Saturday, March 22, 2014

WILTIMS #124: T-3 years until Match Day

As you may have seen on the internet or news, today was Match Day for fourth year medical students around the country. The Match is the almost dystopian system used to pair graduating medical students with hospitals for residency programs. The whole process is completed by a computer algorithm that finds the best fit between the 35,000 applicants and 30,000 positions based off of ranked lists submitted by both students and hospitals. If you read those numbers correctly, you'll note that not everyone matches, though 94% of US allopathic seniors do (international and osteopathic schools generally don't fare as well).

A week before Match Day, emails go out to all applicants telling them whether they matched and, if they did, not saying where. Then on Match Day, all the matched seniors across the country meet at their schools and, at the stroke of noon eastern time, simultaneously open envelopes that tell them where they will spend the next 3-7 years of their lives.

Here are a couple videos showing the typical level of excitement:



My first-year class had lecture from 9-noon, so we got out of class right after the fourth-years had opened their letters. It was really exciting. Everyone was hugging and laughing and sharing tears of joy. They don't graduate or become doctors for another few months but Match Day is the real finale of medical school - the culmination of 3½ years of hard work (not to mention the years before that working to just get in!).

3 more years!

TIL: The first hospitals were developed as a place to treat travelers or pilgrims who couldn't be treated at home. Hospital, hostel, and hotel as share the same root.

Medical school admissions interviews and photos were first implemented at the University of Michigan to screen out Jewish and black applicants who were not otherwise identifiable by name.

Myelomeningocele, also known as spina bifida overta (or just spina bifida to the general public), causes hydrocephalus in 80% of babies. Spina bifida is a condition where a portion of the lower spinal cord doesn't form correctly and leaks cerebral spinal fluid (CSF) into the open air. This is incredibly dangerous because if, left untreated, the child will develop fatal meningitis within days. But once the hole is surgically sealed, the CSF starts building up in the brain because the normal draining routes never formed. Excess CSF fluid is called hydrocephalus and it requires the surgical implantation of a shunt that connects the CSF cisterns of the brain to the peritoneal cavity of the abdomen, where the fluid is easily absorbed.

Type I Chiari malformation is when the cerebellar tonsils block the foramen magnum (the hole in the skull through with the spinal cord passes), blocking CSF circulation and pinching the brain stem.

Dandy-Walker syndrome results from a malformation cerebellum and enlargement of the fourth ventricle.

Alobar holoprosencephaly is an often fatal deformation of the brain where the two hemispheres never develop.

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