There are few more memorable days in the life of a medical student than the third Friday in March, known as “Match Day.” It is the day when, precisely at noon, medical students open envelopes to reveal where they “matched” for their upcoming residency training at hospitals all around the U.S. In the 69-year history of the “Match,” this year feels different.
Each year the process works as follows: Having chosen their specialty — pediatrician, surgeon, psychiatrist, internist for example — 4th year medical students visit potential residency programs. After these visits, both parties submit their rankings of each other, which is then entered into a computer program whose function is to match both sides with their top choice as mathematically optimal as possible.
This process is essential for the continuous renewal of the estimated $4 trillion U.S. health care system. After graduation from medical school these new doctors need to continue their education in order to become future licensed professionals — “heroes” as the public and the media dubbed them last spring. Hospitals are mandated to adequately prepare these trainees for their future medical careers and to provide necessary care for hundreds of thousands of patients every day. This annual rite of passage is needed to continuously develop the next generation’s Anthony Fauci.
So why is this year different and how did the process leading up to Match Day on March 19 work in this “virtual reality” year? Because of travel and other restrictions due to the pandemic, most residency interviews occurred via Zoom. This means that unlike previous years, medical school graduates will start their work having never physically visited their residency program.
In the long and arduous conveyor belt that is medical training (11 years on average), this match is surely a natural experiment. Unlike other graduate programs such as law or business, where interview requirements before admission are not universal, the in-person interview has been an integral part of both the medical school and residency selection processes.
Think about what will happen a few months from now. Fourth year medical students, like so many other seniors, will attend their spring graduation virtually. They will then be packing up their well-worn anatomy and pharmacology books, their white coats and stethoscopes and they will travel to a hospital and city many have never actually been to before. When they arrive, they will be greeted by doctors and faculty who will shape their careers in innumerable ways but whom they only likely met once on a small computer screen.
And despite all the unforeseen delays and detours the rest of the world faced over this past year, the official start of residency, referred to as internship, will still take place as scheduled on July 1.
Given all these modified matching rituals, I expect those running the roughly 11,000 U.S. residency programs who will greet their new doctors — coming from medical schools around the pandemic-stricken world — to feel a special affinity for them this year. Anxiety will be especially high. On top of the usual “first-day-at-work” jitters and “new doctor” trepidation, interns this year will also have to quickly repurpose their pandemic fears in an ever-evolving “stay six feet apart” health care landscape.
What is clear is the strength and determination of these medical students and, for that matter, all new trainees who are prepared to devote their lives to help others. In speaking with my colleagues across the country this year’s students and current residents have displayed an even greater sense of purpose, vigor, resilience, opportunism and poise in the face of adversity and uncertainty. These are important qualities every doctor should have.
Whatever the reason, and there are many, patients and their families should breathe (with their masks on) a sigh of relief in knowing that these new doctors — who will be saving your life, helping you cope, listening and caring, putting you back together physically and emotionally and often doing so in the middle of the night when they stay overnight in the hospital “on call” — are ready to face the public health and medical challenges put before them.
And if a pandemic won’t stop them, I believe nothing will. In fact, I would argue that it may turn out to be a perfect Match.
Dr. Alan M. Langlieb (firstname.lastname@example.org) completed his training in psychiatry, preventive medicine and public health at Johns Hopkins and teaches residents and medical students at Georgetown.