Resident Match breaks records for applicants and couples

Over a flauta and a chicken-spinach enchilada, Brandon Bolfing and Shahed "Sky" Izaddoost took a breather from their final year at the University of Texas Medical Branch at Galveston to celebrate their Match results with friends and family at a Mexican restaurant.

"This is the first place we went in medical school," Bolfing said. "And it will be the last now that we've matched."

Izaddoost will be in pediatrics at the University of Texas Medical School in Houston. Bolfing will work 40 miles away at the Conroe Medical Education Foundation's family medicine residency in Conroe, Texas.

Bolfing and Izaddoost, who plan to marry May 24, are among a growing number of couples participating in the National Resident Matching Program. This year, a record 738 couples applied for residencies, with 94% matching on Match Day March 20.

One reason behind the increase in medical couples, educators said, is that women have made up nearly half the entering medical school class since 2002.

But matching as a couple is no simple feat.

Applicants who participate as a couple create pairs of program choices on their rank order lists so they can mix geographic locations and specialties according to their needs. In addition to the challenges of deciding on a specialty, figuring out where to interview and how to rank their choices, couples want programs in the same vicinity.

"Most couples I've talked to have had to make some kind of compromise," Bolfing said.

Bolfing and Izaddoost were among 28,737 applicants who competed for 22,240 first-year residency positions in the Match, making this the largest group of applicants ever, according to the NRMP.

Primary care specialties, which have seen a downturn in interest among U.S. medical school seniors in recent years, had mixed results.

Family medicine saw a 5% increase in the number of U.S. seniors matched, according to the NRMP.

"We're hoping it's a trend, but it's too early to say," said James King, MD, president of the American Academy of Family Physicians.

Dr. King said the AAFP's initiative to encourage schools to develop new family medicine training models, called "Preparing the Personal Physician for Practice," or P4 project, may be starting to influence medical students' choices.

Fewer pick internal medicine

Meanwhile, internal medicine saw a slight decrease in the number of U.S. seniors who matched, dropping 20 students to 2,660 U.S. seniors. Overall, internal medicine numbers have held steady in recent years, though many graduates continue in subspecialty fellowships instead of practicing general internal medicine.

"If this trend continues, a shortage of general internists and other primary care physicians will likely develop more rapidly than many now anticipate," said Steven E. Weinberger, MD, senior vice president for medical education and publishing at the American College of Physicians.

Bolfing and Izaddoost found primary care appealing, despite lower pay than other specialties and long hours.

"You could make more money and have better hours at something more competitive, but I think the smartest people should be in family medicine," Bolfing said. "They have to see everything and know everything."

Izaddoost said pediatrics was an easy choice.

"I get a lot of joy and fulfillment with the kids," she said. "You have to be professional enough so the parent understands and be able to give the child a sense of involvement in their illness."

When they were seeking residencies, Bolfing and Izaddoost considered compromising their choices. Bolfing could have jettisoned his desire for a rural family medicine program. Izaddoost could have given up her dream of an urban, hospital-based pediatrics practice.

Instead, they decided to find programs that fit their needs within commuting distance of each other.

"Our ultimate goal is to live somewhere in the middle, then we drive in different directions for our residencies," said Bolfing, who expects to have a 30-minute drive from a mid-way location, while Izaddoost may spend 45 minutes on the road as she manages Houston's traffic.

To increase their odds, each interviewed at 12 programs in Texas and Oklahoma.

They were relieved and excited with their Match Day results.

"We got exactly what we wanted," Izaddoost said.