March 15, 2013 was a huge day for thousands of people across the United States, my family included. It’s Match Day, the day fourth-year medical students find out where they are going for residency, something for which they have prepared years, or even decades. My wife is a fourth-year medical student and has been working to become a doctor since she was a child. As you can imagine, this day had huge significance for our small family of four.
Medical students will choose their specialty sometime in their third or fourth year. Then they will do everything in their power to make themselves interview-worthy to their desired residency programs. This is a skill they have honed through demanding pre-requisites in college and grueling medical school interviews. Once the medical students submit their applications to ERAS (Electronic Residency Application Service), they wait for interview invitations. They are requested to interview at a few residency sites. My wife was invited to 18 and interviewed at 14. They fly around the country trying to size up residency programs while putting their best foot forward, hoping to make a good impression.
Then comes the insane part. Each applicant ranks the residency programs where they have interviewed in order of preference. Each residency program ranks everyone they interviewed in order of their preference. At this point there is often some jockeying to get programs or students to rank each other highly. And then? A computer cranks through the data (supposedly favoring the students’ preferences) and spits out legally binding residency assignments. This is how the match is decided, by algorithm. It is a Nobel Prize-winning algorithm, but still insane. What other profession would have people so whipped by hoop-jumping to put up with this nonsense? And if they don’t match? They scramble for a week to find any open slots, in their desired specialty or not, around the country because creditors are at the door waiting for repayment of hundreds of thousands of dollars in student loans. Like I said, insane.
For our family there was a lot riding on the match. My own career would be effected, as well as the children. While deciding our rank list, we weighed several factors with each potential residency site, aside from the quality of my wife’s training. Here are a few of them: cost of living, career opportunities for me, child care costs, closeness to family, climate, restaurant options (a surprisingly important factor for me), outdoor activities,family friendliness, opportunities to speak Spanish (my wife and I are both trying to keep fluent), traffic, church community (we’re Mormon and will attend whatever congregation is assigned to our city and neighborhood), school quality (my daughter will begin kindergarten next year), and Trader Joe’s availability.
All this and more gets thrown into a pot, mixed around, and fought over in order to rank sites in a way we can live with. This was our family’s task during interview season, from October to February. Then the computer decides. It is a strange state of limbo in which to analyze options so thoroughly and then turn everything over to a black box, but that is how it is done.
Match Day finally came and my wife’s residency assignment with it. We’re going to Grand Rapids, Michigan, ranked number one on our list. I cannot tell you the relief we felt to have a destination, but after celebrating for a day we had things to do.
We are now in Perú for my wife’s last rotation of medical school, where I lived for two years as a young missionary. While here we are buying plane tickets, contacting potential employers, looking at houses, renting moving trucks, and eating mangos. We will return home in mid-May and immediately travel to find a home, pack up our U-Haul, and start driving eastward across the country, stopping briefly to pick up my wife’s M.D.
This saga sounds extreme, but I don’t know that we’ve ever had simple transitions. Having a family certainly multiplies the pieces to be coordinated for any effort to succeed, but I wouldn’t have it any other way. When we formed our family we agreed to see each person’s efforts as our own. This transition is not my wife’s alone. It belongs to all of us.