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Matching Rites—Sooner or Later
Med students learn their destinies on Match Day, but some are delaying their residencies.


Adena Greenbaum shares her news with Redonda Miller, who reassures students delaying their residencies that there's more than one recipe for success.

With predictable fanfare, the National Residency Matching Program’s March Match Day evoked shrieks and hugs as 99 Johns Hopkins School of Medicine students ripped open envelopes to learn their fates for the next three to six years. The program uses a complicated algorithm that aims to match applicants to their most desired residencies.

The process actually begins the previous summer: Students meet with advisers to create a living file of experiences, personal statements and recommendation letters. Many travel hundreds of miles to interview for potential residency programs. By February, students must submit their rankings; residency program directors also submit their list of top-choice students by this time.

Though Hopkins’ medical students almost always find a desired match—and this year was no exception—they’re increasingly deferring internships and residencies, says Tom Koenig, associate dean for student affairs. Instead they’re spending an extra year, typically between their third and fourth year, doing advanced research or pursuing additional degrees. Fifteen (of 120) members of the class of 2008 have opted to enroll in master’s of public health programs or to conduct research in their chosen fields.

These students, says Koenig, are viewing their education with more flexibility. Redonda Miller, assistant dean for student affairs, has noticed this shift as well. “When I graduated from Hopkins in 1992,” she says, “maybe two in my class of 120 added a year of study before the match. Now I’m finding that as many as 20 per class do.”

Adena Greenbaum, ‘08, is one such student. She took off last year to earn a master’s degree in public health at Hopkins. Having spent a semester studying ecology and conservation in Africa, Greenbaum gravitated towards public health and spent two years after college working in that field. But she’d always wanted to be a physician. Pursuing an MPH at the same time, she reasoned, would complement her medical training.

Greenbaum’s infectious diseases work last year, she says, added a new dimension to her clinical work during this final year of med school. Greenbaum, who matched at Hopkins in internal medicine—her first choice—hopes to do a fellowship in infectious disease.

Similarly, Jamie Cowan, ‘08, spent last year at Harvard studying global health, a field that’s also attracting more students, observes Koenig. Cowan says he may eventually pursue a career in health policy. Rozalina Grubina, meanwhile, who started medical school in 2004, spent two years at NIH doing basic science research and won’t graduate until 2009. Grubina points out that in her native country, Latvia, the option to explore other venues during medical training doesn’t exist. “I discovered that I’m too chatty for research alone,” she says.

But how to explain the growing popularity of these extended journeys? Says Miller, some students argue that it will make them more confident about their career choices; others say they’ll never have the chance to explore these paths once they have other responsibilities. “We’re used to people adding research years here,” she says. “What’s striking is that students are exploring diverse ways to find fulfillment in their careers.” Regardless of this trend’s impact, come Match Day, says Koenig, “the emotional underpinnings are always the same.”


—Judy Minkove



Johns Hopkins Medicine

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