What Nobody Tells You About Match Day

Alexa M. Mieses, MD, MPH


February 20, 2019

Three years later, I still remember Match Day as if it were yesterday: the excitement and anticipation, the nerves, and feeling as though my stomach was in my throat as I glared at the envelopes resting on the table in my medical school's lobby. My medical school had a very informal ceremony. After a few words of encouragement from our deans, envelopes containing our individual match results were released at once at a certain time (a time mandated by the National Resident Matching Program [NRMP]). Then we were permitted to go and be free to celebrate or cry wherever we wanted.

Some took their envelopes and went home without opening them. Others took their envelopes and opened them in a circle with close friends. I had two friends with me on Match Day for support. As soon as the envelope touched my fingertips, I eagerly opened it. I was so excited that my hands shook. As I read the results, I was overcome with emotion. Tears spilled from my eyes, and I hugged my friends, as I learned that I matched to my top-choice residency program. It felt as though a lifetime of work had finally paid off in that moment.

This process is supposed to be a time of great excitement. And it is. However, a lot of people do not openly talk enough about the emotional roller coaster that is Match Day.

You, or Someone You Know, May Not Match

The NRMP is a private, not-for-profit corporation, established in 1952 to optimize the rank-ordered choices of applicants and program directors. It was created to help formalize the Match process. Around 1975, the total number of applicants surpassed the total number of PGY-1 slots available for the first time. In 2018, 96.2% of slots were filled, making it the most successful Match year ever (successful for the programs that had slots to fill). However, this also means that many applicants did not match.

Last year, more than 1200 slots initially went unfilled, as unsuccessful applicants "scrambled" in the Supplemental Offer and Acceptance Program (SOAP) to find a residency training position. Only 31.6% of independent applicants matched to their first-choice program. As you can imagine, this is one of many things that will stir up emotions come Match Day.

The weeks, maybe even months, leading up to Match Day are nerve-wracking. Some people have worked their whole lives for this moment. Others have worked for at least all 4 years of medical school to get into the residency program of their choice. It can be exciting, scary, and intimidating. While some people wonder whether they will match to their top-choice residency program, others worry about not matching to a residency program at all.


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