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The One Thing You Need to Know about Match Day

By IHI Open School | Monday, March 16, 2015

Alla Smith, MD, is a senior resident at Boston Children’s Hospital. She wrote the following advice to medical students facing Match Day, the third Friday in March when graduating medical students learn where they will do their residencies. In the months leading up to Match Day, medical students submit a ranked list of the residencies that they are interested in, and the residency programs in turn submit their own ranked list of medical students. A computer matches the students to the residencies, and on Match Day, the results are revealed. Medical students learn where in the country they will be training for the next three or more years, and, in the case of students who have ranked residencies in different specialties, they also learn what type of doctor they will be.


Alla Smith, MD, second from left, with fellow graduating medical students on the day she learned she would be a resident at Boston Children's Hospital.

What you need to know about Match Day is that the thing everyone keeps telling you is actually true: it’s all going be OK.

I'm not saying that I recognized this during my own Match Day. Hardly. At the time I thought the whole process seemed like a sadistic prank. What evil mastermind thought it would be a good idea to take a group of type-A people who have been relentlessly working toward a goal, let a computer decide the outcome of these years of effort, and then give the results out in a public forum? It is a recipe for nausea and tears.

My own experience of Match Day was relatively benign. I didn’t have to walk alone across a stage, open an envelope in front of hundreds of people, and announce whether I had managed to match at the place that I wanted. Thankfully, instead, my classmates and I walked into the auditorium together. Lining the entryway were our families and friends — cameras flashed, babies cried, and spouses looked excited and nervous. Inside, on rectangular tables lining the walls, were the envelopes containing our futures. With my husband at my side, I pulled out the piece of paper with shaking hands.

While stress is inevitable in this unveiling, the truth is that we medical students are part of what makes Match Day so upsetting. It’s hard to get to the end of medical school without being a control freak. There are good reasons for that: We skip the Thursday night party to study for our final in organic chemistry because we believe that our efforts control the outcome of that exam. When we achieve the desired result time and time again, it’s easy to believe that we’re the masters of our destiny. We start thinking that, if we just try hard enough, our medical careers can proceed on the exact path that we desire. But that is a dangerously seductive mirage. Part of what makes Match Day so terrifying is that we’re forced to watch that image dissolve. Our futures are palpably out of our control, and we’re not good at handling that.

While the experience might be unnerving, it is important. Medicine is a career that deals in uncertainty: You’re about to encounter patient after patient whose life course has been abruptly, and sometimes brutally, diverted. Your patients will live in the uncomfortable unknown. So what can you learn from them that might help you cope with Match Day?

First, some perspective. On the spectrum of life problems, these are good ones. Really good ones.

Second, that there is joy in embracing the moment. Match Day is cause for celebration because it represents the culmination of years of hard work, a triumph no matter what is written on the piece of paper you are handed.  

And finally, that if you think your life has been forced off track, just hold on, because sometimes these detours end up being pretty spectacular. In life and in medicine, your ability to turn challenges into opportunities, your willingness to work hard, your compassion for your colleagues and your patients — these are the things that will bring you success and acclaim, no matter where you end up. Honestly. My friends and I didn’t all match at our top choices, but I don’t know a single one who isn’t content with where she or he is now, three years later. That has very little to do with where they went, and everything to do with who they were to begin with.

So, when the day comes, take a deep breath and hug someone you love. It’s all going to be OK. 

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