The optimal solution of the NRMP match algorithm is deceptively simple, but its implication for the lives of applicants is anything but simple.
Three years ago, my then-girlfriend and I sat down and parsed through what would become the most important determinant of our lives moving forward.
Because we attended different medical schools, we carried on a long distance relationship for five years. The NRMP match was more than just a residency choice. It was also a solution that could finally close our distance and take the relationship forward again.
The ranked list seemed like the most difficult decision we had to make. There were so many variables, each with differing levels of importance.
There are many forms of innovations. Sometimes medical innovation is nanotechnology, molecular imaging, high-precision targeted therapy, or 3D-printed prosthetic, which are advancements whose adaptation rate are limited by the rate of research. This is a good thing.
And then, there exists technology that has become commonplace in every other industry but is still considered “innovation” in medicine due to their glacial adaptation rates in hospitals and clinics. Case in point: When was the last time you saw a pager that doesn’t belong to a healthcare provider?
As a rite of passage as well as part of the regular work schedules of a radiologist, a resident trainee must take on the role of independent interpretation for exams that come into the hospital at night. I happen to work at a place where attending backup is readily available by phone, but an attending radiologist is not in-house at night. This provides an abundance of learning opportunities.
After finishing one week of radiology night duties as one of two trainees, I’ve begun to think how the progression of the night always seem to follow some pattern, and what that means for a radiologist trainee on call.
First, it’s probably useful to introduce the concept of a pareto-efficient curve. The curve explains the relationship between two desirable but partially mutually exclusive qualities. For example, a radiologist wants to be very fast at interpreting studies. A radiologist also wants to provide very high quality interpretations. Alas, we cannot do both at the maximal capacity. One might imagine the relationship between the two to look like this:
Standard pareto-efficiency curve
In the state of Pennsylvania you need a special permit to practice medicine outside of the supervision of an attending physician, called the unrestricted license. For most residents, this is not a requirement – your training license allows you to train, and your unrestricted license allows you to practice, well, without restriction (really, it’s not that complicated). Usually this means moonlighting.
Moonlighting is actually a glorious thing for a resident. You get hands-on experience for problem solving, and the extra income goes a long way to supplement rent, food, and student loans for an in-training doctor. Continue reading