Match day
Authors: Jehan El-Bayoumi
Journal: Journal of Clinical Investigation (2010)

Every year in March, very close to Saint Patrick’s Day, around 15,000 graduating medical students open letters telling them which medical facilities they will be working in for the next several years of their lives. The complex task of pairing up students and their preferred residency programs is conducted by a complicated computer algorithm known as the Match.

In his wonderful book Match Day: One Day and One Dramatic Year in the Lives of Three New Doctors, Brian Eule follows the real-life journeys of three young women that we meet as fourth-year medical students who are going through the agonizing process of deciding where they want to end up for their residency training programs in their chosen fields, all the while keeping their fingers crossed that they too will be chosen by their top program. The whole idea of matching is akin to the awkward pairing of a couple — “matching” sounds like courting. Indeed, Eule introduces these three young women to us not simply as random members of a couple, but rather as three complex lives embarking on what will be a challenging career in medicine. We get an up-close and personal view of the excitement, the fears, the disappointments, and, ultimately, the agony of making the choice. Deciding where to go, but, also, where not to go. Choosing what each one wants, but also forgoing dreams and sacrificing, not always so easily, so that a spouse can have the hopes of finding a job in the same city. Eule does this with concern for and sensitivity to his three subjects — one of whom he is dating and all of whom give him full license to write about their innermost hopes as well as their vulnerabilities — with the respect that comes from having befriended each of them over the course of the year and a half that he spends chronicling their lives; time that includes following them through their grueling first year of residency, known as internship. 

What Eule manages to do, while engaging us in these personal and human stories, is educate us about the process of the Match: how it came to be, from its origins in the early 1950s to its current state, as well as some of the controversies, such as an antitrust lawsuit that was filed in 2002 by a resident and two former residents alleging that the National Resident Matching Program (NRMP) along with several professional associations and medical schools kept wages low by denying them the right to negotiate. He also shows us how the debt that students accumulate at the end of their four years of medical school ultimately impacts career choices, making the coveted R.O.A.D. (radiology, ophthalmology, anesthesiology, dermatology) to happiness a goal for many. Eule infuses this book with well-researched facts and information, while maintaining the focus on these women’s stories. To have stopped with just their narratives would not have done justice to what ends up being a case study for women grappling with the complex decisions involved in trying to negotiate a career in medicine as well as a life outside of the field, often with children. The societal double standard is exposed over and over again, with examples such as a program director stating that married male residents make for more stable residents, whereas their female counterparts may be more problematic, since they inevitably feel the pull of their outside responsibilities. What is interesting is that at times, the propagation of some of these biases may actually be perpetuated by women faculty who themselves were the victims of such stereotyping and discrimination. The author himself is put in the position of feeling somewhat defensive about his career as a journalist and a writer in light of his girlfriend’s surgical career. In a bit of role reversal, while female spouses of physicians are viewed as having a “good catch” in a doctor, it ain’t necessarily so for the husbands or boyfriends of doctors. Further­more, to think that this is a book that only speaks to the issues that women physicians face would be to miss the societal discourse about professional women who find themselves in the intricate dance of finding the ever-elusive work-life balance. An alternate title might have been Match Day: Are Women Doctors Really Equal and Able to Achieve Balance While Finding True, Long-Lasting Happiness? In summary, Brian Eule’s book is a well-researched look at the process by which fourth-year medical students end up at their chosen institutions for residency training, while sharing the very compelling stories of three women who weathered the storm. Not only did they match, but they survived the legendary internship year and lived to tell about it. Match Day is about the coming of age and loss of innocence that all young adults eventually face in life.