So, I spent a little more than 2 weeks thinking about how to make this post. Two weeks that, in many ways for many reasons, most good and some bad, felt much much longer. I’ve talked here before about how I love OB/GYN, and that was the residency I was hoping to match to. I didn’t talk here about how, because OB/GYN has about a 2/3 match rate, I also backed up with Family medicine, as Family-OB would still let me practice heavily in women’s health, OR assisting and low risk OB. But, I’ll not lie, I was hoping for OB/GYN because of the OR and surgical aspects. Well, two weeks and a couple days ago, we had our “Match,” where we find out what residency we have been assigned to.
And I matched to Family Medicine.
There were a lot of emotions on match day for me…strongest perhaps were relief, and disappointment. Relief, because the CARMS match is a stressful, tiring thing. You pour so much work and money and blood, sweat and tears into that system, and then you wait, powerless to see what the answer will be. And I think I made my feelings clear about The Waiting Place before.
And for some – an increasing amount, as the years tick by – that answer is “Unmatched” the boogyman that hides under every single medical students bed. As students and medical professionals we like to say about unmatched applicants that well, they applied too narrowly, or didn’t back up in a competitive speciality or, there was some personal factor, because those things make sense to us. And that is occasionally true, but the simple truth is that, there are simply too many medical students and too few residencies. Of the unmatched students in my year – and we had unmatched students – the majority of them had applied to moderately competitive specialities and simply hadn’t matched because there were just too many applicants for those spots. MUN OB, as an example, takes only 4 residents per year: they interviewed over a 100 applicants, about 10 from my own class, and all whom would have made excellent OB/GYNs. Med schools continue to increase class sizes, for revenues and yes, to help meet the physician need in this country, but they do so without being able to increase residency funding, and so the ratio of residencies to applicants has shrunk from a more comfortable 1.2:1 in past years to 1:1, and many of those spots are rural family medicine residencies in Quebec, where because of the language requirement many applicants cannot go. And that idea: that medical students, after spending hundreds of thousands of dollars and working so hard and being deserving can’t find a residency just because of numbers is freaking scary.
And going unmatched has serious consequences. Your line of credit was likely only budgeted for 4 years and might not be able to bear a 5th, and many schools have no formal 5th year, so trying to keep with with clinical electives is based on a who you know basis…to say nothing of the emotional toll. Only recently, a med student in Ontario named Robert Chu committed suicide after being able to match to a residency twice: he’d started with radiology, a relatively competitive one, and then had attempted to match to family medicine, where he had been judged as not being genuinely interested in FM because of his radiology focus (which I disagree with as family is really a speciality where you can make any interest work but I digress). This is a crisis that has serious impact, and without funding for more residency spots, nothing will change.
That said, coming back to my own Match, disappointment was the other emotion, and I figure that’s relatively self explanatory: I’d wanted something and I didn’t get it. But, thankfully, time gives us all perspective, and I can say that the disappointment has mostly faded at this point. Yes, I’m still a little bummed, but honestly, like I said, I backed up with Family because I knew that I could make the life I wanted, and that Family-OB had it’s own perks. Shorter residency, ability to move and live anywhere, more flexibility of practice, options for a 3-12 month low risk OB “plus one” after residency, better work life balance, options for OR assisting, women’s health, case room call and ER call, etc. And, I have options: switching residencies is one, and while it’s likely to not work out it’s still an option I have. But, if it doesn’t, then I’ll finish out my Family residency, maybe do a 3-6 month plus one, then loccum around for a couple of years, trying out Family OB and paying off my substantial debt and then, in my early 30’s I can decide if I’ve fallen in love with Family-OB and want to stay, or if I want to go back – debt neutral – and tackle an OB residency then. I got into med school on my third try, off the waitlist, and if that experience taught me anything, it’s that perseverance is the most important quality to have: that when life hands you a stumble you need to brush yourself off, get back up again and try harder next time.
They say you don’t win silver, you lose gold. And I’ll admit, you rarely see happy silver medalists at the olympics.
But honestly, I have an embarrassment of blessings in my life. I got into a Canadian med school, got through my 4 years, made amazing friends, matched to a great residency in a city I love that will let me live and amazing life, with other options in the future. I just signed a lease to rent a beautiful condo, am on a waiting list for an adorable kitten, and am planning a magical trip with my little sister to Scotland and London. I’m healthy, losing weight, and I’ve got great friends, a loving and supportive family and a successful small business and creative outlet.
So, you know what? Screw it.
I earned that freaking silver medal, and I’m so proud of myself for that. If Family-OB is my silver medal then I’m going to certainly shoot for gold, but in the meantime, give this thing all I’ve got and live my best life, with a smile on my face.
Two more months and I’ll be a doctor, and you know what? That’s a pretty darn gold coloured medal if I do say so myself 😉