a miss match?

Today, like any other day, at a hospital people are born, come in sick, leave stabilized, die. Like in any teaching hospital, today is a day when many find out if they have been accepted, or not, into a residency program.

According to “On Becoming a Doctor” by Tania Heller, MD a Fellow of the American Academy of Pediatrics, the process for Medical Students and for Foreign Medical School graduates is based on applications whereby you are reviewed for qualifications and those “wow” factors like fluency in more than one language, projects completed both domestically and internationally, extra-curricular activities such as summers at a clinic in poor or crisis ridden areas, career goals, etc., all depending on the program’s criteria and the hospital’s ‘culture’. “Residency programs review each applicant and may invite an applicant for an interview. After completing interviews, the student [and foreign graduate] ranks his choices and submits a rank-order list to a central service, the National Residency Matching Program (Match). The residency program also submits a list to the same service. A computer matches students to programs based on the submissions, and on a specific day in March, the results are announced.”

Having experienced by proxy the anxiety that-certain-day in March can provoke, I can honestly express the turmoil that can result when you get the news. My husband was literally paralyzed that day. The man couldn’t even have bite to eat, he was so nervous. The million and one thoughts crashing against each other: Did I put down all my choices? Did I rank them properly? Were my interviews as great as I thought they were? What ever compelled me to want to become a doctor in the first place?!

Then the moment comes- and you hear those words- your selection or your failure. Those who are matched run the gamut from ecstatic to miffed because they did or didn’t rank where they thought. Those who are not matched, however, are faced with some deep, heart wrenching decisions to make. Their lives are now defined by it in some ways, and they have to calmly (something easily said, never done) assess their options and hopefully move forward.

My husband got matched to the program he had ranked second. He had put his hopes on four programs and was actually surprised in getting his second choice. He, until that moment, believed he would probably get into the fourth choice. So for us it was a cause for celebration. It would be the beginning of many sleepless nights for me- my husband being the bigger insomniac didn’t feel it as much. I kept pumping him with lots of energy rich food to keep up his stamina.

During the first two years we set up the routine that we still maintain to this day. The ‘Friday night’ not followed by an on call the next day was our night out for movies and dinner- with no shop-talk, no exceptions. Being a couple who dealt with healthcare from two different sides can have tremendous disadvantages- all we talk about IS healthcare. We understood it and promised each other that we would create a space where the term would be left out so we could enjoy other things. Going to the opera, the ballet, going for walks, dining out, playing a sport were all activities that we did in that space. It helped us survive residency as a married couple.

The other disadvantage in our case was my husband going to medical school when others his age were half way through their residency or in a Fellowship program. That added an additional burden. As well as being a Yemeni immigrant during a time when education was the least of the priorities for many of his compatriots. The men he knew from his village would go into factories or stores. Not much has changed since. Everyday more come to be those seasonal immigrants- living with one foot here and everything else in Yemen. It continues to be a topic of conversation that invariably makes my husband upset because of the “yemeni group-think” so prevalent across their country and more so in the mountains. He has “bucked” their version of traditional work and social roles. You should see the thunder cloud that descends upon his face when he is introduced to fellow Yemeni and they ask him what store he works in. Now that, is not a pretty scene.

For those that find themselves without a residency program match, that-certain-day in March can spell doom for them, depending what was riding on the outcome. This happened today with one of our volunteers. Educated in the Philippines this volunteer came to New York with her husband. He was chosen for a residency program from the-get-go last March. She applied this year. The outcome was not what she expected. My boss wrote to me, when I gave him the news, that a few things may have affected her chances and now she would have to regroup and build strategies for the road ahead. But, he said, he was not surprised: She should not have taken “the year” off. My husband echoed the same.

She was too upset to talk beyond saying that she was not matched. We told her to come in and we would help her plan next steps. But somewhere in there I wonder if being “the doctor’s wife” took some wind out of her sails.

It is not exactly easy being the doctor’s wife when your chosen career is the same as your spouse. Heck, its not easy even if you’re your spouse’s opposite. But it is less competitive. There is more room to maneuver within your relationship. Other professions, obviously, can be just as competitive or more so, but my opinion comes from experiencing two different professions in my husband alongside mine.

I hope she will be open to suggestions from our medical staff and from our administrators, whatever they may be in whatever ranges are proposed. There are options, I hope she sees them for what they are.


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