty, second only to plastic surgery. I wasn't at the top of my class, and there were 9 other people from my medical school class alone applying into dermatology, which is a lot! But lots of people in positions that seemed like they knew what they were talking about told me that while it was challenging, they had every expectation that I would match SOMEwhere.
I stood up in front of my classmates on Match Day and proudly announced that I had matched into a pediatrics intern year in Philadelphia. Everyone cheered, I got champagne, and congratulations were passed around, but underneath all of that was the truth that went unspoken: I did not match into dermatology. I was one of the (usually few) people each year from my medical school who failed to match. Often this would be chalked up to not following advice for ranking programs, or not applying to enough residencies. But in my case, it was simply because I wasn't good enough. I did everything I could, and it wasn't enough.
Friends and non-friends alike would come up to me and start talking about it, about how well I was handling it. They talked about how, if THEY hadn't matched, they would be a complete mess and wouldn't know how to deal with everything. How did I do it? What did I think had gone wrong? What was I going to do? I smiled and thanked them and told them it wasn't that bad. They didn't see me bursting into tears, breaking down into an ugly cry on my roommate's shoulder the night I found out I hadn't matched. They didn't know how I had sobbed a mere hour after Match Day in my Dad's hospital room across the street (more on that later) before rejoining everyone for the festivities. I didn't let them see, because I was so embarrassed to not be welcome in the field I desperately wanted to go into.
This unique combination of embarrassment and devastation was what I think made me look so put together. I gave advice to third year students on the match process with poise and fake confidence, while all the while a voice screamed in my head, "Why should they listen to you?! You didn't even match!" I still feel that way, a year later. I envy all the fourth year students who matched into residency programs, who know that at the end of a certain number of years they can practice medicine. That's security that I still don't have. But I'm also nearly done with my intern year, infinitely wiser and more capable than where I was my first time applying for residency. Maybe this time around, I'll proudly announce where I match and people can congratulate me with no unspoken truth. Maybe this time around, I'll get to be a dermatologist.
*~*~*~*~*~*~*
I've enjoyed my time in my pediatrics intern year. Due to a rather strict social media policy regarding blogging about patient care, I have been absent from this blog. While I did try for a few months to get approval for this blog from upper level management, I was also struggling to be an intern and probably didn't try as hard as I could have. Now intern year is winding down and much more time will be opening up for me starting in July. I'm renewing the effort to get official blog approval so I can share some of my stories about being a real-life physician while still protecting patient care. Wish me luck, and either way I hope to be back to the blog soon.
