What We Get Wrong About Match Day

Liana Meffert


April 13, 2022

If you think about it, nearly 4 years of concerted effort and sacrifice comes down to a single moment. How many times does something like that happen in your life? The crossroads of life are never so clear.

If you have a poetic lean, this scene might inspire recollection of Robert Frost's "The Road Not Taken": "Two roads diverged in a yellow wood, / And sorry I could not travel both / And be one traveler, long I stood…"

Changes tend to occur gradually, so much so that your choices hardly ever feel like choices at all. You don't swerve; you drift and try not to drive off the road.

No college or medical school offer was ever binding the way that submitting your match rank list is. Any other life trajectory–shifting decision I've made has been a series of options from which I chose just one. In matching, you have one offer that you have already ranked on the basis of preference — you just don't know which one. It's thrilling and terrifying, and we can do better.

It was only in the last few months that I started thinking about how Match Day would go. To those who are less familiar: You walk up to the center of the room (or stage), you get an envelope (you also get an email, but it feels vital to hold the thing deciding your future), and then your tear it open.

In the time between getting the envelope and finding a spot to open it, you might feel ready for the waiting game to be over or are already missing the minute before, when your future was an unnamed horizon line with 15 independent scenarios across eight states.

My partner and I were both matching this year and we already had a plan; we would find a quiet spot and open our letters together. This felt like anything but a public event. It felt as deeply personal and life-changing as it was.

Of course, not everyone will feel this way. Match Day is a public celebration for the school, the students, and so many others. A friend once commented, "It takes a village." We only become doctors through the support of a large and deeply invested community. It's also seldom that we get such opportunities to savor our successes (or allow ourselves the chance).

Until last month, my concept of this day only encompassed the pictures that medical schools advertise on their websites: parents crying, friends hugging, soon-to-be graduates waving their match letters in the air like Charlie's golden ticket. It was all smiles and success and congratulations and "Look: all of my hard work has paid off just like I'd hoped it would."

This is what you don't see: My friend who didn't match that didn't come to the celebration. Or maybe more heartbreaking, my friend that didn't match and did come. I fully expected that they would both be opening match letters with me that day, as I think they envisioned too, but that didn't happen.

The American Medical Association reported recently that 28% of medical students (MDs and DOs) don't get their first, second, or third choices. Furthermore, for the 2022 match cycle, about 7% of US MDs and 9% of DOs went unmatched.

People don't match for myriad reasons, and with the ever-changing landscape of residency interviews — all of which were virtual for the second year in a row — the process feels even less predictable.

On Match Monday, medical students find out whether they matched and wait an excruciating 4 days to find out where they matched. I thought hard about what would happen if I didn't match. I'll admit, my first thought was what others would think. I knew I had worked hard and done well by my own standards, but it felt like matching to residency was the final arbitrator. The lines between success and failure felt terrifyingly stark.

And then one of my closest friends didn't match, and I found myself following another line of thinking. It felt more like a system error with a multitude of unknown variables: where she applied and who else applied and interviewed, who read her application and who didn't, who mentored her, and who those mentors knew. I never once doubted her future capabilities as a doctor, and I told her as much.

Until now, the successes and failures of medical school have mostly been kept from public view. It's a pervasive theme throughout competitive academic cultures. Most medical students only share grades or board scores with their closest friends, if at all. Asking someone's exam score is like asking about their credit score. We are all shut doors, toiling away behind them. But Match Day is the grand reveal.

My partner and I are happily matched (in more ways than one). Hard work and a little luck were on our side. But what if they hadn't been? Just as important as it is to provide the space to celebrate and revel in student successes, schools need to provide for the students for whom this day falls short of their expectations. I don't have an answer, but I've witnessed firsthand the bittersweet pain of one friend's joy and another's disappointment standing side by side. This is a great day for many and a Kafkaesque nightmare for a few.

We need to reconsider what this day means for all students, not just some. This should be an opt-in day, not an opt-out one, where students who successfully and happily matched can join in the celebrations, while students who need space and time to reconsider what the next year has in store for them can have that time, away from their celebrating peers.

I know that Match Day is done similarly across the country and is deeply rooted in tradition but if I had a vote, I would open that letter at home. No matter what Match Day brings, it's a magnificently abrupt pivot for every graduate. It's time to create space for those who take the road less traveled.

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About Liana Meffert
Liana Meffert is a fourth-year medical student at the University of Iowa's Carver College of Medicine. She has previously been awarded an Academy of American Poets Poetry Prize, Stanford's Irvin David Yalom Literary Award, University of Iowa's Carol A. Bowman Creative Writing Award, honorable mentions for the William Carlos Williams Poetry Award, and the F. Sean Hodge Prize for Poetry in Medicine. Her work has been featured in The Examined Life and The Healing Muse, among others.


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