Match: A Spouse’s Guide

Q: What is the match, and how does it work?

A: When your spouse is a fourth year medical student, he/she will begin the match process. Most match hopefuls will apply to the ERAS match, but some (like ophthalmology) will apply to the San Francisco Match. 

First, your spouse will upload their CV, step scores, and personal essay to an online program (letters of recommendation will be uploaded by those writing them). From there, they will select which programs they’d like to be considered for, and pay a small application fee for each program in addition to a flat fee charged by ERAS. Generally, the fee is about $40-50 per program. After he/she applies to a certain number of programs, the fee is reduced for each additional program. (It’s important to note that some programs may require additional information from applicants, such as another personal essay or specific pieces of information.)

After everything has been successfully uploaded and the programs have received applications, you will wait to hear from programs offering interviews. Most programs will send out emails to prospective interviewees. The programs will typically offer a few interview date options to prospective residents. It’s important to be diligently checking for interview offers, because occasionally the interview slots will fill up quickly and even though an applicant may be offered an interview at a program, they may miss the chance to sign up and lose out on the opportunity. Additionally, it’s important to keep track of the interviews accepted, because no one wants to accidentally double book two program interviews and risk losing out on an interview opportunity. Be sure to remember that not all programs send out interview offers on the same day, so the offer for your first interview may come one week, and another may not come for several more weeks. 

Your spouse will then interview at all the programs he/she is interested in. Some applicants end up with dozens, and others with only a handful. This has to do with several variables, including the strength of the applicant, the prestige of the programs, and the competitiveness of the specialty. If your spouse ends up with dozens, you may have to strategically choose which interviews to attend. Generally, most applicants do not end up in this position, and it is considered wise to attend every interview offered. 

Following interview season, your spouse will rank the programs he/she is interested in, putting his/her top picks high on the list. He/she will submit this list to ERAS, and the residency programs will do the same with their applicants. This information is compiled, and residents are matched with their program. This information is disseminated during “match week.” It usually takes place in late March. (Although, again, some specialties will find out their match information much earlier.)

Typically, on the Monday of match week, applicants will find out if they matched or not. If they did not match, they will need to go through the SOAP/scramble process, which will will discuss later on in this article. If they did match, they will find out which program they matched into the Friday of match week. 

Each medical school does the official “match day” a little bit differently. Some have students come on stage and announce their residency to the entire medical school. More commonly, students are given an envelope and instructed to open their envelopes at the same time. Either way, at the end of the day, you’ll know where you’re headed for the next three to eight years!

Q: What’s a rank list?

A: The “rank list” is something your spouse will assemble following the completion of his/her interview season. Everyone prioritizes different things in terms of a residency program, so there’s no magic formula for compiling this list. When you and your spouse have decided which programs you’d most like to attend for residency and which one’s you’d rather not, you will submit your rank list online. The residencies will do the same for all their interviewees, and the lists will be compared. Your spouse will match based on the highest mutual interest.

Q: Is there really a “magic number” of interviews?

A: There’s a lot of chatter out there about the amount of interviews one must go on to make matching into a residency statistically probable. There are raw numbers to be found if you scour the internet enough, and each specialty has a different “magic number” of interviews that matched candidates typically receive. 

However, the general number you’ll hear is eight. Statistically, if you have eight interviews, you are likely to match. Five to seven interviews puts you in the median, and of course, the more interviews you have, the higher your likelihood of matching. Still, there are plenty of applicants who have interviews in the double digits who don’t match, and many more who have one or two interviews and end up matching. As much as our analytical minds would love it to be simply a numbers game, it’s not. My husband, for instance, applied to an extremely competitive specialty, and only received five interviews. He ultimately matched at his number one program, and did not have the “magic” number. We know many other such stories.  The most important thing, of course, is for your spouse to put his/her best foot forward at every program, giving each respect and attention.

Q: What happens if we don’t match?

A: After all the hard work and money put into medical school and the interview trail, not matching can feel absolutely hopeless. Your spouse will likely feel horrible and defeated, but the good news is that there are plenty of options for those who don’t match into their desired specialty.

The most common option is to SOAP. SOAP stands for the Supplemental Offer and Acceptance program. Those who didn’t match into their specialty of choice can try to “scramble” into a program that didn’t fill all of its residency positions. Family medicine, internal medicine, general surgery, and radiology are the specialties most likely to have openings for SOAP candidates. The National Resident Matching Program (NRMP) website has a list of unfilled spots. Candidates who did not match can apply to up to 35 of these programs. Applicants are not allowed to reach out to these programs, and must wait to be contacted. Your spouse may receive phone interviews, and if those go well, may be offered a residency position.

Another option is to wait a year, and apply to match again. However, if you take this route, your spouse must use that year to make him/herself a more competitive applicant. This can mean bolstering his/her CV with research, publications, etc. It can also mean working on interview skills and the personal essay. Be sure to have your spouse review his/her application/interview process and make sure small errors (like not applying to enough programs or only applying to top tier programs) did not cause the failure to match. Also, understand that while people do match a year after failing to match initially, the rates of match success are much lower after one failed round. 

Finally, though it may seem harsh, this may be a good time for your spouse to assess whether he/she wants to continue down the traditional medicine path. Plenty of MDs end up consulting for legal firms or  insurance companies, working in research positions, or taking up another field where MDs are valued and compensated well.