Match Day

The last time I checked in I was at the end of an intense 3 month block of Cardiothoracic surgery. Spending a month each at Brigham and Women’s Hospital, USC hospital and Emory University Hospital. The rotations were called sub-internships (or away rotations) and they marked the beginning of a journey that would climax on Match Day, March 16^th. The last away rotation ended October 20^th. Earlier, on September 15^th I submitted my residency application via the ERAS system. I applied for an integrated Cardiothoracic surgery position. At the time of submission there were 26 such programs and a total of 36 positions offered in the country. My application consisted of class grades and evaluations, board scores, a personal statement, research, volunteer activities and letters of recommendations. Once the application was in interview invites began to trickle over the course of the next few months. 

I scheduled my first one in Ohio at the University of Cincinnati. The night before the interview the program hosted a dinner. These dinners were pretty standard for most programs interviewing. They ranged from casual get-togethers with the residents to fancy formal dinners with distinguished faculty and staff.  I imagine besides the obvious the dinner provided an opportunity for faculty and residents to observe applicants in a more social setting. It was also a chance for us, the applicants, to ask questions that might not be possible to ask on the interview day. Popular questions revolved around cost of living, resident camaraderie and work/life balance. Nerves were high at the beginning of the interview trail. No one knew what to expect of the interviews. Would they be conducted using a conversational style? Would there be ethical scenarios? Would they expect us to suture or answer complicated questions regarding clinical emergencies?  On top of it all we were all strangers to one another. Besides the odd moments of nervous laughter we sat mostly in silence only spared when a resident or faculty surgeon would lead a discussion. I was also very conscientious about proper etiquette when it came to eating. Whether at the dinner the night before or breakfast provided at the interview. In my mind, what was worse than appearing too ravenous/greedy or even worse making a mess! My second interview was in Durham at Duke University and I woke up the day of the interview STARVING. There were 5 applicants, including myself, on that interview day. Once we were all accounted for we were led by the program coordinator to the conference room where we would wait in between interviews. Waiting for us was a mountain a food intended to satisfy the protests of our stomachs and break our morning fast. Yet as hungry as I was I ate like I was on a diet! I convinced myself that if I ate too much I might get sleepy or make a mess on my suit before the interviews even started! Driving to the airport all I could think about was all the FREE food I had passed up on, a decision I mourn to this day! As I progressed through the interview trail these concerns withered and I developed many friendships with the other applicants. 

As just mentioned above, after Cincinnati the next stop for me was Duke University. It was early days yet on the trail and the excitement of traveling the country and exploring new places was still novel. As a big fan of college basketball its was a big deal to walk around the campus and see Cameron indoor stadium! While on the trail I was always cognizant of the fact that I was not only looking for a program to train at but also a city that I could see myself living in and enjoying. 

On of the challenges of the interview trail early on was balancing the travel with my clinical responsibilities. You see, even though we have to interview for the upcoming year and secure employment for after graduation, it is expected of 4^th year medical students to also complete the requirements necessary to graduate. In November, when I wasn't flying I was working in an outpatient pediatric clinic. Fortunately, the pediatricians I worked with were very understanding and accommodating of my interview schedule

After Duke my next stops were to Indiana, USC in Los Angeles and Brigham and Women's in Boston. I became an expert navigating airports and packing light. I was most grateful for getting TSA precheck. With precheck I did not have to take my laptop out of my bag, take off my coat, shoes, or belt when passing through security. What’s more I was often in a separate line that had considerably less people and which moved much faster!

The most difficult stretch during the interview trail came in December. December 4^th I left home and hit the road not to return to Texas until December 16^th. During that time period I would go for interviews at Emory, University of Washington, University of Maryland and University of North Carolina… Now you’re probably thinking this is pretty inefficient traveling! Why doesn’t he just group his interviews geographically so he doesn’t travel back to same area multiple times. You’re right, that would be the smart move… alas, it was impossible! Interview offers trickled in without warning with schools usually offering only 1-2 interview dates. What was maddening was that some programs seemed to offer more interviews than interview spots available. Even worse these spots were then awarded on a first come first serve basis. This came as a shock and became a challenge while on my away rotations as I would find myself in the operating room when interview invites would be sent out. So I devised a plan to have offers forwarded from ERAS to my email and have several people checking sporadically to ensure I would be amongst the first responders should I receive and invitation! Now, even though there are only 26 integrated Cardiothoracic residency programs I discovered interview schedule conflicts were a major issue! It was not uncommon to find interview dates of some programs overlapped, forcing applicants forego one for the other. At times I felt planning out my interview schedule was akin to solving a Rubik's cube puzzle!

In January I started emergency medicine and continued along the interview trail. I worked closely with my medical school to create a schedule that allowed me to attend all my interviews that month while satisfying my clinical duties. I started off  2018 with an interview at the University of Pennsylvania. From there I visited the University of Texas Health Sciences Center in San Antonio, Stanford and University of Pittsburgh. By this time I had become quite familiar with many of the applicants on the trail and the prolonged silences that prevailed at the beginning of the interview process were replaced the sounds of joyous reunion. My last interview was at Yale on Feb 3. It was a great way to bring and end to my travels. Many new friends, cities explored, airports navigated and hotels/airbnbs later my interview season came to an end.

It was a welcomed relief to stop traveling and it provided an opportunity to reflect on all the programs I had visited and begin to consider the order of my rank list. The important dates to consider at this point were February 21^st ( Rank submission ), March 12^th (Match Monday) and March 16^th (Match Friday). What is match you ask? I dropped a link in my previous post that gave a brief explanation... but a little staggered repetition is good for the memory. Fair warning its kinda complicated to explain… *Takes deep breath* …. So the applicant (me) gets a chance to rank all the programs interviewed at, in order of preference. At the same time programs have the opportunity to rank all the applicants it interviews. In both cases the longer the rank list the greater chance of a successful match (or outcome). So on Feb 21^st both program and applicant submit these preference rank lists. From then until March 12^th a computer algorithm works its way through all of this data and attempts to match each party to their highest available preference.

Here's the same link that shows an example of the matching process... http://www.nrmp.org/matching-algorithm/

Okay! Hope you’re still with me here. On Match Monday applicants receive an email telling them whether they have matched or not. If the applicant matches, great. They are rewarded with a week of nervous waiting until Friday before they are informed on WHERE they have matched. If the applicant does not match (meaning no program that they ranked had them ranked high enough on their list to match) then they have an opportunity to go into the SOAP (supplemental offer and acceptance program). Briefly to explain the soap, applicants who did not match are shown the programs from all specialties that have available spots remaining that went unfilled in the match. They have an opportunity to apply and be interviewed for up to 45 of these positions. Then on the Wednesday and Thursday of that same week they may be offered a position at one of these programs. 

On Monday I received an email informing me that I had indeed matched and I began the anxious wait for Friday for the other shoe to drop! The week was spent celebrating with classmates over the tremendous achievement of matching, the culmination of 4 years of hard work throughout medical school. We used each other and the festivities as distractions to ignore the building nerves as match day drew closer. My younger brother, Tolu and my Mom traveled down to Galveston to experience the medical field’s version of march madness with me. The whole thing was quite a spectacle. The Match day ceremony was held in Levin Hall, the biggest auditorium on the school campus. The fate of over 200 fourth year medical students sealed in envelopes waiting to be opened.

In an attempt to further spice up an already colorful day, students names were called in random order. Applicants would then walk down collect their envelope, drop a dollar into a jar and stagger back to their loved ones, hands trembling with nerves and excitement. The monetary contributions were reserved for the last student called. A reward for enduring the suspense. Faculty came together to donate another generous sum to the student called second to last… When was my name called? Third to last of course! Classic.

From the first name called the room was buzzing! The atmosphere was full of tension, joy, disappointment, disbelief. Everywhere you looked you could see friends and family crowding around students, phones at the ready as they ripped open their envelopes. It was so loud that I could not hear the names as they were being called towards the end and I was afraid I would miss my announcement. However, when my envelope was finally in the hands of the MC I saw him hesitate like many people who have tried to pronounce my name before him. He held it afar and then brought it close as if changing the distance from his eyes would make the pronunciation easier. He began to sound it out... O-lu-wah-toe-mi-sin. Before he could finish I was already halfway down the stairs to relieve him of the envelope and its precious contents.

As I made my way back up to my mom and brother I tried to breathe normally and not to show any outward signs of nerves. I passed the envelope to my mom, giving her the honor of revealing the location at which I would be continuing my training as a Cardiothoracic Surgeon.

Below is a raw footage. The pure disbelief and joy plainly written on my face….

I give all glory to GOD. The journey wasn’t without its highs and lows but he made the end result possible. Two days later I find myself sitting on a plane typing out this post headed to South Korea then Japan for 3 weeks! The reality of the past few days has not yet set in but I'm sure it will as I reflect over the next few months 

Wow.

나중에 봐요.

(bye for now)