Opening the Envelope: An Inside Look at the Class of 2025 Match Day
You are seated at a round table, surrounded by friends and family, and in your hands, you clutch a white envelope. Scattered throughout the room, your peers each grasp an envelope of their own as a jittery anticipation permeates the room. Inside this envelope, your life’s direction awaits. All the hours of dedication and work, the sweat, tears and blood, have all culminated in the contents of one standard, white envelope. Monday you learned that you matched. Now the contents of the envelope will tell you where.
“The Match,” officially recognized as the National Resident Matching Program (NRMP), is the process by which fourth-year medical students are linked with their desired residency program. Think of it as the most intense dating app imaginable. Students rank the programs they would like to attend, and the programs, in turn, rank the students they interviewed. A complex algorithm works to ensure that top applicants are ranked with their first choice programs, maximizing the likelihood of students and programs matching their most preferred counterparts.
Although “The Match” happens for most students on the same day in March, the process stretches across months. Beginning in September, the process culminates in a springtime decision that often feels like a march toward one’s destiny. The Monday of Match Week, a standard email is sent out to all participants explaining whether any of their ranked programs ranked them as potential residents. Those who did not match have the opportunity to “SOAP” (Supplemental Offer and Acceptance Program), which constitutes a fast-paced secondary application process. After five agonizing days, the results of where all students matched are released on Match Day, allowing the celebrations to commence.
Three Students’ Experiences
On March 21, the USD Sanford School of Medicine Class of 2025 sat around tables with friends and families, thumbing white envelopes. Three of them shared an inside look on what their own personal day of anxiety and celebration was like. Sam, Narysse and Jess all dreamed of this moment: viewing the piece of paper that would propel them into the next stage of their training as physicians. While all three have different goals, hopes and expectations, one thing unites them: They have matched, and are about to become resident doctors.
Narysse, a lover of public health and figure skating, has just completed the Asniya Rotation in Pine Ridge, teaching health education and career exploration with elementary and middle school students. Between working with grant funding to increase outreach to the unhoused population in Rapid City and increasing mental health education in immigrant and refugee populations in Sioux Falls, Narysse’s love for psychiatry and holistic health care shines through in all she does.
“With my background in public health as well as my upbringing in a neighborhood where people faced many systemic barriers, I was drawn to the complex social situations and stories of the patients,” she explains. “I found that many treatments for health conditions came back to underlying mental health conditions that played a role in their health overall.”
When asked how she is feeling, she responds with, “Most of my thoughts are just ‘where am I headed?’ There is so much anticipation leading up to match day.”
Sam, ever the innovator and trailblazer, has chosen a specialty somewhat uncommon to SSOM: a combination of internal medicine and pediatrics commonly called Med/Peds. As he puts it, “Twice the boards, triple the friends!” Originally from Aberdeen and having completed undergraduate studies in Utah, he’s turning his eyes west again. With his last interview in January, this day has been long in the making.
“I’ve admittedly struggled with the uncertainty of not knowing where I’ll be for the next four years,” he says. “But I’ve been staying connected with family and friends.” He taps his phone, prepped and ready to FaceTime his out-of-state family when he opens his letter. “Plus it’s been warm enough in Rapid City to get out and enjoy the beauty of the hills.”
Lastly, there’s Jess. With her freshly earned pilot’s license in her purse, her eyes are bright with anticipation for what the future holds. A member of the South Dakota Army National Guard with an interest in combat and flight medicine, she has spent the weeks leading up to Match Day in an emergency medicine rotation, and training for a 30-kilometer military ruck march. Her decision to apply for family medicine was greatly influenced by her clinical year at the FARM Site in Mobridge, where she experienced the impact that rural family medicine can have on a community.
“I love that I can take care of all ages and genders, and for an extended period of time,” she explains. “I also love the flexibility that family medicine offers. I really enjoy procedures, inpatient medicine, emergency medicine and OB, so having a specialty that allows me to do a little bit of all of that is really exciting.
“I have so many emotions about Match Day - nervousness, excitement, a little bit of fear,” Jess goes on to say. “But I also have been feeling very proud of myself and my classmates because of how hard we’ve worked to get to this day. It truly is the culmination of years of dedication and sacrifice.”
For USD SSOM, Match Day is a long-honored tradition. Originally founded in 1907, the school spent its first 67 years granting students two-year degrees in basic medical sciences before they were sent out across the nation for their clinical rotations and remainder of their medical school education. Students completed their last two years everywhere from Duke to Northwestern, finding their ways to top-end programs across the country. However, many physicians-in-training who left the state did not return, with only 18% staying in South Dakota. In 1974, the institution transitioned to providing a four-year degree and has been helping provide South Dakota homegrown doctors ever since.
SSOM has done more than its fair share of alleviating the primary care physician shortage our nation faces today. In the last five years, over 40% of each graduating class chose to match into internal medicine, pediatrics or family medicine, one of the three primary care specialties. SSOM also ranks in the top percentile of students who practice in a rural setting, and 75% of its graduates who complete residency in South Dakota stay in South Dakota to practice medicine.
A voice rings across the room: It’s time to open the envelopes. The sound of tearing paper, laughter, excited screams and cheers fill the room. The wave of nervousness and anticipation has crested and broken, and there is anticipation and eagerness for what is to come.
For Narysse, surrounded by her husband and her mother, matching at the University of Minneapolis in the Twin Cities is a dream come true. With her husband and her dog in tow, she’s ready to start her next adventure. When asked for advice, she reminds future applicants to keep their minds open.
“I feel that I didn’t bank on matching to any one specific place,” she says. “In the end, I think that made me feel better that any of the locations could be listed when I opened my envelope. No matter how happy you are to be matched to your program there are some considerations of the ‘what-ifs’ of other programs. I think it is ok to have a multitude of feelings about the process as it is a big step towards the next chapter of your life.”
Sam is just getting off the phone with the University of Southern California/Los Angeles General Medical Center. A personal phone call from the Med/Peds residency program director is reminding him why he ranked their program so highly: the welcoming and wonderful people there (escaping winter for a few years isn’t a terrible alternative reason either).
“The whole process is self-selecting in that you will be drawn to programs that seem to share your values,” he explains. “Programs that legitimately share these values will see you and want you on the team. If you trust in that, it’s hard to go wrong.”
Support from his mentors and family has been essential for Sam.
“They were a fantastic sounding board for helping me set realistic expectations during the application cycle,” he says. “They also helped me keep my head set on straight through the uncertainty that accompanies the whole application cycle.”
Jess is laughing, her face alight with joy. Her envelope says Idaho State, a program she had fallen in love with during her time visiting.
“I don’t think I’ve ever opened an envelope faster in my life!” she giggles, elated at the news. “Before I opened the envelope, I was reminding myself that no matter what it said, I was going to receive amazing training and grow so much as a person and as a physician. Once I saw that it said Idaho State University, I was overcome with joy and relief.”
With her active lifestyle and her adventurous hobbies, a state filled with hikes, skiing and hot springs is the perfect fit. Before submitting her rank list, Jess said she spent a good amount of time reflecting and thinking on her experiences. For advice, she recommends keeping a journal regarding your thoughts and experiences at each program. When the time came, she revisited her entries and pondered how each program made her feel.
“If you have an unexplainable feeling that a program feels like home, trust that!” she advises. “Talk about your programs with people close to you and make notes about how programs make you feel.”
Jess found her perfect fit. With her community growing and her passion for family medicine already blooming, she’s ready to start harvesting the fruits of her labor.
“I’ve met some of my co-residents and feel so welcomed already,” she says. “I’m excited for the learning to begin!”
All three seniors are now on to their next adventure. Whether it be a trip to Australia, studying wilderness medicine in Utah, bridal showers or skiing trips, each is enjoying their last few months of freedom before graduation and the inevitable start of residency on July 1.
For them, Match Day is about more than just a program or a place. It’s about being chosen. It’s about belonging. It’s about becoming. With their friends and families at their backs and the whole world in front of them, we can’t wait to see what they become.
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