Introduction

“Three… Two… One…” The room explodes into a cacophony as envelopes are torn open. I take a deep breath, steadying my nerves, and with a resolve I didn’t know I possessed, I open mine.

For a moment, time stands still. I scan the letter, once, then again, ensuring I’ve read it correctly. A surge of emotion washes over me—relief, joy, disbelief. I’ve matched! I’ve matched at my top choice program, a place I’ve dreamt of, not only for its prestige, but for the opportunities it represents, the lives I’ll touch, and the doctor I’ll become.

Of course, as a second-year medical student, I am yet to experience this myself. I had the opportunity to volunteer as an usher for this year’s Match Day in my medical school. Having witnessed the anxiousness before opening the envelopes, the speed at which each student (or should I say doctor?) opened theirs as the countdown clock hit zero, and mixes and waves of emotions in a single room has inspired me to write about this.

Match Day, for many, is one of the most important days for rising physicians where their future is contained in an envelope. These envelopes hold a letter from the National Resident Matching Program (also known as NRMP, or simply, “The Match”) where the residency program and specialty the student has been accepted to are revealed. Why is it so nerve-racking, you may ask? The answer is the uncertainty of “where?”. How is it possible you do not know exactly where you may be headed for the next few years?

Applications and Interviews

At the beginning of 4th year, medical students apply to their desired residency programs through what’s known as the Electronic Residency Application Service (ERAS). Typically, ERAS applications require personal statements, transcripts, USMLE Step 1 and 2 exam results, letters of recommendation, and the student’s CV. Once submitted, the residency programs review the applications submitted by the students and begin to choose potential candidates for interviews, this occurs between fall and early winter. Given the recent nature of utilizing online calls as the most frequent mode of academic communication, many residency programs have remained opted to perform interviews in this format, while others retain the classic approach of in-person interviews. Through interviews, both parties can assess fit.

Rank Order Lists and Algorithm

After the interviews, students submit a Rank Order List (ROL) to the NRMP, where they rank the residency programs in order of preference. Similarly, the residency programs rank their interviewed candidates according to their preferences. Once done, the rest is simply math.

The NRMP utilizes a computerized mathematical algorithm (don’t ask me how it works, I really don’t know) to match applicants to residency programs, taking into account the preferences of both parties to create the best possible matches. The algorithm is applicant-proposing, which means it will match the student with their highest-ranked preference as long as the program still has an available spot. If you would like to better understand, take a look at this short video provided by the NRMP:

Match Week

Finally comes the most nerve-wracking week, Match Week. It takes place in the third week of March when students find out about their matching status on Monday, and on Friday they are revealed the destination in which their professional lives will take place for the next 3-7 years. 

At around 10:00 A.M. on Monday, students are notified through NRMP if they are matched, unmatched, or partially matched. For a matched student, it is a first big sigh of relief, until a few hours later the student begins wondering where they have matched, and they would have to wait until the end of the week to find out. For an unmatched student, there exists a very fast-paced process known as the Supplemental Offer and Acceptance Program (SOAP). During this process, unmatched students can apply to unfilled positions, and offers are extended to candidates after several rounds of short interviews over a few days.

Usually on the Friday of Match Week, the students gather together along with their envelopes that dictate their next few years. It is tradition for many schools to host a ceremony and have their students open their envelopes at the same time, leading to the rush of emotions many people see in videos of Match Day. It is a day in which many students will reflect on their trajectory, including all of the sweat, tears, and hard work they experienced to get there. A new beginning, the start of their careers as resident physicians. 

Takeaway

Of course, the details of every single step I mentioned would lead me to a much longer article, but I decided to keep it as short and sweet as possible for students to gain a generalized idea of what Match Day is. Although I am a second-year medical student, I conversed with many peers who had just crossed the bridge to matching and becoming physicians in training to provide the information as objectively as possible, along with official information from the NRMP. Knowing the order in which these events take place in advance can help you prepare yourself mentally for what’s to come, and to know when to start creating a strategy to apply for residency. Match Day is a very important day for all students, and I wish the best for all my peers. 

References

Electronic Residency Application Service (ERAS). (n.d.). Application process. Association of American Medical Colleges. Retrieved from https://students-residents.aamc.org/applying-residency/applying-residencies-eras/

National Resident Matching Program (NRMP). (n.d.). Main residency match. Retrieved from http://www.nrmp.org/residency/main-match/

National Resident Matching Program, Data Warehouse. (n.d.). Results and data: 2023 main residency match. National Resident Matching Program.

National Resident Matching Program. (n.d.). How the matching algorithm works. Retrieved from https://www.nrmp.org/intro-to-the-match/how-matching-algorithm-works/