Cautionary tales about the matching process

Within the next two weeks, anxious fourth-year medical students will submit their residency choices to the National Residency Matching Program. I have written many posts about how to investigate residency programs and the workings of the match.

Here are a couple of stories about deception and disappointment. The first appeared as an anonymous comment on a post I wrote about how to rank surgical residency programs.

I am the spouse of a surgical resident halfway through their residency. When I hear of the idea of "vetting" the residency program as med school graduate, it makes me laugh and cringe. Its not really possible.

We were extremely concerned about not getting stuck in a malignant or toxic program. But these people must have been aware of how bad the program was, we thought the place had the happiest, friendliest people. What a facade.


So now what? We struggle. If it gets too bad I suppose we will try to switch to a new surgical program. Maybe the switch is to a different discipline altogether. Time will tell.

The take-away is perhaps make sure you are lucky, because if you are not, life is hard, and options to fix it are even harder. [I wish I could tell you how to make sure you are lucky.]

In the mean time we will show up at each and every required recruitment dinner. We will smile, we will follow the script and lie our asses off. Why? Because if we dont we will be labeled a "problem" resident and never get a recommendation from the PD to another program. So the cycle continues. Does the program kick out good surgeons, perhaps, but how many do they lose or worse ruin?

Vetting...no. Luck of the draw.

The second, also by an anonymous writer, appeared on the KevinMD website. At over 1700 words, it is too long to reproduce here. But it echoes the theme. Here are a few excerpts.

Within only a few days of starting my residency, I was called “retarded” and referred to with homophobic slurs. Women were commonly referred to with misogynistic labels.

After one semester of training, I was told that I had not been studying enough because I didn’t do well on the national in-service examination, a test given nationally used to measure your performance versus residents at other programs. I was threatened with academic probation and warned that I needed to read more. [Do you think the writer might be a surgical resident?]

He describes his increasing despair at the lack of teaching and respect. He failed to obtain a fellowship and speculates about possible reasons.

Today I remain discouraged, jobless, and deeply regretful of the decision I made as a medical student to choose the residency program that I did. I try to remain hopeful that someone will give me a chance and renew my interest in practicing medicine the right way, but it is hard to remain optimistic.

My goal in writing is that as this year’s match day approaches, I plead with the newly graduating doctors out there to please do your homework. Do ask about board passage trends, do try to find out why questionable programs don’t always fill with applicants in the NRMP, and do not assume that an appropriate educational plan is being offered at a program simply because it is accredited. The ACGME and the NRMP publish listings of programs that are on notice, so avail yourself of these listings. Your residency program is a place where you will work very closely with what may amount to be only a small number of supervising doctors, and you only really get one chance to make the right decision.

In my case, there were red flags that I did not pay close enough attention to. During my interview, the residents gave very short and incomplete answers to my questions, and several of them seemed downright unhappy. I had just assumed that the faculty were part of a medical school which was never the case, and I failed to do any research with respect to the effect that program size might have on education. Don’t make the same mistakes that I did, and best of luck to all of the new docs out there. 

I don’t think the match depends on luck, nor do I think that the size of a program makes a difference.

There are two sides to every story, and we will never hear the other sides of these.

However, do not completely discount these anecdotes just because the writers are anonymous. You can understand why the writers did not reveal their names.

I hope all of you did your due diligence, but as these stories show, sometimes it is not enough.

Related Posts by Categories