NRMP | wellnessrounds

Like every doctor in the United States, I remember every detail of my “Match Day” …..The envelopes with our match results were placed in our mailboxes sometime during the morning. The entire class crowded in front of the mailboxes until the dean announced it was time. The doors were opened, envelopes were torn open and cheers erupted as we (finally) knew where we would be training!

Every medical student knows this process cold, but for their families and friends, here’s what this year’s graduating class went through to get to this moment:

Sometime last spring, students made their final specialty choice. Over the summer, they filled out the Electronic Residency Application Service (ERAS) application, made sure letters of recommendation were submitted and met with their dean to provide information needed to complete their Medical School Performance Evaluation (MSPE). From October through January, they travelled around the country visiting programs that offered them an interview. Last month, they ranked those programs in their order of preference and signed off on the final list. At the same time, the residency program directors submitted a list of the applicants they interviewed in their order of preference.

And then we all waited….

Today is the first day of “Match Week.” The National Resident Matching Program algorithm has been run with the goal of placing every graduating medical student in the United States into a residency training program. The system works well, with more than 95 percent of residents successfully matching to programs. For the few that don’t match, there is a second opportunity to match through the “SOAP” (Supplemental Offer and Acceptance Program), which will take place this week.

On Friday, our team from the Office of Student Affairs will take the envelopes containing the match results for our 189 graduates and staple them to two large boards. The boards, covered in paper, will be taken to a courtyard while students, family, faculty and friends gather. There will be congratulations from Dr. Klotman, the president of BCM, short speeches from the deans and comments from the class president. The class may (or may not) have a surprise as part of their celebration, like last year’s flash mob. And then, at 11 a.m. sharp, the class president will tear the paper from the paper from the boards, the envelopes will be opened…and the celebration really begins!

Congratulations to everyone matching this week and to the family, friends, faculty, Program Directors and Deans who make this possible!

This post appeared originially on BCM Momentum, the blog for Baylor College of Medicine.

By January of the 3^rd year of medical school, most medical students have had rotations in 3-6 medical specialties (out of the 145 specialities in medicine). With what feels like really limited knowledge, they have to decide on their specialty and move forward. They apply through the NRMP in the summer, interview at training programs in the fall, and in March go through “the match” to find out where they will train.

I started off believing that if you pay close attention, you will find the specialty that is “right” for you. Cal Newport, in his book So Good They Can’t Ignore You: Why Skills Trump Passion in the Quest for Work You Love, calls this the “Passion Hypothesis”. The “Passion Hypothesis” states that “the key to occupational happiness is to first figure out what you’re passionate about and then find a job that matches this passion”

I moved past the “passion hypothesis” as the sole way to choose a medical specialty when I realized that there were other variables like debt and family obligations that were important, too.

Here’s where I am now….

There may be a few people who have a lightening bolt hit them and know instantly what specialty they should go into, but they are few and far between. Most people gravitate in a direction without a clear destination i.e. more medical than surgical, more procedural than not, more or less direct patient care, children vs. adults. At some point they pick a specialty that is in their “zone” of interest…. and then they worry that they haven’t seen enough specialties or they may be making a bad choice.

“The more I studied the issue, the more I noticed that the passion hypothesis convinces people that somewhere there’s a magic “right” job waiting for them, and that if they find it, they’ll immediately recognize that this is the work they were meant to do. The problem, of course, is when they fail to find this certainty, bad things follow, such as chronic job-hopping and crippling self-doubt.” – Cal Newport

Here’s where it gets interesting.

What Cal Newport explains in his book parallels what I have seen in the happiest physicians I know, regardless of their specialty. We have all seen the chief resident or seasoned attending light up when they learn something new at 2am, or when the complex diagnosis becomes clear with steady, deliberate investigation. Cal Newport calls this the “craftsman mindset”. It’s the process of devoting yourself to deliberate practice in order to master your field. When you adopt the “craftsman mindset”, the passion follows. Or, as Cal Newport summarizes it “working right trumps finding the right work.”

If you want to love what you do, abandon the passion mindset (“what can the world offer me?”) and instead adopt the craftsman mindset (“what can I offer the world?”) – Cal Newport

As I’ve thought more about it, I have also begun to wonder if picking a specialty isn’t somehow similar to how we choose the important relationships in our lives. You may fall head over heels in love with another person or slowly realize you have met the person you want to spend you life with – but either way, the real relationship comes with time and “practice”.

One other thought, if you are currently struggling with your specialty choice.

There are no bad choices.

All the specialties in medicine are noble and important. It’s a privilege to serve others… and we need all the specialties to be able to do it well. Take the plunge. Make the best choice you can and then devote yourself to being a craftsman in that field.

Cal Newport video from Authors@google.com