100 Perfect Matches

From the March 10, 2023 issue of the Transformational Times

100 Perfect Matches

Kathlyn E. Fletcher, MD MA – Program Director, Internal Medicine Residency

Dr. Fletcher reminds us that regardless of where you do your residency, you will ultimately have a meaningful career with very close friends that you will meet in your program.

I’m terrible at cocktail parties.  In fact, I went to a black-tie gala two weeks ago and proved this point (again).  I was standing in a small group with my friend Jayne and a couple of her acquaintances from the banking world.  One of Jayne’s acquaintances had recently taken a new job, so I asked her how she was enjoying it.   She smiled and said, “When you love your work, everything is easy, right?” And before I could stop myself, I said, “Is it really, though?”  Jayne started laughing.  She knows me.  I really am terrible at small talk.

What I want to explain to them is that you can love your work, and it can still be hard.  That’s the thing about medicine as a career.  The work is usually hard.  The NATURE of our work is hard.  We interact with people on very difficult days.  Sometimes patients we see are in pain or very ill or very afraid or all those things at once.  When we are leaders, we talk with colleagues and learners who are struggling through personal issues or professional issues or both.  We meet people where they are.  We imagine their backstories.  We try to walk alongside them through their very worst times.  That is hard work.  But it is also meaningful.  And when we have meaning, we can have joy.  And when we have joy, we love our work. But it is rarely easy.  

In my role as program director, I am in that time of year between submitting my rank lists and waiting to see who will be my future interns. It is a strange space for program directors as we worry about whether or not we remembered to submit our lists (I literally woke up last night in a panic that I might have forgotten), wonder which of the candidates who said that they ranked us at the “top” of their list really meant it, and try to keep ourselves busy so as not to think obsessively about the Match (which I am clearly doing as I write this).  

I led a session this week with M4s on using art to develop empathy. In this session, the students choose pieces of art that speak to them and pieces that they think would speak to others.  One of the students chose a beautiful and dramatic painting by Homer Winslow called The Gulf Stream. In this painting, there is a man trying to navigate an extremely angry sea with a terribly damaged boat.  To make matters worse, there are sharks in the foreground.  According to the MET’s website, Winslow added a schooner far in the background, possibly to represent a glimmer of hope in the otherwise dire circumstances.  Interestingly, the students identified this painting as reminding them of this pre-Match period.  This really is a stressful time for them.

I have been thinking a lot about my daughter’s quest to find the perfect college.  She is a junior in high school and is just at the beginning of that journey, trying to discern what it is that she wants in a college experience.  She just finished her first college tour at Emory University.  She is anxious.  Her practice ACT tests are not (yet) in an “elite” range.  Her grade point average is amazing, but she is not in line to be the valedictorian of her class.  She has done some remarkable things, but she hasn’t patented an innovation or started a non-profit.  How could she stand out in the crowd?  

As other parents know, my ability to soothe her fears is limited to short bursts of time which she arbitrarily chooses.  I, therefore, have to pay attention so that I don’t miss my opportunities to drop perspective snippets.  The only message I have really come up with is one that I (ironically) took away from a cocktail party.  I think it has relevance to the Match.  Another couple with children in college commiserated with my husband and me about the stress of college applicatipons and early admissions and early decisions, etc.  But then, the dad said, “This is the thing: there are 100 perfect colleges for everyone.  The kids just have to believe that too.” 

Our residency program recently hosted an in-person second look day.  Because all residency interviews were virtual this year, we wanted to give applicants an opportunity to see Milwaukee, MCW and our residents in person.  At the end of the day, I told them not to worry too much about the Match. I told them that regardless of whether they ended up here or at the 7th place on their list…or if they ended up here and we WERE the 7th place on their list…that they were all going to be fine.  

So here is my message to the soon-to-be graduated medical students: Regardless of where you match, you will be fine.  There are plenty of perfect programs for you.  Wherever you land for residency, there will be things that you love about it and things that you want to change.  You will make lifelong friends.  You will learn and stretch and grow.  You will have hard days, and you will have meaningful days.  At the end of your training, you will be independent physicians.  

Also, once you start residency, it will never again matter where your program was on your Match list.  After July 1, no one will ever again ask you if you got your first choice of residency programs.  Not even at a cocktail party.  

Kathlyn Fletcher, MD, MA, is a professor in the Department of Internal Medicine at MCW. She is the program director for the Internal Medicine residency program and the co-director of the GME pillar of the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education.