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Matched!

E-mail | Print | Comments () Posted by Ishani Ganguli March 18, 2011 03:44 PM

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Short White Coat is a blog about learning to be a doctor. Posts appear here as part of White Coat Notes. Ishani Ganguli is a fifth-year Harvard medical student. E-mail her at shortwhitecoat@gmail.com.

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With the flip of an envelope lid, the next three years of my life flashed before me. I found out at noon yesterday, Match Day, that I’ll be in the 2014 class of Massachusetts General Hospital’s Internal Medicine/Primary Care residency program.

Thus ends a seven-month courtship that began with personal details -- photo, narrative, letters, and numbers -- sent through a centralized service to programs each of us had selected in our chosen specialty. Throughout the winter, we visited these sites, students feeling out program directors and vice versa. Sometimes, notes and phone calls were exchanged.

Last month, we told the service which residencies we liked, the residencies told the service which of us they liked, the matching algorithm did its thing, and voila, on the third Thursday in March, we received notice of our training program soul mate, printed in Times New Roman on a single folded sheet.

For medical students, Match Day can be exhilarating or deeply disappointing. Some schools create pageantry around the event, asking students to come up to the mike in front of an amphitheater of classmates to receive and read aloud their results. Others, like Harvard, simply pass out the envelopes and serve lunch. Either way, I felt a bit strange, even queasy, having my future handed to me like that, perhaps because I had no control, no undo button, at this stage of the process.

But there was method to the strangeness. The match was created in the 1950s in response to concerns that the frenzy to recruit residency applicants had pushed less competitive programs to require commitments earlier and earlier, to the point that the market unraveled (in econ-speak).

Recently, I visited Harvard Business School’s Al Roth to ask him about the matching calculation. He likens the process to the romantic version of matchmaking. Students get preference in this algorithm, he told me: To extend the metaphor, they "propose" to their first choice program and if not accepted, move to the next one on the list.

"We’re trying to get an outcome of the match that people will accept voluntarily," says Roth. "What that means is that if you [the student] get your third-choice residency, it’s because your first and second choices got people they liked better than you."

In 1995, Roth was asked to redesign the match to allow couples to match in sync, and he says he jumped at the chance: the residency application process was the ideal substrate for a stable matching algorithm, with its neatly contained sets of students and programs to link together.

Now that the algorithm has calculated my future, the reality is slowly starting to sink in that in just a few months I’ll be an M.D., with a salary, working across town in a program that I love. I’m grateful and excited, giddy and just a bit terrified.

tags Match Day, medical education, medical school, residency

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About white coat notes

White Coat Notes covers the latest from the health care industry, hospitals, doctors offices, labs, insurers, and the corridors of government. Chelsea Conaboy previously covered health care for The Philadelphia Inquirer. Write her at cconaboy@boston.com. Follow her on Twitter: @cconaboy.

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