Perhaps the biggest event in all of medical education outside of graduation itself is match day. Match day is the day during fourth year when medical students across the country find out where they have been accepted for residency. In many ways, it is like a professional sports draft; students file past a large table of envelops to receive theirs, not knowing what residency program they've matched to until they open that powerful letter. A little background on the match process...
Students initially register for the match process in their fourth years with the Electronic Residency Application Service (ERAP), and through the fall and early winter of fourth year interview with the residency programs in the specialty field of their choice/interest. By early January, students begin to submit a rank list of the programs they are interested in, in order of interest. The programs that they interviewed with then submit a rank list of students they wish to accept as new medical interns. A computer then "matches" each student with the program that is the closest match in terms of ranking. For example, if the program you rank #1 also ranks you at the top, or at least closer than the program you ranked #2 ranked you, then you match there (i.e. - ranks of 1 and 2, or 1 and 3, are closer matches than 2 and 6, for example). On Match Day, the third Thursday in March, students receive their envelops which inform them of their residency placement.
It was exciting to stand atop a bench in the Atrium of the medical school and gaze out on all the familiar faces I have seen and people I've known in the last almost two years. First through fourth years were present, along with families, friends, husbands and wives, doctors, residents, mentors, and many more as well. Many hugged, some kissed, some screamed for joy, some cried tears of happiness, some of sorrow. To think that I will be one of the many students receiving their match in the next two years suddenly seems so very close and near. It is not far in the future that I will be transitioning from student to working physician. It's a little scary, in many ways.
As I see more and more patients through APD, I am feeling more and more comfortable with doing a history and physical exam (although I still have far to go before I can be considered expert in proficiency or efficiency). My depth of knowledge is gradually growing, almost it seems on it's own. My ability to learn seems to be getting better as well, as I become better at determining what is most important to remember, and being able to put what I know with what I observe clinically. Still, the idea of being the person who will make the call on how to treat a patient is something that strikes a chord of fear in me. What if the patient asks me a question I can't answer? What if I don't know what to do? What if I make a mistake? What if I have to tell them I messed up? What if I can't, because they died from my mistake? Those questions, if you could tell, gradiate the level of fear that comes with being autonomous in the care of your patients. For the time being at least, even through residency, I will have the safety net of an attending supervising me. It will thankfully be a good five years or more before I remove the training wheels.
