The Match

Towards the end of Gary’s third year of medical school, we were thinking about next steps. Though graduating from medical school is a significant milestone, it isn’t close to the end of the journey. Internship, residency and, likely, fellowship remained to be completed. And, before he could begin, he had to go through a process called ‘the match.’

Medical students choose a specialty and then apply for programs in that specialty. Gary chose internal medicine. The way it works is that he fills out an application, which includes his transcript, the scores on the different medical boards that are taken along the way, and references. I don’t recall all the specifics, but after the initial application, you would be invited for an interview if the program was interested in you. During the 4^th year of med school, about four weeks were set aside so that the student could travel around for those interviews. Then, the student ranked his/her preferences from top choice to places they would accept. At the same time, the programs ranked their choice of students. The two sets of rankings were fed into a computer and voila! – a match was made.

So much went into this process; so many decisions along the way – from choosing the specialty to deciding what part of the country we wanted to consider. Although we enjoyed our time in Pittsburgh, we wanted to be closer to family so Gary focused his attention on programs in the Northeast – mainly New York (upstate and the metropolitan area) and Philadelphia. He scheduled the interviews and we created an itinerary. The Toyota Celica we had when I first came to Pittsburgh had died, we got tired of pushing it downhill to pop it into gear and donated it to a local vocational school, and we were without a car for a while. We were fortunate that Gary’s brother Steven bought a new car at that time and generously gave us his old one – a car way too cool for us, a Pontiac Firebird with a t-top. We gratefully accepted his gift, it would make the interview process so much easier and less expensive.

Gary left Pittsburgh early afternoon on the first Sunday in November to make a grand tour of Pennsylvania and New York, with his first stop in Syracuse. I would meet him at the end in Brooklyn for Thanksgiving. We said our good-byes, I wished him luck and he went on his way.

He was driving on the Pennsylvania Turnpike, not that far out of Pittsburgh (but far enough), when the engine light came on. Neither Gary nor I were knowledgeable about cars. He drove for a bit, thinking he’d get off the next exit. But, exits on turnpikes aren’t that close together. To make a long story short, he had to pull over onto the shoulder when he saw smoke wafting from the engine. A state trooper luckily came upon him quickly. The car got towed to the nearest service station.

At that point, I got a collect call from Gary, explaining that he was in Breezewood, Pennsylvania and was being told that the engine had seized. The car would be out of commission for quite a while, even if they were able to find a replacement engine. Gary was in something of a panic, his interview was scheduled the next day at 8:00 am in Syracuse. I went into problem-solving mode. We decided I would deal with the car. We got off the phone so he could look into transportation back to Pittsburgh and I would figure out how to get him to Syracuse.

A number of things fell into place: he was able to get a bus to Pittsburgh very quickly, then he grabbed a cab to the airport. I found and booked him a flight to Syracuse and arranged for a rental car. It looked like we would be able to pull this off in time to make his interview. It also meant that we spent hundreds of dollars we couldn’t afford, but that’s what credit cards (and parents, if you are lucky) are for.

The rest of his travels went well. When he finished all the interviews, we had some decisions to make. I put my policy analysis skills (I knew I’d find some use for them) into action to help sort things out. The task of figuring out how to rank the programs was overwhelming. Without going into the gory details, we made a matrix – yes, a matrix! The elements that were relevant to the decision were listed on one side (quality of the program, quality of life for us, closeness to family, affordability, etc.). I think we had something like 7 factors. We gave a weight to each factor (quality of program got the most weight, and quality of life was second). Then we ranked each program according to each factor and came up with a score. Much discussion went into this, as well as many hours of thought. While the matrix was helpful, it wasn’t an exact science. Ultimately, Gary ranked Columbia (in New York City) first, Albany Med second, I think one of the Philly programs was next and I don’t remember after that (maybe Gary does). I know he ranked ten programs

One of the considerations in this equation was what each program offered in the way of experiences. The sad reality was that this was in the midst of the AIDS crisis, before any viable treatment options were available. When Gary visited NYU (located in Manhattan) and Downstate (located in Brooklyn), the combination of the huge number of AIDS patients, their suffering and not being able to offer much to relieve their symptoms, was devastating. All hospitals were challenged by this crisis, but the internal medicine programs in those two locations were simply overwhelmed. I don’t recall if Gary included either of those programs on his list, or if maybe he ranked them at the bottom.

All the paperwork and interviews were done, now it was up to the invisible, giant (in my imagination anyway) all-powerful computer to do its magic. Match day was March 19, 1986.

All the students gathered in a large common room in the medical school at the appointed hour – I think it was noon. I took off from work to be there to get the news hot off the press with Gary. Each student’s name was called and they were given an envelope. Inside was a computer-generated letter that indicated the program.

Our hearts were thumping. I believe names were called alphabetically – it was good to be a Bakst. Gary went up and got the envelope and quickly made his way back to me so we could open it together. He ripped it open, our eyes scanned the paper and found…Albany. I looked at Gary to see his reaction – after all this was his second choice. I did not read disappointment. I felt a small let down and maybe a bit of surprise. Of course, I had no idea what would happen, and had no reason to assume he would get Columbia. We compared results with our friends – it seemed that everyone was happy with their placement.

We knew our families were waiting to hear where we would be going. We went over to the pay phones to call them. As we made the calls, and processed the outcome, we got more excited. Then we joined friends and went out to celebrate.

We would have a few more months in Pittsburgh, and then start the next phase of our lives together…in Albany, New York.