My feelings of anxious anticipation and excitement were nearly canceled out by the sheer terror that flooded through my body as we trudged through the large crowd in search of the table that contained my husband’s envelope. I clumsily followed behind him, seeing mostly his back, I bumped shoulders with others. I turned my body to squeeze through spaces in the crowd that were much too small for even my three-babies-ago frame. With a medical school class of approximately 130 students, the banquet hall was bursting at the seams with each of these students and their hopeful families. I would catch glimpses of the blurs of faces as we passed quickly by, staying our course. The many others in the busy, loud hall weren’t really noticing me either, as most of them had reached their tables before us and were laser-focused on the process of opening their own envelopes.

While walking for what seemed ages, I was occasionally startled by the sporadic whoops and cheers that reverberated from the walls, as another satisfied customer learned of their joyous fate. Each time a cheer was released, I couldn’t stop myself from hoping and praying that God’s plan for us was the same as ours; that we would be among those cheering in response to our news. In response to what we saw in my husband’s envelope. In “our” envelope.

it was Match Day.

Match Day was the day that every fourth-year medical student who had an envelope with their name on it would learn something important about their future; information that would forever change the rest of their lives and direct their future careers (or the career of their significant other, as it was for me). There was precious information inside. They would learn which residency program they had successfully courted which also indicated where they would soon be moving. No small matter. This is where they would each first begin work with the letters “MD” behind their name. They would learn whether they would match in their top program of choice, whether they would match in their top specialty of choice. Neither of which is a guarantee.

Those without an envelope had been notified earlier in the week and were graciously spared the public disappointment of this scenario. This situation, accurately dubbed “the scramble” is a less desirable outcome. But one that does not mean the end of one’s journey in medicine, by any means. The system is set up to provide those in this position with other options and opportunities. We were relieved, however, when my husband was most fortunately among those that had been notified that there would, in fact, be an envelope waiting with his name on it.

As the spouse to a hopeful surgeon, opening this envelope meant finding out if my husband would be one step closer to achieving his dream of becoming an Orthopedic Surgeon.

It would also impact how easy or difficult supporting him would be in the coming minutes, hours, days, even years. I would, of course, be his rock, no matter what information the envelope contained; a heavy burden to carry. I dreaded the emotional turmoil that would potentially ensue, knowing my perfectionist husband, in the event that he was disappointed on this day. I knew that the only acceptable outcome in his eyes would be if the name of the program inside the envelope was his #1 choice.

After all, his preparation for this moment had begun long before this day. And he had dedicated an immense amount of work to this mission.

It began nearly the moment he entered medical school.

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Early in my husband’s first year of medical school, we were jogging together on a North Carolina sidewalk near our dirt-cheap, rented apartment. We noticed a young-ish fellow walking his brilliantly beautiful bulldog. We first learned nearly all of the details about this pup. (Because HELLO! That is always the priority when meeting a bulldog for the first time.) Then we, finally attempting to be polite, asked the owner about himself. His name was Peter. We were surprised to learn that he was an Orthopedic Surgery resident at the same hospital where my husband was attending school. Thus began a beautiful mentorship with Peter; one that would impact the course of my husband’s career and life.

Though my husband was years away from being required to choose a specialty; Orthopedic Surgery had been nagging at him, enticing him closer with every new piece of information he learned. Peter’s marked qualities included a loud and boisterous manner. He was well-trained, highly gifted, intelligent, and generous in knowledge and spirit. He quickly became my husband’s guide when it came to all things Orthopedic. Peter’s mentor style was a perfect match for my husband. My husband quickly committed to Orthopedic Surgery as being his preferred path; after exposure to information about the specialty, meeting the talented faculty members in Orthopedics, and learning more about the daily life of Orthopedic Surgeons and residents.

Thanks, Peter. (No, but seriously).

Choosing the path ended up being easy. Staying this path, however, would require sacrifice, dedication, and excellence beyond what is typical of other specialties. He would need at least a 230 on Step 1 to prevent immediate exclusion from Orthopedic Surgery residency programs, preferably a 240 or beyond. Also, he would need to complete a research project in Orthopedics. He would have to dominate all of his med school rotations, striving to receive the highest scores in each. It would be necessary for him to coordinate multiple away rotations to gain deeper insight into his favorite programs.

On these away rotations, he would need to get to know some of the faculty personally, as well as ask enough questions to determine if the program would be a top choice for him; worthy of a fervent pursuit. He would need to get to know faculty members in his medical school and away rotations well enough that they would be willing and comfortable writing a glowing recommendation letter for him. After all of this, he would still have to apply to programs. He would need to be invited to interview and crush those interviews. Then finally, submit his rank list of programs. Then, come March 18th, he would need to actually MATCH into an Orthopedic Surgery residency program.

No, the gravity of Match Day was not lost on me.

After all, I supported him through each of these steps outlined above. I would bring him plates of (poorly-cooked) food during his Step 1 studying marathons. Though I would miss him fiercely, I encouraged him, to leave me for his away rotations as I knew it was best for his chances of Match success. I visited him each time he went away. I even made an 8-hour drive to surprise him on one occasion. To help him decide where to apply to residency, I made a complicated spreadsheet. I bought and read books about residency program options.

After documenting all information relevant to his specialty that I could find, I researched every school. I would type things like, “light surgical experience until year 4,” and then I would add details such as “congested city living,” or “no free parking,” or “could live on the river!” under my personal pros and cons columns. I edited his CV, and when the online system began accepting applications; I was next to him, helping him click the right buttons to double-check that everything was being submitted properly.

According to my records, he applied to 37 programs to ensure his best chances at matching in Orthopedic Surgery, historically one of the most competitive specialties. In 2018, according to THIS article by the American Medical Association, nearly 5% of Orthopedic Surgery applicants didn’t match in the specialty, with surely fewer applicants obtaining positions at one of their top three (or 10) choices. Therefore, in addition to all of the preparation, it’s necessary to apply to many programs.

Applications were expensive.

Every application would cost a sizable fee, comprehensively totaling nearly $1,000 for us for the applications alone.

But before we knew it, my husband’s interview invitations began rolling in. There were more than expected. Hallelujah. In fact, he had to decline 6 interview invitations simply because he could not be in two places at the same time. Many interviews happened on the same day, and interview season was relatively short. This meant, for my husband, he would have to decide which program would be a better fit before he even stepped foot in the hospital there.

Cue the additional research duties.

I helped him make an ambitious interview schedule and book the travel. I went with him on many of these trips, staying in gross hotels (as our interview budget was…dwindling). My husband had one suit to his name and he wore it at every interview. On interview days, I dropped him off at the door of these unfamiliar hospitals, saying a prayer (or fifty-six), and picking him up when he rang later in the day.

When each interview ended, I helped him make a comprehensive document that outlined exactly what information was given to him; spoken and unspoken. We dissected the resident fit, the facilities, the location, the operating experience, research opportunities, lifestyle, the downsides, etc. When all of the interviews were completed, I agonized with him over the “Rank Order List” that he was now tasked with creating.

Deciding which program to rank first felt overwhelming.

Do you rank the program you feel you have the best shot at getting into first? Or do you choose a program that may be more of a reach, and risk bumping yourself lower in the algorithm for another program? Were the faculty really as interested as they may have seemed during the interview?

After all, on the other side of the application process, the faculty in each residency program complete the same for their applicants; ranking them in order of preference. The algorithm makes the final determination regarding which program gets which applicant.

Rules govern how much information programs are allowed to share with applicants regarding their rank status. Think “The Bachelor” or “Bachelorette.” Suitors can express their love during the process but would have to wait until proposal day to gloriously hear that “I love you” back. An applicant may have an idea about how a program feels about them, but Match Day is when you find out, undoubtedly, if your love for a program is reciprocated.

The algorithm for matching applicants with programs is a tricky, elusive beast.

The company line, however, is that you should rank your programs based on your “true preferences” rather than where you think you would have the best shot at matching.

The night before my husband submitted his rank list, I cried in confusion, (which I didn’t know was “a thing” until this day). I wanted him to get into the best program for him, but I also, selfishly, really, really didn’t want to move to Washington. And if you read, “The Contract: The Ultimate Doctor’s Wife Compromise,” then you already know what I’m talking about here. So I bit my lip and pressed on, supporting his decision to rank the University of Washington first on his list.

With the click of a button, he left his fate in the hands of God and that award-winning, but ever-so-cold and impersonal, algorithm. Then, we waited.

And before we knew it, we would wake up and it would be Match Day. March 18th, 2010.

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We eventually made it through the seemingly endless crowd. My husband was the first to spot his name on one of the few envelopes remaining on the table. The table was covered by a cheery yellow cloth as if to blissfully ignore the possibility of disappointment. Only happy tears would be accepted here. Each envelope sat under a small envelope opener which was quickly forgotten, in our case. Once my husband had snatched up his envelope, he guided me away towards a door.

My introverted man found it strange that such an important moment could be potentially experienced in front of his classmates, many of whom were merely acquaintances. He had, therefore, already scoped out the hallway in which he wanted to open his envelope. He had previously asked me not to video record him opening the envelope, I assume in the case that the outcome was not what he hoped. So after going through a heavy door, he led me down a quiet, isolated hallway. It was again, a painstaking walk as that envelope rudely screamed to be opened with every step. We made our way to the intended location. Knowing we would soon be joined by our friends, we stood in the hallway only a few seconds before my husband took action.

With his breath obviously wavering, he calmed himself by sighing heavily and then ripped open the left side of the pristine envelope.

He quickly pulled out and unfolded the dense paper, adorned with the simple logo of the National Resident Matching Program. He stared and read silently for several seconds.

Attempting to nonchalantly peer over my husband’s shoulder, I could see only that there were more letters and numbers than I had anticipated. It wasn’t initially clear to me what the outcome was; that is, until he looked at me and said, “Yeahhhhh!!!” in a hushed, but thrilled, voice that had only been reserved for his most emotionally moving and satisfying moments in life.

We were deliriously happy over what that envelope revealed: that he had, indeed, successfully matched at the program of his choice. Long and laborious, the road that led to this day had ended victoriously at its destination.

Barely functional from our excitement, our best friends met us. We watched on, still in our same, lucky hallway, as they received their incredible news. They responded with loud, unbridled screams and cheers to learn that they, too, would be heading to their first choice of programs. (It’s in my video below!)

Blessings abounded.

In joyful celebration, Match Day continued with a banquet where each student announced their match results over a microphone. A little pin was placed on a large printout of the United States to indicate the location where each student was headed. My husband’s pin turned out to be a lonely little thing, as it seemed that most others were staying close to home on the east coast.

When the many festivities were over, we were left together, cozying up to new hope for the future. I found myself not even wishing in the slightest that the name of that other residency program was on his paper instead. It felt right; ordained; a gift from God that we were to be headed to Seattle.

In the years that followed, there would be more moments filled with nervous-laced anticipation and excitement, but none so much as on residency Match Day.

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To those of you headed to Match Day:

It is my deepest hope and prayer for you that you or your spouse (or both of you in the case of a couple’s match) will receive your most favorable outcome. You did your best work; you have applied and interviewed to the best of your abilities, and you have submitted that rank list. Now you wait until March 15th.

Be encouraged that according to the American Medical Association in THIS 2018 article, 94.8% of fourth-year medical students matched into a residency. This means that chances are great that a match will happen for you, too. If my husband’s outcome had been different, I would have told him that it’s okay to mourn that loss for a time. I would hope that he would consider that often those kinds of situations, though not initially desirable, make for some of the best opportunities for growth and continual pursuit of excellence. I would have wanted him to have faith that one closed door will lead to another, more suitable, and potentially more fulfilling path. Now is not the time to give up.

As you wait, all of you. Know that I’m behind you, supporting you, and one day, this too will be a distant, but vivid memory. Enjoy the ride the best you can.

Happy Match Day.

For more info on this crazy experience, check out Married to Doctors, who wrote an extensive post on Match Day. Married to Doctors is absolutely one of my favorite sources.

Love and Blessings, as always.

PS: I’ve included pictures, as well as a teeny tiny little video of our Match Day experience below. It’s all I have remaining from that day (in addition to the memories). It contains portions of what I describe in this post, including our friends receiving their news. Enjoy!

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Copyright 2019 by Honestly Ann Marie (formerly Surgeon Wife Life).

May not be reproduced in part or whole without the written permission of Ann Marie: honestlyannmarie@gmail.com)