MATCHED

So, now that this journey has reached its first major milestone, I’m going to stop worrying, relax and write a post. I can’t get my head around the fact that I have matched and come 07-17, I will be PGY-1 resident at some awesome program in the United States. All that worry, indecision, regret, hopelessness, guilt, the awesomeness of the interviews has reached the end.

The worst part about applying for residency in the US is the long long journey. While my batch mates here, took one entrance exam, got ranked according to their marks and then participated in counselling rounds to get the specialty they wanted, I had to wait a year before I was even eligible to apply. Where they just took a single exam, I had to take 3 nine-hour exams, one of them in the United States. While they studied in the library of our medical school, I was applying for electives and experiencing the brilliance that the American Medical system is. Its been a whirlpool of all sorts of emotions. Worth a movie really. Or at least a book – The Hitch Hiker’s Guide to the Match J

I have questioned myself at numerous times throughout these past two years. The first time: when I got my first rejection for a clinical elective. I probably disguise a bit my own low self-confidence in the form humility, but I was asking myself why I even thought that any university would love to have me there. Then came a great moment, when Yale sent me an acceptance into their Infectious Diseases clerkship. I could see my plan forming a little bit, moving a couple of steps.

And then it stopped again. No more acceptance emails. I needed at least one more elective to get the minimum required US Clinical Experience (USCE). And nothing. One fine day, I get an email from Harvard saying I was accepted into their elective. The elective that clashed with my Yale dates. I had to reject it. I remember saying to my mother on the day I left for the US, “if I get one more elective, it’s a sign from God that this is the path I’m meant to take.” Harvard decided to smile upon me yet again and offered me a second elective, this one at none other than Mass Gen Hospital. Yes, during those two months, I felt pretty great about myself.

The USMLE exams are a whole different ballgame. Studying for them was tough, yes. But, sitting through an 8 hours exam for the first time ever, is enough to knock you flat. I knew I didn’t do fantastically well on it. When I got my score, I knew it was good. But that’s just what it was. Good. Not the best, not awesome, not the see-the-score-read-the-eras-profile kind of score. When I took the Step 2 CS, I was sure I had given it everything I had. I wasn’t sure whether it was enough though. I think everyone needs to take this exam once in their lives. It is so real and so strange. I was pretty sure I was going to fail it, actually. Because I thought my cases were weird. Now I know everyone says the same thing after coming out of this exam. I was most petrified of that result. The moment I saw that ‘PASS’ written on my score report, I started crying. That was a first. Crying because I felt like I’d gotten some major victory under my belt.

It was after this result that I went into a sort of manic mode. I decided that applying immediately would serve me best. I ended up taking the Step 2 CK as late as I possibly could, but still early enough that I’d be eligible to apply in Match 2015. That exam was a disaster. When I came out of the Prometric Centre, I knew I would be questioning what went wrong in my head, when I decided to take this whole USMLE plan through. Even now, I feel a mix of relief and disappointment when I think of my CK score.

My next questioning moment was when I applied to fewer programs than everyone else in the same boat. When I was doing my research, it made sense to me, to apply to programs that could see me as a potential candidate. Why should I apply to a program that said they wanted 3 months USCE when I had only 2? Why would I apply to a program that was situated in a place I knew I’d never stay in? So, yes, it all made sense at that time. After MyEras opened and people started getting interview calls from everywhere, I questioned all of that rationality. What harm would it have done to apply to a few more?? When I got my first interview call, I was delighted. Again, this plan appeared to move further towards its destination. Then came the stop. Nothing more for almost 1.5 months. I started thinking back-up plans, avoiding my own thoughts to avoid my own questions and wondering why at 24, I couldn’t even believe that I was 24 years old.

Going to the interviews was nerve-wracking to say the least. I had half a mind to not get into that US-bound aircraft. I was more than happy to run away and figure out something else for myself. I had to keep playing all those morals I had learnt from Harry Potter and Lord of the Rings in my head to give me courage to face this head on. It did not matter that I actually had fun at the interviews, met new people, made conversations with students from all over the world and felt great about my chances. When I came back, I had another disaster heading towards me – my ECFMG certification.

Once you get your degree, you send ECFMG (the Dean’s Office for International Medical Graduates) a copy of that degree. They look through it and then send a form to your medical school, asking them to verify stuff from their side. The school is supposed to do this and then resend the form to ECFMG who finally verify your medical credentials and issue the ECFMG certificate. As has been the pattern in my USMLE prep, this took ages. I had to get certified before the last date of Rank-Listing. Phone calls to ECFMG and trips to my medical school did not seem to fasten the process. That was the first time, I decided to bury my head in the sand and just let go of this dream. It was sort of my fault that this process did not happen earlier, right? If I’d planned things properly from the very first day of my internship, I’d have spent a happy February with nothing to worry about. Instead, I spent sleepless nights and frowning days, avoided talking about the future even when my parents pushed for it, dove into fiction as if it were my last tank of oxygen. When that certificate was issued 6 days before the last day of Rank-Listing, I felt like a phoenix rising from the ashes. I was reborn. At least now, if I did not match, it would be because I wasn’t good enough. Not because I didn’t have the documents in place.

You’d think that believing something like that, rejection because you’re not good enough, would be a blow to your mental health. But, I’d rather have a failure that I could blame myself for. Maybe this is a little childish, but it gives me a sense of clarity to think like that.

Now, lets come to Match Week. Frankly, I did not believe that it was really happening, All that I’ve done, the electives, the exams, the interviews still feel like a dream. I’ve never thought that I could be brave enough to do it all, so looking back, it doesn’t seem real. I couldn’t believe that I would match because of this whole dream thing. I mean, how could it really happen right? How could a dream just become reality?

I had a sleepless Sunday night. Having avoided the thoughts for the whole day by keeping my mind busy, I couldn’t bring my mind to calm down during the night. I was jittery. I had to attend a new OPD, shadow a new consultant on Monday. That always makes me a little nervous. Add on these nerves, and I was pretty gone. I jumped at the opportunity to convert this OPD day into a research day instead. Then I plugged on my head phones and listened to music and buried myself in the records section of the hospital. When evening came though, there was nothing else left. No defence mechanisms that could suppress the thoughts of not matching and having to deal with SOAP (the post-Match Supplemental Offer and Acceptance Program). When you are in a time zone that’s 9 hours ahead of the US, it sucks to participate in the SOAP. You can’t be physically present for any interviews that might come your way. You have be up all night to make sure you at least get a skype or telephone interview. And you have just 2 hours to accept an offer. This goes on for 3 whole days. If you are at an institute like mine, where you are busy all day from 7 am in the morning, this is a nightmare.

It goes without saying that I did not want to have to go through SOAP. But, I couldn’t stop stressing, couldn’t stop thinking. And then fate decided to intervene. The wifi connection at my house decided to give way. Completely. And it refused to right itself. Suddenly my thought were torn from having to participate in the SOAP to whether or not I would be able to even see my Match status in the first place. I had to make the decision to come back to my hostel room and rely on the so-s- wifi here. That relaxed me a little. For a while I had to think about arranging transport to the hostel, my food requirements, etc.

Of course, the moment I got to my room and set things up, the jitters came back. This time, good old site-load helped me through. I couldn’t open the NRMP pages fast enough, there was no message anywhere saying that I had/hadn’t matched. That made me believe I hadn’t matched of course. So I went onto the SOAP link. And it said: You’re not Eligible for SOAP.

There is only one reason why you go from being SOAP Eligible on the Friday before Match Week to being SOAP Ineligible on the Monday of Match Week. Several agonising minutes later, I saw the message that calmed me to numbness, such a strange numbness I think I floated out of my body and saw myself sleeping peacefully for the next three nights in that hostel room bed.

CONGRATULATIONS! YOU HAVE MATCHED!

I think in the line of major achievements, this by far trumps everything. I don’t know where I’m going to my residency. I know that the places I interviewed at, I loved. So anything I get will be awesome and make me happy. I can’t ask for any more. What I can do now, is reflect on how this journey helped me grow up a little. I know if it hadn’t been for this decision, I would never have ventured out of my own city. Instead, I flew all over the US twice in the past year and am now spending a month in Hyderabad by myself. I would never have been capable of believing that I can meet new people and make new friends, and not feel out of place. I would never have known that I do have the mindset and belief to see myself through anything.

I never believed that I’d ever take the path less trodden. Robert Frost’s “The Road Not Taken” had struck a big chord back in school. But I never thought I’d embark upon something like that. You always hear stuff like, challenge yourself, get out of your comfort zone, the success you achieve by going straight ahead is never sweet enough. But do you actually do it? I’d like to believe this me doing that. Yes, I always wanted to get my further education in the US. But I saw myself going through SAT/GRE and getting into some academic program there. When I got into medical school, those dreams were buried by the wealth of knowledge there was, to accumulate.

I never liked Frodo Baggins in LOTR. I felt he was too dark, too depressing in his journey to destroy that Ring. I understand him now. Yes, my life was never in danger, I did not have to worry about the basic necessities of life in this journey, but it was a journey that questioned me, a journey that put obstacles in my path, a journey that challenged but did give some respites.

I have always loved Harry Potter for facing challenges head-on and getting through it all. He was the first to say he always had help, but what use is the help if you don’t have the courage to stand in the battlefield? I had to dig deep into my own stores of courage, gather every dialogue from both these series that shaped my childhood. I might still not feel very worthy of any new achievement that may come my way. But, I know that if I could snag a residency in the US, be the first from my entire family to do it in medicine and feel proud of myself right now, I will be able to do anything I want in the future.

My family and God, thank you so much for supporting me through this and allowing me this opportunity. To my Idol, the late Kalpana Chawla. You talked about a journey from a small village in India to the stars. You have always been my inspiration, from the time I had a photo of the whole Columbia Team stuck to my study table, to every interview where I talked about you and your incredible journey. I hope that this leap I am taking from my own small city to the Land of the Free will help me build my own new dreams and reach for my own stars.

I matched! Game, Set, Match J