Fourth year medical students crowded into the Health Sciences Center Galleria on Mar. 15 anxiously awaiting news of where they will be spending the next few years of their lives. On ‘Match Day,’ coordinated by the American Association of Medical Colleges (AAMC), fourth year medical students around the country were informed of their residency program matches.

For medical school graduates, residency is a post graduate training period, usually between three and five years long, in a given specialty area, such as pediatrics or general medicine.

Three computer-based matching systems -‘ the National Medical Residency Program (NMRP), the San Francisco Match, and the match sponsored by the American Urology Association (AUA) – are available to students seeking residency positions after graduating from medical school. While the NMRP caters to a wider range of residency programs, the San Francisco and AUA matches are specific to a few particular residency options.

After months of interviewing at various hospitals and deciding which field of medical specialty was right for them, American medical students each entered a list of hospital residency programs by rank into the ERAS computer system. Likewise, hospitals around the nation with available residency positions entered their own lists of about 100 prospective physicians, also by preference, into the same system.

After the lists are prepared, ERAS shuffles the lists together and pairs graduating medical students with resident-seeking hospitals by best possible match. The results of these pairings are revealed at medical schools on Mar. 15, Match Day.

Students are chosen based on the quality of their applications which consist of transcripts, board exam scores, a personal statement, letters of recommendation, including one from the Dean of Medicine, and an interview. Once the applications are submitted, all that students can do is ‘hope for a good match,’ said Schiavone.

‘The system is really geared in favor of the students,’ explained Fred Schiavone, M.D., associate dean for medical education at SBU Medical School.

Every year 22,000 residency positions are available in the United States. 16,000 of these positions are taken by American medical students through the ERAS matching program. The rest of the positions are filled by foreign students. Nearly 85% of applying students are matched to a hospital and residency program within their top three choices.

Many students want to remain close to home while they continue their training. From this year’s graduating senior class of 108, 66% of students were matched to hospitals in NYC, Long Island or Upstate New York. Of these students, 20 will be remaining at Stony Brook University Hospital for at least a year of residency training.

‘I basically limited my looking to the Northeast because although I was ready to leave Long Island for a while, I wanted to stay within driving distance from friends and family,’ explained Dava Szalda, a fourth year medical student.

The medical specialties chosen by these students ranged from ophthalmology and radiology to gynecology and emergency medicine. Highly competitive fields, such as surgery and anesthesiology were among the most popular residency matches for this year’s fourth year SB medical students.

Medical students choose which field of medicine best suits their interests during their third year of schooling. Students pass through a series of rotations through different departments during their third year of medical school to help them decide which path is right for them. ‘I tell my students to find their passion and make sure they will love what they’re doing,’ said Schiavone.

‘I became interested in a combined internal medicine and pediatrics program during my third year when I recognized a group of chronically ill adolescent patients who were getting lost in our current healthcare system,’ explained Szalda of her inspiration for finding the right specialty field. ‘I wanted to help find ways to best treat these patients.’

Increasingly, lifestyle is becoming a more important deciding factor in which field of medicine students pursue. Being able to balance a healthy family life with a strong and demanding career is critical. ‘Times are changing,’ continued Schiavone, ‘it is difficult to be continually available, or ‘on call,’ while simultaneously trying to maintain a life.’

‘Location was my main concern during the application process,’ said Richard Hong, current fourth year medical student recently matched to a radiology residency program. ‘My and my wife’s families are in NYC and I really wanted to move back to be closer to them.’

Students look for programs that not only meet their family and convenience needs but also those that will best meet their career goals as physicians. ‘I was looking for a large academic center with the opportunity to do great clinical research. I think I found it!’ exclaimed Szalda.

However, jumping straight into residency after graduation is not for everyone. ‘Some [students] will take a year off to do research or pursue a Master’s degree, often in public health [M.P.H.] or business administration [M.B.A.],’ notes Schiavone ‘others will take a year off in order to start a family.’

Often, if students feel unsure of the strength of their candidacy, taking a year off to pursue an additional degree can enhance a future residency application. A year of dedicated research is especially valuable as medical residents are required to perform it as part of their training.

Students expressed their anxiety the morning of the Match Day ceremony as being intense. ‘It was such an odd experience,’ explained Szalda, ‘take a group of type A personalities and put them in a room with small white envelopes that hold the answer to the question ‘Where will I live, work and grow over the next 3-5 years of my life?”

‘I was anxious,’ said Hong, ‘I was uncertain as to where I would match since radiology is one of the more competitive fields.’

Uncertainty is part of the matching game for these fourth year students and future residents. ‘There are a terrific group of applicants out there, so you never know how things will pan out,’ said Szalda of her matching experience.

Every medical school holds its Match Day ceremony differently. At SBU Medical School, residency program directors from SBUH for each specialty hold the envelopes. Students seek out the program director of their chosen specialty ‘in a mad rush,’ recounted Schiavone. ‘Most students appeared satisfied with their match results,’ he said.

‘I couldn’t wait one more second after waiting so many months,’ Szalda said ‘I opened my envelope immediately.’

‘I peeked at [my envelope] and told my wife we were going back to NYC,’ recounted Hong ‘we hugged; she cried tears of joy.’

In evaluating the entire matching experience Hong noted that the system favors students. ‘I felt that [hospitals] were trying to sell their program to you rather than the other way around,’ he said.

For future fourth year students, it is important to keep goals in focus. When making lists of prospective residency programs, ‘be realistic about your choices,’ said Hong ‘but try to relax and enjoy the process as much as you can.’