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I Didn't Match At My First Choice

Match Day is an exciting time. It is the culmination of many years of hard work as an undergraduate, pre-medical student, and medical student. Come Match Day, our Facebook feeds fill up with smiling faces from our friends and classmates: "I matched!" "I'm going to my #1 pick!" "I'm going home for residency!" On the flip side, every year approximately 6% of U.S. allopathic seniors (and 20% of applicants overall) don't match, and while some are able to obtain a position through SOAP, many have to figure out how to navigate the unclear path that lies ahead. Fortunately, as a medical community we are talking more about this process and how to deal with it more and more.

I'm writing now for the medical students who fall in the middle: those who matched, but didn't get their top choice. More than 50% of applicants don’t get their first choice, but we don’t really talk about how it feels. For some, picking a number 1, 2, or 3 on the rank list was hard enough, so matching to any of them is great news. For others, who had their heart set on their number one pick, there are so many mixed emotions that we don't talk about. Here are some of the emotions and thoughts I went through, some or all (or more) of which you may have experienced in varying order.

Shock. I didn't get my number one? Well, it was a long shot anyway, who am I kidding. I knew it wasn't going to happen, I shouldn't be disappointed. But I really wanted it! And I didn't get it.

Disappointment. It would've been amazing, working with those residents and attendings, the educational opportunities, living in that area, all of it, I'm sure. This sucks. All the times I imagined myself as a resident at my number one program are now just a fantasy. 

Relief. Wait, I need to keep in mind that I matched. There were times I was afraid I wouldn't. I mean, everyone said I would be fine, and I wanted to believe them, but sometimes the little nagging, worrying voice in my head got to me. The match system does its best, but people fall through the cracks every year because of how rank lists were made, so I worried. But I matched, so it's okay.

Guilt. I should be happy that I matched, right? But all I feel right now is disappointment. But I'm just being an ungrateful brat. What about those people that didn't match? I should feel lucky. I'm a terrible person for feeling negative about this. And now my family is upset because they see that I’m not totally happy. They came all the way out to see me and I’m just being such a downer. 

Peer pressure. Besides, I'm supposed to show a happy face that I matched. Everyone else is celebrating, and I don't want to bring it all down with my complaining. 

Shame. I also don't really want to admit that I didn't get my first choice. That would be awkward, and what if it gets back to my program or to my co-residents? I'd feel terrible. 

Jealousy. How come it seems like everyone else got their first choice? Why didn't I? 

Insecurity. Is everyone else better than me? I knew it, I'm secretly the bottom of my medical school class but just never knew it because we're pass/fail. ​

These emotions and more are part of the whirlwind of Match Day for many of us, and yet because we don’t talk about it, some of these thoughts have the opportunity to take hold and fester. So here are a few points to keep in mind:

  1. It is OK to feel however you feel about this. It is a big day in your life, and no one can take that from you.
  2. Remember that more than half of us don’t get our first choice, and you are not alone.
  3. Know that things will more than likely go just fine at your residency program. In case they don’t, transferring is an option (I would recommend doing your research if you’re thinking about this, and realize that the number one advice is to examine the situation: will it really be better somewhere else, since everywhere has pros and cons, and is there something you can do to help improve your program for yourself/everyone?)
  4. However long your residency is, it is a unique time for growth and learning. Try to make the most of it. You matched!

For me, residency has been an amazing experience. Once I got over my initial shock, I tried to focus on the positives of my situation, and my excitement for becoming a doctor soon overtook my initial negative feelings. Then, once I started residency, there was so much to learn and such wonderful co-interns, senior residents, attendings -- and nurses, therapists, social workers, etc. too -- to learn from that I have truly enjoyed the long hours of residency much more than I had ever anticipated. In the end, residency is what you make of it, and no matter where you go, you will learn what you need to learn to be the best doctor that you can be. 

Cathy Zhang is a resident in internal medicine.

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