What’s next?

I’ve abandoned blogging. It wasn’t intentional, it has just been an intense two years. I know, it’s hard to believe that having a 4th baby a week after moving to a new state, and a husband starting clinical rotations, could be a lot to adjust to ūüėČ

Anyway, we’re all doing well it’s just been two years of continuos adjustment. But, I’m a writer and I need to get back. I’ve been getting a lot of questions about what is next for us in the med school journey. I thought this would be a great forum to explain/educate the outside world on what happens from here. It’s such a unique process and situation for medical school families and something that I never knew ANYTHING about until experiencing it.

So, let’s start from the beginning. For the last 4 years we’ve been completing medical school. In Grenada, we did 2 basic science years which were done in a classroom. After that, we returned to the United States and¬†prepped for weeks to take the¬†USMLE (United States Medical Licensing Exam) Step 1 (of 3). Nothing like the course of the rest of your life hinging on the score you get on an exam! Not stressful at all. (Your score is more critical/important if you choose a competitive specialty, for example, surgery or anesthesia) Once that was completed, and we received our score, we were placed at a hospital in Detroit, MI to complete 2 years of clinical rotations. The first year of clinical rotations (3rd year of med school) you spend 6-12 weeks in each of the core specialties (Pediatrics, Family Medicine, Surgery, Internal Medicine, Psychiatry, and OBGYN). The hope is that during that year you find out what speciality is your calling. Near the end of¬†3rd year, you take the USMLE Step 2 which is broken into 2 grueling, 8 hour exam days that requires weeks of prep. One written and one clinical.

The 4th year of medical school is a bit more relaxed. You’re given a bit of freedom to choose a few rotations. Typically students in their 4th year try to do, what we call, an ‘audition rotation’ or ‘away rotation,’ where you attempt to get into the specialty you’ve chosen at the program/hospital(s) where you want to do residency. We were fortunate enough to be able to do this and it proved to be a GREAT decision, and worth the cost and effort that it took to make happen. The rest of 4th year is filled with 4 week rotations at your home hospital. By August-ish of 4th year (or sooner), students have decided which specialty they are going to pursue.

They say 4th year is more “relaxing.” Haha, that’s cute. Just after you start 4th year, you know, right after you just studied for weeks for a board exam, AND are now away from home doing a rotation, you have to apply for residency.

Speaking of it, let’s talk about residency briefly. Residency is done after you graduate from medical school, and even though you’re technically a medical doctor at that point, you’re still “in training” throughout your residency. One major change from med school is that residents start to receive a salary/living stipend. And although the amount is fairly minimal (the average US resident makes $55,000/year but this varies based on geographical location), at least there are no more student loans!! The length of time you’re a resident depends on which specialty you choose. Here are a few examples:

Pediatrics 3 years; Surgery 5+ years; Family Medicine 3 years; Internal Medicine 3 years; Anesthesia 4 years.

Many will go on to complete a fellowship after their residency, they typically range from 1-3 years and allow you to specialize even more.

Back to 4th year where we apply … so in the fall of 4th year all medical students in the country complete an online application for residency. It’s lengthy and requires a lot of time, energy and attention to make it great. Students enter basic information about their schooling, their life experiences, transcripts, evaluations from hospital rotations and more. They also need to write a personal statement, which is an opportunity to set yourself apart from the rest of the applicants. The final piece is letters of recommendation from other physicians in their field of choice. All applications are due on a set date each September. Once applications are submitted, programs can start contacting the applicants to arrange an interview. Interview requests can come within hours, days or weeks of the application system opening. Some applicants will get 2 interviews and some will get 20. We were very fortunate with the number of interviews we received and all were in the locations we were hoping for.¬†So, the months of October, November, and December Chris toured the US. That’s where my questioning of 4th year being relaxing comes in, ha. Between flights, hotels and interviews I was running a full blown travel agency from my living room. And of course him traveling so much made things at home a bit more complicated. But we did it and it truly went great and was over before we knew it.

So, the interview. The applicants arrive in small groups. The night before the official interview, most programs host a residents dinner where the applicants are able to meet and have dinner with the current residents of the program. This allows the applicants to get a feel for the program in a less formal setting and ask questions. Spouses are often invited to the dinner as well. The next day the applicants go to the hospital for their official interview. The format of the dinner/interview really varies greatly between specialty and program, this was just a generalization based on our experience.

Interview season typically wraps up in December/January, but some interviews even taper into February. Throughout interview season, students are still completing their clinical rotations and are given a set amount of days off for interviews.

After interviews are complete, the programs and the applicants create their rank order list. This is where you rank the programs based on the interview and where you want to do your residency. The programs do the same and create a rank list of which applicants they want. In early February both groups submit their lists and then we all wait. And wait. And wait. Guess what we’re doing right now? Waiting! But the end is in sight!!!

MATCH WEEK: Next Monday, March 13th, all of these lists from every program and every applicant will enter a giant database and run through a massive algorithm and determine IF each applicant was “matched” to a program. THIS IS THE MOST IMPORTANT DAY OF MEDICAL SCHOOL. If you care to have a more in depth understanding of how it works (it’s actually pretty interesting) then here is a great video explaining the process:

http://www.nrmp.org/match-a-to-z/video-tutorials/about-the-matching-algorithm-tutorial/

Or ,skip it, and be happy with my VERY basic explanation. At 11am EST, one week from TODAY, we, along with every other 4th year medical student in the US, will receive an email that will either say, “Congratulations, you have been matched to a residency program,” or “We’re sorry, but you were not matched for a residency program.” I feel like I should put this whole paragraph in caps so you fully understand the intensity and importance of this moment. It’s a big deal. And, that’s all you get. You only get to learn whether or not you matched. Then you WAIT AGAIN. And then Friday, March 17th, we finally get to MATCH DAY. At 1pm EST, we will finally learn WHERE we matched. I have lived this moment in my head a million times over the past 2 years. I’ve pictured all of us standing there together waiting for the email to come in. I’ve pictured all of us jumping up down and hugging each other. I’ve heard us screaming and I’ve heard us crying. I don’t think any of us will ever forget this moment, no matter where we end up.

4 years of hard, brutal, intense effort. 4 years of figuring out how to stretch every penny of our budget to cover basic necessities. 4 years of giving every ounce of energy, every single day, because there is no room for faltering. 4 years of working tirelessly at making sure the struggle doesn’t affect our children. 4 years of crazy, wonderful memories. 4 years of spending random nights wondering if we were all going to survive it, and if the struggle was worth it. 4 years of celebrating successes and results. 4 years of accumulating hundreds of thousands of¬†dollars of debt. 4 years of some of the most raw, incredible moments of our lives. 4 years that have forever changed us and reminded us what’s important. 4 years of some of the hardest, scariest moments of our lives. 4 years of true blood, sweat and tears that come down to ONE defining moment. Needless to say, this day will go down in the record books right next to our wedding and the birth of our children.

Some basic facts to help relay the intensity of the situation: in 2016 there were 35,476 applicants that submitted a rank list and 26,836 of them matched. If you’re doing the math, that means 8,640 people graduated from medical school and did NOT match into a residency program. I find that to be completely insane. What happens to them? That’s probably a whole other post topic. But the quick answer is that they can try to scramble into any spots that were unfilled, or they can attempt to match again the following year (more difficult to do). Sadly, some of them never go on to practice.

Heading into Match Week we are actually very excited, optimistic and calm. Obviously anxious for it to get here so we know WHERE we’re moving to in April, but we’re pretty low stress and very¬†excited for the future. And for now, we wait ….

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3 responses to “What’s next?

  1. Kristi, thanks for sharing your story, I learned something! I pray your family dreams, goals and aspirations come true, especially after all of your hard work! But then again, it is evident that in so many ways this has already come to fruition. What a beautiful family and your children have learned the most incredible life lessons from the great examples you and Chris have set forth! We all will celebrate your upcoming news!

    • Wow, thank you for that! We’re looking forward to sharing wonderful news next week and would love for everyone to join the celebration!

  2. You two are nothing less than amazing! All this plus raising four beautiful children and keeping a strong devoted marriage! I love hearing your stories and I know you’re both fighters and will come out swinging to get to your goals! I’ll be “waiting” to hear where the next leg of this journey takes you all!

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