Mar 24, 2014

The Match, The SOAP, & the reality of being an IMG

This past week was Match week, which for those of you readers unfamiliar with this term, it is the means by which MD graduates get "matched" into a residency placement.  For many people, Match week is the highlight of your 4 years of medical school, when you finally have a job post graduation and the reality that all of your hard work has in fact, paid off.

However, what many people don't understand is that there are far more MD candidates trying to "match" then there are spots in residencies.  Every year, there are thousands of applicants, many of them international medical graduates (IMG's) who don't receive a spot in a residency.  Therefore leaving them with the degree of MD but unable to be licensed and practice due to the inability to obtain a residency position.

The Facts:

  • Josh is finished with all of the requirements to graduate from medical school at SGU and will receive his diploma in June.
  • Josh passed all of his board exams, Step 1, Step 2 CS, and Step 2 CK with scores above the average for both IMG's and AMG's (American Medical Graduates)
  • He had strong letters of recommendation
  • He is in the 1st quartile (top 25%) of his graduating class academically for both the basic science years (first 2 years) and currently
  • He applied to 100+ categorical surgery residency programs both community based and university based across the entire US
  • Josh only received a few interviews to residency programs
  • We found out Monday that Josh did NOT Match

While not Matching did not necessarily come as a complete shock because of so few interviews, we were still very disappointed.  It is extremely scary to know that you not only don't have a job after 4 years of medical school, but you also have no job with $200,000.00 worth of educational debt that will have to start paying back after you graduate.

The SOAP (Supplemental Offer and Acceptance Program):

  • When you don't Match into a residency, you can enter the SOAP, a process by which you send out up to 45 more applications to residency programs that did not, for whatever reason, fill their positions during the Match.
  • On Monday afternoon, Josh sent out the full 45 applications to programs for Surgery (both categorical and preliminary), Family Medicine, Emergency Medicine, and Internal Medicine.  At this point he was willing to do anything.  We thought FOR SURE he could SOAP into something based on his grades and Step scores.
  • From Monday through Thursday, applications are reviewed by programs, phone interviews may happen, and every few hours, offers to those programs are made.
  • There were approximately 900 positions in the SOAP.  There were over 1100 AMG's unmatched and over 8000 IMG's unmatched trying to obtain these spots.
  • Josh got ZERO phone calls or emails the entire week.  NOT. EVEN. ONE.
  • It is our belief that international graduates, regardless of citizenship were filtered out from the start, that Josh's application was not even looked at all week.
Our interpretation of the SOAP from an IMG standpoint was that it was like being stabbed with a knife and then having it twisted around inside of you in order to kill you slowly and painfully.....a slow, painful death.  There is nothing like sitting around all day for a week, waiting for a phone call, and one never coming.  The stress level in our apartment was sky high and yet we knew there was nothing to do but wait and hope and pray that something would work out.  Josh was a part of message boards online for people in the same position and we know that AMG's with significantly lower Step scores were getting multiple phone interviews as well as offers.  Never has the stigma of being an international graduate felt more damning.  Both Josh and I were so discouraged.

Post SOAP:
  • On Thursday at 5:00pm EST, the SOAP ends, and unmatched applicants are then allowed to contact programs by phone or email that still have openings.
  •  At this point, there were less than 50 spots across all specialties left after the SOAP and programs are not required to fill their positions.
  • Josh began sending out what I call hail Mary emails to programs with unfilled spots hoping that someone might throw him a bone and at the very least email him back.
  • He received many automated response emails saying either the positions had been filled or that they had decided not to fill their positions this year.
  • By Friday morning, Josh was beginning to look into alternative options for the next year.  These included doing an MPH (Masters of Public Health), unpaid medical research, delaying graduation in order to do more hospital rotations, and jumping off a bridge....joking...kind of.
On Friday around noon, Josh received a call from the program director at the University of Massachusetts, one of the programs he had emailed the night before.  He conducted a 10 minute Face Time interview and offered Josh a general surgery residency position for this year on the spot.  Within minutes of getting off the phone, an email with the offer came through, Josh signed it, and that was that.  Relief immediately followed.

What we learned/Our advice:
  • Apply on time.  Do not wait even a day to send out your applications. Being the first to get them in is likely key to getting multiple interviews.
  • If you can, have all of your Step scores IN before applications are due.  You are best off if you have a COMPLETE application at the time of submitting it.
  • Have realistic expectations.  If you are an international grad, it will likely hurt you.  Most IMG's go in to primary care (FM, Peds, IM, Psych).  If you do not want to go into one of these, consider apply to some anyway as a back up choice.
  • Avoid the SOAP at all costs!  It is NOT set up to be in the interest of the applicant, especially IMG's.
  • It is better to have a residency of any kind than not.  Trust me.
We feel very lucky.  Not only did Josh end up in his residency of choice, surgery, but amazingly he is also going to be at a university program at one of the top surgery programs in the United States.  It is nothing short of a miracle and we are definitely counting our blessings.

****EDIT: Here is a link to the follow up post regarding our match process.  Josh did, in fact, match into categorical surgery in the 2015 Match.  Read about it HERE.

Mar 20, 2014

Birthdays and Pony Rides

Last weekend, Ryan got to attend her 2nd cousin Piper's 1st birthday party.  Obviously, she had no idea that the day was any different than a normal day, but the party put on by Josh's cousins Allee and Barrett was just beautiful and it didn't hurt that it was 85 degrees in March!

At the last minute, I found the perfect little skirt at Target even though I wasn't even really looking for something for her to wear.  Isn't that how it usually works at Target?  You go in for a bottle of shampoo and come out with two outfits, a pair of strappy sandals, some groceries, a picture frame, a new DVD, and about $100.00 worth of other things....please don't tell me it's just me.

Anyway, little did we know that Ryan would be wearing the perfect outfit for the party.  People thought I planned to match the birthday girl!
This picture kills me.  Kids are seriously hilarious.
We had SUCH a good time.  The highlight of the party was Ryan's first pony ride.  We were a little hesitant to let her ride the pony, but the child LOVES cats and dogs and so I figured horses would be no different.  I wasn't wrong, she was on cloud 9.

The worst part of the whole pony ride was that my little baby looked like such a big girl. Tear.  She is growing up far to fast for my liking.

This party gave me all sorts of ideas for Ryan's 1st birthday, which is only about three months away! Oh man, thinking about that makes me excited and sad all at the same time.  Babies growing up is so so bittersweet!

Mar 18, 2014

St. Patrick's Day....Baby Style

There was once a time in my life where St. Paddy's Day included green beer and a late night of shenanigans.  Case in point, March 17, 2011, Newcastle, England.

Fast forward four years and March 17, 2014 was only lacking the beer, the late night out, and the only shenanigans that occurred were the green food coloring in our breakfast and a pinch or two because Josh wasn't wearing any green.  Tis the life of parents!  I did however get to dress Ryan up in the cutest St. Patrick's Day attire out there, which is significantly more fun then dressing myself up in green.  Josh, Ryan, and I enjoyed lunch at the local deli and an early evening walk around the neighborhood to cap off our day.

Maybe next year we can partake in some of the shenanigans of St. Patrick's Day past....or at least have a green beer or two!

Mar 11, 2014

8 Months

My little Ryan Cathleen turned 8 months old this month!  And I have to say it's quite crazy to me that she is now 2/3 of the way through her first year.  I feel like I say this a lot, but seriously, where on earth has the time gone?

Ryan continues to have mama's milk as her main nutritional content, nursing approximately 5-6 times in a 24 hour period.  My goal has always been to make it to a year of breastfeeding, but I have to say, she has become increasingly more interested in what's going on around her then with eating.  At least during the day, so we'll see how much longer this lasts.  She also eats pureed food three times a day (morning, afternoon, and evening).  I have to admit, I had big goals of being one of those Mom's that makes ALL of my baby's food, but to be honest, it's hard to find time to make my own meals let alone hers.  So, she gets a mix of Mama Scurlock's concoctions...and Gerber's. :)  She will eat most things that I give her, but especially loves fruit...and Puffs.  Those dang Puffs could entertain her for hours!

Auntie Anna (Antenna) and Ry matching at church.

We officially have an army crawler in the house this month.  Ryan started pulling herself along right at the beginning of the month and has quickly perfected the art of belly crawling around the house.  She will get up on her hands and knees and rock back and forth but has yet to figure out that she could be a lot faster and have a lot less carpet burns, if she would crawl with her tummy off the floor.  Although I have to say, she's fast enough as she is.  I can't turn around for one second anymore without her getting into something.  She's also learning to pull herself up, which quickly led to the crib being lowered. Baby proofing needs to happen stat!

Ry continues to be a rather good night sleeper, usually going down around 7:30pm and waking up sometime around 7:00am.  She rarely wakes in the middle of the night anymore and about 3-4 times a week wakes around 5:00am for a quick nursing session before she's back to sleep for a few hours. Her daytime naps continue to be a slight challenge, but I have come to the conclusion that my child is just never going to be a stellar napper.  She takes 2-3 naps a day still and goes down in her crib easily, but the length of her naps range from 30 minutes to 2 hours, most falling in the 1 hour range.  It is just not predictable which makes getting things done tough.

Ry and her twin cousins Cole and Jacob.
Other Tidbits:
Ryan cut 6 teeth this month. Poor Mama.  She now has a full set of 8 teeth (4 top, 4 bottom).  It was rough, but they are through and I am hopeful that we will have a bit of a break before it's time for more to come in.  She actually is a rather good teether but I don't think it's fun for anyone no matter what.
Baby torture.
She also started babbling this month.  Her first "word" was "ba ba ba ba" followed quickly by "ma ma ma ma."  And don't you worry, I will forever hold over Josh's head that Ryan's said "mama" first.  She did eventually say "da da da da" too.
Ryan has started to develop some sense of stranger anxiety.  She started crying when I leave her at the nursery at church and is hesitant even when I'm holding her if she doesn't recognize the people around her.

Her favorite things are doggies, Puffs, bath time and Mom and Dad.

Her least favorite things are car rides, green veggies, and strangers.

Josh and I can't imagine life without this little bug.  She is so fun, even on her not so fun days.  Tonight, after she'd been asleep for awhile, Josh asked if we could wake her up to "play."  To which I quickly replied, absolutely not! But in all seriousness, we love this little girl and we thank God every day that He entrusted us to be her parents.