Welcome to March, Home of Match Day Madness

March 18 is Match Day. It's the day fourth-year medical students find out where they will be doing their residencies and in which specialties. Some have described it like some kind of arranged marriage where you get to meet your bride on your wedding day.

Here is what to watch for to spot recent trends:

1. How many decide to match into primary care specialties versus specialty residencies

2. The percentage of minorities and women

3. How many don't match

4. How many decide to forgo the match and join the dropout club

5. How many foreign medical graduates and international medical graduates match, in which specialties, and where

6. What is the chance you will match if you were unsuccessful the first time around?

7. How much time and money did you spend the fourth-year of medical school interviewing and applying?

8. Whether there is any correlation between student debt and specialty choice

9. How many matched as couples

10. How many programs went unmatched, in which specialties, and where

Many older physicians remember the days when you were given a slot with a wink and a nod. That changed many years ago.

How we choose residents continues to be an expensive and time-consuming affair that seems to perpetuate generalist/specialist, racial, and geographic disparities. Also, because medical students often don't have the clinical skills to take care of patients, there is a "July effect." We also don't do a good job identifying those who match that will wind up on probation and never get board certified.

Maybe it's time to consider a lottery, eliminating all that travel, wasting most of the fourth-year of a very expensive education and deluding ourselves into thinking that performance in interviews is a correlated with job satisfaction or performance on the job.

Come March 18, some will be cutting down the nets because they got that cherished slot in orthopedics, while others might be sulking in the locker room or walking out of media interviews. Most will have had an inadequate job preview and not know what they don't know. But, they should all be celebrating that they made it to the big dance.