Navigating the Gray: The Match Process

“What will you say when they ask if we are leaving for residency?”

“I am not sure,” I reply, with a sigh.

“My sisters asked again if you had accepted any offers from programs,” my wife responds with a grin.

“If only that was how it worked.”

“The idea of the Match is confusing to them, but they really want us to stay close to family,” she says and gently touches my shoulder, affirming she will be supportive whatever the outcome of the match. Then we drive in comfortable silence for the remainder of the short, familiar trip to my parents’ home for Christmas Eve.

When we arrive, we’re greeted warmly by my parents and grandfather in the living room. The absence of my grandmother, who recently succumbed to pancreatic cancer, leaves a void of warmth and attentiveness in the room. She was a perfect match for her Navy captain husband. As the rest of the family settle into a familiar game of Yahtzee, I find myself pulling up a large nest of blankets across the room mindlessly watching the TV, which remains on in the background.

My brother’s family soon arrives, the cool gentle breeze accompanying them in. The air is refreshing but I find myself embroiled in uncertain thoughts about my future. Should I leave moments like these behind in search of… something more?

Usually the socialite, I am now trying to blend into the familiar surroundings, hoping to delay discussions about my future as long as possible, thereby hiding my own struggle. I squirm, slowly sinking until I silently disappear into the couch’s embrace. Soon, however, I see my grandfather approaching me. The tall, formal sailor bluntly asks, “When can I call you doctor?”

“I will be a doctor after I graduate in May,” I respond, absentmindedly.

After a moment, he raises his eyebrows in understanding and asks, “Where do you want to go for residency?”

I feel every eye in the room turn toward us. Is the TV quieter or is that only in my head? Deep down, I know the question is really: Am I staying or leaving for residency.

I’ve been asking myself the same question for weeks.

I loved my interviews with programs across the country, drawn to the allure of exploring beyond the familiar 50-mile radius where I've spent the last 15 years. Born abroad and exposed to travel early in life, I crave new experiences.

The general advice from my medical school was, “follow your gut.” But my gut is conspicuously nonmotile. How am I to weigh competing factors like program size, location, and cost of living with interview “gut feelings” and 5-minute personal interactions? When I contemplate staying, all I think of is the support and peace here while still having a sense that something is missing.

As I contemplate a response, the knot in my gut tightens. A couple-second pause feels like minutes. I sit wrestling with my thoughts. I exist somewhere in the gray of when a decision has no right or wrong answer, yet must be made. There is not fear here, only uncertainty of what my next steps in this journey ought to be. I hear the echoing remarks of my wife’s family wanting me to stay tempered by my wanderlust. I desire to challenge my perspective and gain insight and wisdom for the future. Residency is in my future, but where will it be? The interview process was supposed to be the hard part, not this.

I hint to my grandfather, “I interviewed across the country, though nowhere out by you in California.” A cheap answer, I think, and wonder if it will satisfy him.

“Well, where would you like to go?” he responds, chuckling.

My undergraduate training in history taught me to view problems from a variety of perspectives. Yet, I cannot seem to find my own perspective. Will I look back on this decision with regret and remorse, or wonder and contentment? As my mind lingers on the question, my unease is palpable.

As a student doctor I long for an algorithm to help guide my choice. However, like any good clinician I must first hear my patient. Listen for the subtle crack in their voice that belays their intended wishes. I may not have answers, but listening is therapeutic too. However, now there is no patient, just me.

My thoughts swirl at the idea of leaving as I look around. What will next year hold? My grandmother passed away this year, will someone else be gone next year? Or will I? The demands of training overriding traditions and leaving me in a hospital somewhere far away. When I was applying to medical school, my family was supportive of us leaving, but the recent loss of my grandmother has highlighted the value of family. However, is staying submitting to some undisclosed fear I have yet to confront? Is the right answer staying, or going?

I shift in my now uncomfortably warm nest of blankets, seeing my grandfather’s tender and reassuring gaze, realizing I am not alone. As my mother rolls the dice next to us hoping for a five, the outcome is out of her control. Like chance determining her roll, the algorithm looms over my match. There is no answer right now, only patience. I must be present and listen to myself and those around me. There is nothing I can do; more importantly, there is nothing I should do. I can only allow myself to find comfort in the gray and know I am not alone: I have family, mentors, and students across the nation wrestling with the same questions I am.

“I don’t know where I want to go,” I declare. My grandfather responds with only a reassuring smile. In his smile I see the same care and warmth my grandmother would often bless us with and know I am not alone, even if I go.