Happy Match Day to those who celebrate! For a Wellness/Feel Good Friday- I thought it would be fun to take a look at the history of Match Day and explain for our colleagues who did not fortunately experience the chaos of the match!
Match day started in the 1950s as a way to try to control the chaos of hospitals hiring medical students during the end of their medical school training. The offering of jobs started to become more and more ridiculous with students being offered halfway through medical school and given 12 hours to respond to offers. In 1952, a centralized matching process and the organization known as National Resident Matching Program (NRMP) was formed.
This process has evolved over the years and has become a computerized algorithm. Today, the match process started in September of a student's fourth year of medical school. At that time, an extensive application is pieced together including undergraduate/medical transcripts, national board exam scores, letter of recommendations, evaluations from all rotations, a personal statement, a list of extracurricular activities, and essentially anything that you have done leading up to that point in your life. This application is sent out to residency programs.
When applying for residency programs you apply specifically to a hospital and speciality. This means that most candidates are picking a speciality prior to applications, though it is often for people to dual apply, meaning they apply for two different specialities. Usually when this happens, there is a more competitive speciality that they are anticipating needing a back up plan. Or they truly cannot decide what they want to do yet.
This year, approximately 50,000 medical students (a combination of MDs, DOs, and IMGs (international medical graduates) applied this cycle, which is fairly similar to the more recent years. Applicants will apply to programs and pay a fee. On average, the US MD applicant applied to 71 programs and US DO applicants on average apply to 93 programs. Applicants spend the next few months interviewing. Prior to covid, applicants flew over the country and interviewed in person, now these interviews are mostly virtual. Applicants are offered interviews usually to a fraction of programs, and depending on the competitiveness of the speciality and the candidate, a person is not guaranteed any interviews.
After interviewing, applicants can put programs on a rank list. Each person ranks their programs and enters a formal rank list in the beginning of February. At the same time, each program ranks all of the applicants who were interviewed. This enters a computer algorithm which favors the applicants. The NMRP describes this preference as, “The matching algorithm is “applicant-proposing “meaning it attempts to place an applicant (Applicant A) into the program indicated as most preferred on Applicant A’s rank order list. If Applicant A cannot be matched to this first choice program (because the program doesn’t also prefer Applicant A), an attempt is then made to place Applicant A into the second choice program, and so on, until Applicant A obtains a tentative match, or all of Applicant A’s choices have been exhausted (meaning Applicant A cannot be tentatively matched to any program on the rank list).”
This process ends when all applicants are considered and ranked to their highest ranking program. For some context, Maimonides received approximately 1000 applications, interviewed 250 applicants, and matched a class of 18 incoming residents.
This process does not always have a happy ending. During Match Week, which occurs the third week of March- the first significant day is Monday. On Monday, all applicants receive an email notification signaling if they matched into a program or not. This year, Emergency Medicine residency programs filled 97.9% of their spots, which was an increase after there was a decline at 81% in 2023. For some context, other specialities such as OBGYN had 10 national spots open in the entire country out of approximately 1100 spots.
Nationally, for US MD/DO students the rate of matching is ~93%, compared to 67.8% of US citizens with international medical graduates, and 58% of non US citizen IMGs who matched.
For those who unfortunately do not match, they enter a process called the SOAP (Supplemental Offer and Acceptance Program) which attempts to find unmatched applicants with unfilled positions. This becomes a whirlwind race to virtually interview, receive offers, and accept positions over a 3 day period.
The Friday of Match Week is the infamous Match. Applicants either return to their school and receive a printed letter which they open in front of colleagues, peers, family, and faculty or they opt to open their email at home all of which lists which program you are slotted to start on July 1st. Once you are placed in this spot, that is it. You cannot change your mind on locations, specialities, or timing without restarting the process and entering the match next year.
Fortunately for us, Maimonides welcomed 18 brand new interns who hopefully opened their letters and emails today with joy and a sense of accomplishment. Every doctor can tell you about their match day, the anxieties leading up to it, the relief, the joy, the tears. It’s one of the most insane experiences I have ever lived through.
So with that- Happy Match Day to those who celebrate, a huge shoutout to our recruitment team who works tirelessly combing through applications to find our special group of 18 who will come home to Maimo and learn the wonders of Southside later this year.
https://www.nrmp.org/intro-to-the-match/match-fees/
https://www.nrmp.org/intro-to-the-match/roles-responsibilities/
https://www.ama-assn.org/medical-students/preparing-residency/biggest-match-day-ever-here-s-what-2025-numbers-reveal#:~:text=Emergency%20medicine's%20rebound,were%2098%25%20to%2099%25.
https://students-residents.aamc.org/applying-residencies-eras/applying-residencies-eras-system