Match Day Could Burn You!

Today 16,000 soon to be Medical School grads will find out where they will be doing their residency. It's crazy! You basically go to a lunch where they give to a letter that will tell you, if you matched, and where you matched... You have some idea what program your going to, but not really...

This was the day that, as a spouse, you realize how expendable your career is... Kinda humbling, but ya gotta do what ya gotta do...

Oh and the economics of the deal is great... Imagine owing $100-200 grand.. and in less than 4 months you need to relocate, w/o any assistance, to a new city on bread truck driver wages... Not to mention the spouse has to find a new job too... and employers love that.. your typically treated as temporary.. oh and lucky... because your married to a doctor...

Here's how it works..

Access to graduate medical training programs such as residencies is a competitive process known as "the Match." Senior medical students usually begin the application process at the beginning of their (usually) fourth and final year in medical school. After they apply to programs, programs review applications and invite selected candidates for interviews held between October and February. After the interview period is over, students submit a "rank-order list" to a centralized matching service (currently the National Residency Matching Program, abbreviated NRMP) by February. Similarly, residency programs submit a list of their preferred applicants in rank order to this same service. The process is blinded, so neither applicant nor program will see each other's list. Aggregate program rankings can be found here, and are tabulated in real time based on applicants' anonymously submitted rank lists.

The two parties' lists are combined by an NRMP computer, which (theoretically) creates optimal matches of residents to programs using an algorithm. On the third Thursday of March each year ("Match Day") these results are announced in Match Day ceremonies at the nation's 155 U.S. medical schools. By entering the Match system, applicants are contractually obligated to go to the residency program at the institution to which they were matched. The same applies to the programs; they are obligated to take the applicants who matched into them.

On the Monday prior to Match Day, candidates find out from the NRMP if (not where) they matched. If they have matched, they must wait until the Match Day (Thursday) to find out where. If they have not secured a position through the Match, the locations of remaining unfilled residency positions are released to unmatched applicants the following day. These applicants are given the opportunity to contact the programs about the open positions. This is what is known as "The scramble." This frantic, loosely structured system forces soon-to-be medical school graduates to choose programs not on their original Match list. Occasionally and unfortunately, this sometimes requires students to choose entirely new specialties. The scramble is widely considered to be an unfavorable and highly stressful way of obtaining a residency position.

Inevitably, there will be discrepancies between the preferences of the student and programs. Students may be matched to programs very low on their rank list, especially in the competitive specialties like radiology, general pediatrics, dermatology, ophthalmology, orthopedics, otolaryngology, radiation oncology, and urology.

A similar but separate osteopathic match exists which announces its results in February, before the NRMP. Osteopathic physicians (DOs) may participate in either match, filling either traditionally Medical Doctor (MBBS,MD,MBChB,etc) positions accredited by the Accreditation Council for Graduate Medical Education (A.C.G.M.E.), or Doctor of Osteopathic Medicine positions accredited by the American Osteopathic Association (A.O.A.).
Further information: Comparison of MD and DO in the US (residency training)

Military residencies are filled in a similar manner as the NRMP however at a much earlier date (usually mid-December) to allow for students that did not match to proceed to the civilian system.

In 2000–2004 the matching process was attacked as anti-competitive by class-action lawyers. See, e.g., Jung v. Association of American Medical Colleges et al., 300 F.Supp.2d 119 (D.D.C. 2004). Congress reacted by requiring that antitrust cases cannot make this argument. See Pension Funding Equity Act of 2004 § 207, Pub. L. No. 108-218, 118 Stat. 596 (2004) (codified at 15 U.S.C. § 37b).

The USMLE score is just one of many factors considered by residency programs in selecting applicants. The median USMLE Step 1 scores for graduates of U.S. Medical Schools for various residencies are charted in Table 2 on page 5 of "Charting Outcomes in the Match" available at http://www.nrmp.org/data/chartingoutcomes2007.pdf.