It's That Match Time of the Year Again!

The CaRMS match day is approaching. I'm still a few years away from that, but since I've been compulsively planning for that day since even before I got my acceptance to Med School, it's still a day I take note of. This year I'll have actually worked a bit with some of the people in the match, so I've got my fingers crossed it turns out well for them.

More selfishly, I like to see the trends in the match statistics. Some specialties are getting more competitive, some less competitive. Which ones are and why can tell you a lot about where the medical field is going and how its perceived at the undergrad training level. More importantly, it can indicate what kind of competition I'll be facing for the specialties I'm interested in.

I realize this shouldn't matter - I'll do my best and if I get my first choice great, if not I'll be satisfied with my backups. However, the competitiveness of a specialty has, oddly, factored somewhat into my decision-making.

I'm very wary of pursuing overly competitive specialties. I'm an ambitious person, I work hard, and I'm not afraid to fight for a career path I want. However, I want that fight to against problems, not people. Highly competitive specialties attract highly competitive people. I like to think medicine is a collaborative enough enterprise that you don't see too much backstabbing or other sorts of power plays where one person wins and other people lose, but I know that it does happen and happens far more often when students are going for competitive specialties. More than that, there's a certain level of one-upmanship. Every time your competition does something noteworthy, you have to do something more noteworthy (or better yet, do noteworthy things first). That approach to a career is exhausting. Even beyond simply matching, when you're in a field with competitive people, the competition never stops. There's always a research position, a fellowship, a potential job opening to fight for. I've got enough pressure to do my best, both external pressure and internal pressure. I want to routinely push myself to my limits to be a productive, effective physician. But I do have limits and don't want others to push me beyond them. I've seen too many unhappy physicians who are working beyond their limits.

By the same token, I'm somewhat skeptical of completely uncompetitive specialties. I worry that there are reasons students avoid these specialties that I haven't considered. I worry that my colleagues in these specialties will be less competent than those in other specialties. I worry these specialties won't be challenging enough, won't be rewarding enough or, to my great shame, won't be prestigious enough.

As an aside, having a more prestigious job is like winning a pissing contest - you satisfy your ego, but it's ultimately meaningless. Yet, like so many medical students, I have an ego that just won't shut up, even when I'd like it to.

So, my first choice of specialty is currently one that is only moderately competitive. You have to do more than apply to get in, but no one seems to be throwing elbows to get matched to it either. Obviously there's more to my interest in this specialty than historical CaRMS match rates, but I do sometimes wonder how much of that interest is affected by rather superficial judgments like the specialty's CaRMS match rate.