This came out in the weekly journal published by Stanford Medical School's Communication and Public Affairs Office. I am sharing this article as written and published by the School of Medicine, and after reading this, i feel so much more towards the medical school graduates in this country who have put themselves through graduate school, the residency program on their path towards becoming physicians and they do deserve the earnings they make later on as doctors.03/21/06
And the envelope, please: An award ceremony for doctors in which most are winnersBy JONATHAN RABINOVITZ
Only a few minutes after Gina Perez-Baron opened the envelope, the weight of the one-page letter inside it hit her like a ton of bricks. “I can’t believe this,” she said, tears streaming down her cheeks. “I was a secretary.”
It had been a long road to get into and complete medical school, but on March 16, Perez-Baron, along with her classmates at the School of Medicine, saw where the journey had taken them: The envelopes held the notice of which hospitals and medical specialty programs had selected them to join their staffs after they graduate in June.
“It sounds strange since I’ve been working towards this full-time for the last 12 years, but you get so busy that you forget that there’s an end goal,” remarked Perez-Baron, who after working for a decade as a receptionist, temp and scheduler went on to become the first in her family to earn a college degree.
Yet within moments of opening the envelope what she had achieved became very real. “Suddenly it’s staring you in the face, black ink on white, and the place has a name, and the words get stuck in your throat, and the tears come as you realize, ‘They weren’t kidding—I'm gonna be a doctor!’” she said.
Perez-Baron, who turns 40 years old later this month, had gotten her dream job. She would be training as a family practice physician at the Contra Costa Regional Medical Center in Martinez.
The ceremony is officially known as Match Day, but some refer to it as D-Day, the Academy Awards of Medicine or the NFL draft for doctors. On that morning, upcoming graduates of medical schools nationwide learn where they will do their residency training and start their careers as physicians. This year, 15,008 students at U.S. schools—including 96 from Stanford—participated in the process, along with about 8,000 others who have already completed their medical studies or are coming from medical schools abroad.
The assignments are made by a nonprofit organization, the National Resident Matching Program, using a computer algorithm to align the preferences of applicants with those of the residency programs. Medical students started the process last year, when they interviewed at different programs. Then, in February, they submitted a ranked list of where they would like to go, while program administrators submitted a ranked list of whom they would like to have. After that, it’s all a matter of mathematics as to who goes where.
But to simply boil it down to an equation would miss the gravitas of the decision—and the amount of energy that students invest in selecting their top choices. On the morning of the big day, about 150 people gathered in the lobby of Fairchild Auditorium, noshing on bagels, lox and quiche from a breakfast buffet. Some had brought children and spouses; others parents and grandparents. Perez-Baron had brought her dog, Maya.
Dean Philip Pizzo, MD, addressed the gathering, acknowledging that they probably all wanted him to be brief so that they could get to the business at hand. “It is 93 days to graduation,” he said, “but in the long run I doubt any of you will remember that day as much as this one: Match Day is transformational.”
Transformational with some very real-world drama, noted Kendra Bowman, whose match would radically affect the job prospects of her partner, Wayne Corzan, a postdoctoral fellow in neuroendocrinology. She had ranked 10 places for a residency in general surgery, but some of her choices would not be conducive to his research. “He had been kind of half-joking that he would go into real estate or fix cars,” she said.
When Bowman opened the envelope, however, she had gotten her first choice, the program at the University of Michigan-Ann Arbor, which would afford Corzan the opportunity to continue his work as well. She soon was hugging other classmates, as she exchanged congratulations.
Bowman said that she had been nervous in the weeks before submitting her rankings but had slept soundly in the three weeks since then. “I felt pretty good about the possibilities,” Bowman said. “It was like opening a gift at Christmas.”
Not everyone felt the drama that day. Kahealani Rivera strolled over to the event in her blue scrubs, having just intubated a patient as part of her anesthesia rotation. She was confident that she would be returning home to Hawaii, another student in the Stanford class who was the first in her family to graduate from college, not to mention medical school.
It had been difficult to decide what her first choice would be a few weeks earlier when she had to place her rankings online. She had been tempted to pursue a high-powered career in one of the specialties for which Hawaii has no residencies. But she also wanted her 2-year-old daughter to grow up among her cousins, aunts and uncles.
“I had to dig deep into myself and think about what was going to best for my daughter,” said Rivera, who at age 27 had to decide what her lifetime priorities would be. “You can’t always have everything you want, and I decided that family comes first.”
So when she opened her envelope to learn that she had received her residency in internal medicine, she was perfectly calm. “Cool,” she said, and held up a finger for No. 1.
Nationally, 84.6 percent of students matched to one of their top three program choices, with 60.1 percent getting their first choice. At Stanford, according to a preliminary review from the dean’s office, showed that 92 percent matched to one of their top three choices, with 80 percent getting their top ranking. While a few students are notified ahead of time that they have not matched and need to scramble to find an opening, the vast majority come to Match Day knowing that they have gotten one of the programs on their list.
Still, if you have a rankings list with dozens of programs, there’s plenty of room left for concern. And that was the case for Erik Bekkers, 31, and Kerri Rieger, 30, who met during medical school and were married in October. The two of them—both of whom are graduating MD/PhD students—were doing a couple’s match, which meant that the system would try to keep them together but that they had to submit a plethora of combinations.
“I’m very nervous for us,” Bekkers admitted a few minutes before receiving his envelope.
Rieger smiled at him. “That’s typical,” she said, brushing aside his worries. “As long as we’re together, I’m happy.”
A half-hour later, they were more than happy. “It’s a miracle,” said Bekkers. “I’m in shock,” added Rieger. They had received their first choice, placing in residency programs at Stanford, him in radiology, her in dermatology, following a yearlong transitional internship at Santa Clara Valley Medical Center.
Terrence Blaschke, MD, associate dean for medical student advising, said that it never gets to be old hat to watch the students open the envelopes. “We all get a little nervous,” he said. It brings back memories of 1968 when he and his wife did a couple’s match, In some respects, he said, not much has changed since then.
But one difference is that in addition to the laughter and tears, hugs and kisses, high fives and anguished expressions, students now are on their cell phones to friends and relatives around the world within seconds of learning their fates.
Within minutes of getting the news, 29-year-old Phuoc Van Le, his wife Erin and his 13-year-old sister Jennifer, whom the couple are raising, ran outside to begin their calls. “We did it,” he told one friend. “We’re going to Boston.”
A few feet away, Erin, a second-grade teacher in Sunnyvale, began to tell a relative, “It hasn’t sunk in yet .... My life was being held hostage in an envelope.” Jennifer just beamed. She had, after all, gotten the morning off from school, and they were now moving to what had been her brother’s first choice: a combination residency of pediatrics and internal medicine at the hospitals affiliated with Harvard Medical School. He already had a plane ticket to Boston and would be flying out in a matter of days to begin looking for a home.
Around the corner, Perez-Baron and her classmate Ana Miranda were also talking into a cell phone on speaker mode to a third student, Jaime Garcia, who had not been able to make it to the event. All three had gotten their first choice, and Perez-Baron said they were overwhelmed.
“It’s finally real, and we’re all in a state of total disbelief,” she said. “It sounds very hokey, and it is, but it’s how it feels—very cool, very surreal, completely overwhelming—and all you can think is, ‘Wow’ and ‘Oh God, I should’ve studied more.’”
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