Tuesday, March 25, 2014

Match 2014 Episode IV: A New Hope

The epilogue

The letters are opened, food has been eaten, dance floors have been trounced. Match day has come and gone.

It was an amazing experience. There was just so much excitement in the air, it was crazy! It was interesting to see how a few hours later... all of us were beat. Maybe it's because we are older now, but more likely it's because of how exciting match day was. I think our adrenal glands were completely done after pumping out gallons of adrenaline to keep up with the match day.



The sheer excitement was amazing and humbling at the same time. I can't believe I spent the last 4 years with these amazing people. Penn Med's match list for 2014 (as it is every year) is amazing. It was also so nice to see so many friends and families come out to support us. I know everyone things graduation is a big deal, but for medical students - it's all about match day. This is what we've worked very hard for over the last 4 years. Actually for many of us, this is something we've worked towards for almost 2 decades. So definitely the bigger deal.

It takes a while for the truth to sink in: I have my first job as a doctor. That's crazy. Personally, it's a bit disappointing that my first job as a doctor pays me less than my first job out of college (almost a decade ago). And I have way more loans. But that's just how medicine works (initially anyway). Besides - life isn't just about money. And medicine is so much more than just dollar signs.

Match day is a happy day. But it's not equally happy for everyone. Most students from Penn match in their top 3. Almost everyone matches in their top 5. Then there are those who do not. Now - matching itself is a great accomplishment. But it's easy to forget that when you have your hopes set high it's easy to get them (seemingly) "dashed". Much of life is about expectation management. Most of us didn't get here by aiming low. We aim high. Very high.

Unfortunately, when you aim that high and miss, the fall is pretty painful. Some people matched "not as well". At their 14th spot out of 14 programs on their list. On the other side of the country from their family and friends. In frigid temperatures. There is no doubt that they will still get amazing training and become amazing doctors. But it fell short of some personal, subjective criteria. And thus, some people are sad on match day. A sadness that is heightened because it stands next to the sheer, unconditional joy that the rest of the medical school feels (i.e. the ones that matched to their top choice). It isn't personal, but it's hard to not take it personally.

Personally? I wasn't very happy at match. I wasn't sad, but I wasn't jumping for joy either. Based on my match results, everyone around me was happy for me... except me.

I will start training at Cooper University for Emergency Medicine in Camden, NJ. Regardless of where you are in the US, you've heard of Camden. And that's the exact reason why it is an amazing place to train for Emergency Medicine. If you try to conjure an image of an emergency medicine doc, you are probably picturing the kind of doctor produced by Cooper (or from any place in the US that has quite a bit of trauma and violence - like Harlem, Baltimore, St. Louis, etc). Camden also has a surprisingly high amount of medically complex patients - again, great training for residents. Camden, in general, has a big focus on medical education and their residents do exceedingly well when they get jobs after residency. I also have a strong interest in higher level management of hospital systems - and Cooper has a specific track devoted to teaching this.

And it's in Jersey (across the river from Philadelphia). So it's obvious why my family (they live in Jersey) and my friends (who are mostly in Philly / Jersey / New York) are happy about this. My fiancee loves Philadelphia so she's happy about it.

So why wasn't I happy? Because of mismatched expectations. And focusing on the things that don't actually matter.

I hate cold weather. Always have. But I ended up living in Canada for a year. I went to Cornell for undergrad. I was in Philly for medical school and went through the polar vortex. I've tried to go to California every step of my life: undergrad (didn't get in), work (did get placed there, but got moved to Jersey soon after), med school (didn't get any interviews) and now residency. So when I said I wasn't as jump-for-joy happy about the rest of my classmates, it was for one reason only: I missed out on the California weather. Yes California is more expensive. Yes California's on the other side of the country from my family and friends. BUT OMG WEATHER!

This single-minded focus meant I shut out all other possibilities from my head. Even though my rank list was pretty split between California and Philly / Jersey, I only thought about California. I dreamed of getting up and walking outside without having to put on 3 layers of clothing. I had blinders on. I wasn't even thinking about "hey, what do I need to do to be a great doctor?" (now, this doesn't mean that California training programs are not awesome, I'm just saying I didn't think about that aspect as much). I wasn't thinking about "hey, what about all the other stuff that matters for the next three years, apart form the awesome weather?"

So, when I opened my letter and saw I wouldn't be in California... I didn't know how to handle that. I have to be in cold weather for another 3 years!? I have every intention of starting a family and putting down roots over the next few years... which meant this was it. I probably would never get to move to California again. And that made me very sad.

Did it matter that when I start a family I'd probably want to be close to my parents in Jersey? Nope!

I never claimed I was the smartest person in the room. And over the last few days, the objective parts of my brain have kicked in and said "Dude. Seriously?" To the point where I feel ashamed that I wasn't happier than I was on match day.

But that's the thing about being human: we aren't objective 100% of the time. We don't approach everything rationally. It's very easy to take for granted the things we have in life.

It takes a long time to realize that we were given what we need, not what we want.

How does that Rolling Stones song go? "You can't always get what you want. But if you try sometimes, you might find, you get what you need!"

The unofficial mantra of the match process is "trust the match."

I'm a believer.

Congratulations again to everyone at Penn Med and everyone throughout the US / world that matched. I truly hope that you matched where you needed to. And I cross my fingers that it lined up with what you wanted.

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