Residency and the Match

I am asked about how a medical student gets accepted to a residency program once they finish medical school. I will try to explain the complicated process here.

It is called the match. During the 3rd year of medical school you rotate through all of the required rotations for 1 - 2 months per rotation. The rotations include surgery, internal medicine, pediatrics, ob-gyn, family practice, psychiatry and some others. While doing these rotations you work as a "doctor in training" seeing patients and learning how to be a doctor. During these rotations you are supposed to figure out what kind of doctor you want to become.

The 4th year of medical school is about doing rotations in the specialty you want to go into and doing other electives that may relate to the specialty you want to pursue. There are some required rotations during 4th year as well. I want to go into emergency medicine so I have done several rotations in emergency medicine. Another strategy during 4th year is to do the rotations in your specialty of choice at programs that you are applying to so that the program can get to know you and you can see if you like the program as a potential place to train at for residency.

In the beginning of the 4th year you apply to programs in the specialty you have chosen and hope to get interviews. Depending on the specialty and how competitive it is, you may apply to a handful of programs or many programs. Once you have completed your applications you sit back and hope that you get several interviews. If a residency program is interested in an applicant they will offer an interview to the applicant. You go to the interviews and check out their residency and you try to impress the program.

Once you finish all of your interviews you submit a rank list in oder of where you want to do your residency. For example; if you have 10 interviews that you went to, you would rank these programs from 1 - 10 (1 being your top choice and 10 being your last choice. The residency programs rank the applicants that they interviewed. Often a program will interview 100 applicants and so they will rank the applicants from 1 - 100 (1 being their top choice and 100 for their last choice). On a certain date the all of the rank lists are due and processed by a computer program.

Then about half way through the 4th year of medical school there is a match day where you receive a letter with the rest of the nations medical students and you open it to find out if and where you matched. You can only match at 1 residency program and you are contractually obligated to train at the program you match at and they are obligated to take you as a resident. Every year there are many students (even competitive applicants) that do not match for one reason or another. There is a program called the scramble where residency programs who did not match all of their spots and unmatched applicants can call, fax, and email each other to try and get a spot or fill their residency program.

It is a rather complicated process but it has been used for years and seems to work well. Basically the program you rank the highest that ranks you high on their list as well will be where you match. The match day is a very exciting day because you find out where your next several years will be spent.