My Journey Through the Match

Kate Freeman, DO

The process through which fourth-year medical students gain entry into residency programs — referred to as “the match”— initially filled me with trepidation and anxiety. Now, years down the line, I see it as a gateway into the next exciting opportunity. Residency is when freshly minted doctors finally get to test their mettle and develop their own identities as physicians — and the match is how they get there. So, whether you are a mentor to medical students or a medical student yourself, I hope you will gain some advice and encouragement from my story.

I am a third-year internal medicine resident at UMass Memorial Medical Center and I will be going into hospital medicine at the end of this academic year. I went to medical school at the University of New England College of Osteopathic Medicine. I enjoy going on adventures with my husband, puttering in my garden and scuba diving. I am from Maine and I would like to remain in New England long term.

When I was eight years old, I read a book about a nurse who rode through the Appalachian Mountains giving medical care to the impoverished families of the region. This inspiring story set me on the path toward medical school because I wanted to spend my life taking care of those in need. This dream solidified when my sister was diagnosed with breast cancer while I was in college. Thankfully she is now cancer-free, although the physical and emotional scars remain. Her journey, and my small part in it, was the final motivation I needed to enter medical school.

Like all medical students, I completed two years of classroom learning and passed my first of four board exams before finally entering the world of clinical medicine. I completed my third-year clerkships at Eastern Maine Medical Center, now Northern Light, in Bangor, Maine. There, I saw the gamut of what medical subspecialties have to offer — from openheart surgery to inpatient child psychiatry to rare medical illnesses like autoimmune meningitis and primary CNS lymphoma. Ultimately, I chose internal medicine because I liked the variety of cases, the excitement of building and narrowing a list of differential diagnoses, and the relationships one forms with patients both in and out of the hospital.

Finally, after about 18 months of clinical work and two more board exams, I was ready to enter the match process. On a fundamental level, the match has remained the same for decades. Each fall, all fourth-year medical students submit applications to a national governing body. They interview through the winter and submit a rank list in early spring. Then, the preferences of applicants and programs are entered into a proprietary algorithm designed to put as many applicants into as many spots as possible. Finally, every applicant finds out where they matched during the same week in March.

That said, the landscape of the match is now shifting. When I applied in 2018, the osteopathic and allopathic matches were two distinct processes with different applications and deadlines. While I participated in the allopathic match successfully, I had to eschew the safer option of the osteopathic match to do so. This meant I had to apply to more programs than the average medical student. In the end, I applied to roughly thirty.

Now that the matches are combined, the field has become more competitive. There are also more applicants entering the pool each year as it has become increasingly popular for graduates of foreign medical schools to come to the U.S. for residency. However, this may change in the coming years because the USMLE Step 1, an allopathic board exam, has become pass/fail. The COMLEX, the osteopathic equivalent, will remain a scored exam.

The match process itself, and the unknown element introduced by all these changes, puts a lot of pressure on applicants. I certainly shed lots of tears over the process because it felt like my whole life had led to something over which I had no control. I want to reassure any applicants reading this, it truly is not as bad as it seems. My advice is this: choose one factor that is most important and use that as a framework. For me, this was location. My husband would remain in Maine during my residency so I limited myself to programs between Maine and New Jersey. Those applying to a more competitive specialty, like dermatology or ophthalmology, will need to be flexible and apply more broadly.

My own match day was bittersweet. UMass was not my first choice and matching here meant that I had to move away from my then fiancé. At first, I was upset and it felt like the end of the world. However, I am thriving here at UMass and have no regrets about matching. I fit in incredibly well with my co-residents and I have made life-long personal and professional relationships. I have gotten married and weathered a global pandemic. My training here has broadened my horizons and challenged me in ways that will ultimately make me a better, more independent, and skilled physician.

If you do not match, all is not lost. A medical school classmate of mine failed to match, waited a year, got married, and couples-matched with his wife. One of my best friends also did not match and had to scramble into a residency in a specialty she did not intend. Now, three years later, she has found her calling in critical care and could not picture herself doing OBGYN as she had originally thought.

All this is to say that you can trust the process. Even though it did not feel like it at the time, I matched into the program that was best for me and, if I had it to do over again, I would not change the outcome. It simply takes a little strategy and a little resilience for young doctors to end up exactly where they are supposed to be. +

Kate Freeman, DO, is a third-year Internal Medicine resident at UMass Memorial Medical Center. Email: catherine.freeman@umassmemorial.org