Is this good for the applicant? Not really. Are there really that many programs that would be a true match—given geographical preferences of family and self, given a positive “gestalt” for some programs and not others, given preferences for 3- versus 4-year programs, and given that some programs are stronger than others in our particular areas of interest? Probably not. And the financial burden is great, given the fiscal constraints that plague students: air flights, rental cars, hotels, and food for each interview add up to an enormous amount of money. But it is better to match somewhere than not at all, so we all engage in the game with full vigor.

And yet with all of these difficulties lies a truth: You don’t know what’s out there until you see what’s out there. I have been quite happily surprised by programs that I did not initially consider to be “true contenders,” and the opposite has been true as well. Programs are not all alike, and one cannot know this unless one goes and visits.

While it has been burdensome to travel to so many places, it has also been a truly interesting and educational experience. The hidden gems have been the people encountered on the trail. Emergency medicine is a small community, and I am sure to run into all of these people many times over the coming decades. That part has been a pure joy—and fun.

Is this madness good for programs? Not really. Most of the program officials where I interviewed said they received between 550 and 700 applications this year. With well over 20 applications per applicant, on average, there is an enormous amount of extra administrative work associated with the match. It causes some programs to go to objective screening techniques, such as board score cutoffs, which prevent looking at the entire application and missing some great candidates. It also means there will be a lot of interview cancellations, particularly toward the end of the match season.

It means that the programs cannot really know that everyone applying is really interested in their particular program, or if they are just part of the numbers game. On the other hand, this is a program’s chance to reach out to and impress applicants who might otherwise not have known of their program.

With interviews done, there is an initial feeling of relief. The “requisite” number of interviews has been completed, and there are enough programs ranked to feel almost certain of a match. The hemorrhaging of money stops.