The medical education system hates families

Prospective physicians in the United States must undergo a gauntlet of resume-building tasks, in the end, to have little control over their career, and for some, their love life.

We just underwent Match Day, the brain-child of Alvin Roth and Lloyd Shapley who won a Nobel Prize for this accomplishment in 2012. The U.S. has been utilizing this tool since 1952, which was an improvement over the previous disorganization, which resulted in offers occurring earlier, sometimes occurring during preclinical years and “exploding offers” which often required acceptances within minutes.

But, the Match works, right? It is often quoted that for most students, they get their top choice. According to the National Residency Matching Program (NRMP) data in 2017, 48.4 percent of all seniors got their first choice, and 74.4 percent got their top three. So what’s the problem? It is still a somewhat unpredictable algorithm to base one’s career off of.

The culmination of over 4 months of expensive interviews, emails, and ranking ended in a single moment of opening a letter in a packed room of classmates and family members, or a week filled with chaos and Skype-interviews for those that were unfortunate to SOAP. It ended even worse for those that are to go unmatched.

My situation is specific to me, but it is not necessarily unique to medicine. I took time off after college to pursue clinical work as a certified nursing assistant. I met a wonderful man while volunteering in a basic science research laboratory, doing menial tasks for a letter of recommendation. We both desired to pursue medical degrees, he advocated for the dual MD-PhD, an eight-year program that ends in two doctorates.

I got accepted into the local state medical program after a year of dating, one year later, he was accepted into a program 3,000 miles away. So, like many before us, we began the journey of long distance, with the hope of rejoining once I finished medical school three years later.

Two and a half years later, I applied. I emailed. I called. I received one interview at a local community program in his city, and ranked it first on my rank-order list. I matched into my 2nd choice, another great program close to my family, but still 3,000 miles away from my significant other.

The possibility of a couple with two medical degrees staying together throughout training either is a result of timing (same year, therefore they can couples-match) or luck (I have another classmate who’s boyfriend got accepted into our MD-PhD program a year after her, and she just matched into her home program). I, unfortunately, have neither.

Why must we live in a medical education system that depends on one partner compromising their career for the physician? What are two future-physicians to do? Because there is no current matching system that allows for the consideration of partners with jobs that are unable to be relocated, others and myself are submitted to a system that may keep us apart for several years. The only other system I know of that keeps couples apart for 6+ years is the military.

We need a graduate medical education system that allows for the consideration of families and significant ties to a particular region. To better care for patients, the medical education system needs to better care for its physicians-in-training.

The author is an anonymous medical student.

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