A group of Drexel medical students are standing around a bar in Center City Philadelphia. They’re holding shots.
“All right, what should we cheers to now, guys?” asks a woman with long black hair.
“To the algorithm that’ll choose our futures!” says another.
“To the algorithm! To the algorithm!” the group echoes.
Yes, the algorithm, the computer code that’s going to tell them where they’ll spend the next few years of their lives.
These are fourth-year medical students at Drexel University.
Maurice Hinson, the one who’s double-fisting his drinks, wants to specialize in internal medicine. Then there’s Bernard Nelson and Yasmin Elkhashab, who both want to go into anesthesiology. And Kelsie Persaud, who wants to go into family medicine.
They’re stressed out. Because a couple weeks from this night, on “Match Day” (aka Friday, March 20), they’ll find out where they’ll do their residencies. In the matching process, students rank their favorite hospitals, and hospitals in turn rank them.
But it’s up to a computer and the algorithm to take that national-sized pile of hopes and wishes, and turn it into thousands of matches of student with hospital.
What are the stakes? When medical students graduate, they’re technically doctors. But they can’t just take their diplomas and go practice medicine. It’s virtually impossible to get a job as a doctor without landing a spot in a residency program.
Nothing matters as much as where you do your residency, says Maurice Hinson. “It’s that last site of training that really determines the course of your career,” he says.
How dreams develop
Maurice is 28, and he went to Johns Hopkins University in Baltimore. He grew up in Philadelphia and has lived all over the city. His mother was addicted to drugs, so his father, Larry, raised him.
Larry was a garbage collector, and when he had to go to work he would leave Maurice, who was 3 or 4 at the time, in the waiting room of a doctor’s office across the street from their apartment.
The administrative assistant would put him in a long white coat and let him run around the waiting room, listening to patients’ heartbeats with a stethoscope as they waited to see the doctor.
Then when Maurice was 8 or 9, he came across some medical textbooks.
“At the time, I couldn’t understand the words but I would flip through ’em, look at the pictures,” he says. “And just from looking at the pictures I got excited about the human body.”
Maurice is the first in the family to go to college, let alone medical school.
He’s trying to land a spot in some of the country’s most prestigious internal medicine programs. His top choice is Weill Cornell Medical Center in New York City, and his second choice is George Washington University Hospital in Washington, D.C.
When these hospitals invited him in for interviews, he had a hard time believing they actually wanted him.
“Up until the day of, I was still waiting for the email saying, ‘Oh we apologize, we made a mistake, sorry for the inconvenience,'” he says. “But when I would go the day of and they actually had my name on a badge I was like okay, I’m really supposed to be here.”
Maurice might not get into one of those top-tier programs. He might instead match into a program from the bottom of his list. It’s out of his hands now.
On Match Day, in a room full of graduating medical students, Maurice will open an envelope that has the name of his residency program. The results he will find are final and legally binding.
That makes this whole process even more stressful.
But Maurice’s father isn’t that worried.
“He’s a blessed kid,” Larry says. “I like to use the word blessed, because I’m a godly person. And I just feel that God has something for this boy to do.”
No pressure, Maurice.
A medical love story
Let’s return for a moment to that bar in Center City on that February night.
Among the friends with whom Maurice is tossing back shots is Kelsie Persaud. She’s 26, from Little Rock, Ark. She’s hoping to match into a family medicine residency program.
“Being [from] the South, we all kind of grew up going to our family docs, and I had a great relationship with mine,” Kelsie says.
Doctors who specialize in family medicine often provide medical care for entire families, from the cradle to the grave. And Kelsie wants that same opportunity to connect with her patients and form long-lasting relationships.
Medical students weigh a lot of factors in ranking residency programs: prestige, location, proximity to family.
For Kelsie, there’s another factor. His name is Evan Somers.
And he complicates things.
Evan is an ear, nose, and throat resident at Eastern Virginia Medical School/Sentara Norfolk General Hospital in Virginia. He’s a year older than her.
They met at an Asian multicultural club during her freshman year at Rhodes College in Memphis.
“Everyone was going around introducing themselves, and then I just remember hearing someone be like, ‘Oh, I’m half Filipino,’ and I remember turning around being like ‘oh cool, I am too’!”
She developed a crush on him from afar. On the weekend, she’d try to figure out whether they were going to the same parties, hoping they would run into each other.
Luckily for her, the summer after her sophomore year, they both landed spots at a program for pre-med students.
“My friends were like ‘Oh, my gosh, you’re going to be on this rotation with Evan Somers!'” she says. “And I was like ‘I know guys. Nothing’s going to happen though.'”
Of course, something happened. About the third week into the program, he asked her out.
They started dating. Too soon after that, he graduated and started medical school. They were a long distance couple.
Kelsie planned to go to med school somewhere near Evan. But she didn’t get accepted anywhere.
And that left her resentful.
“I always found that he just could get things a lot faster than me, and he was a better test taker than I was,” she says. “I would always be jealous, like ‘What is it that I’m doing wrong?’ There is that competition subtly there in this relationship.”
Kelsie pulled it together and got into Drexel Med School the next year. Somewhere in between, she and Evan broke up. And like the hero of a romantic comedy, he tried to win her back by driving all night, showing up outside her dorm at one in the morning, and telling her he couldn’t live without her.
That worked, by the way.
From then on, things went well. That is, until Evan’s fourth year at medical school, when he found out he didn’t match into a residency program.
This happens to between 6 and 8 percent of American medical students each year. Once they find out, they scramble, spending days glued to their computers, trying to score a spot in one of the residency programs that isn’t full yet.
When this happened to Evan, Kelsie felt bad for him. But she also felt a little relieved.
“Not to be like ‘Oh, we’re even now,’ but in some ways or another it makes me feel like okay, we really are, we’re equals in everything,” she says.
A life of promise
Larry and Maurice are looking at photos at Larry’s apartment in Olney. The apartment is small, and lit up by the blue glare from the TV.
Larry was in his early forties when Maurice was born. He says the moment changed him.
“I drank a lot, partied, spent a lot of money,” he says. “And the night he was born is when he changed my life, when they brought him upstairs so I could see him.”
Larry left the hospital, and went to his regular bar.
“I had the drink that I usually drink, and that was the nastiest drink in town,” he says. “So I gave everybody a right-hand salute. That was the end of drinking.”
Larry has seven other children, some biological, some adopted. He says he was tougher on his other kids than he was with Maurice. But Maurice got some of that hard edge too.
Maurice remembers a time when he was acting up in school, and Larry beat him with a belt in front of his second-grade classmates.
“I don’t know if Maurice would consider me a little tough. Do you?” Larry asks his son.
“In certain situations, he needed to be,” Maurice says. “For the areas that we lived in, and how I grew up. And I think just being a young black male in inner-city Philadelphia, you sort of need that.”
Larry remembers a time when Maurice hurt himself and was afraid to come home. OK, they remember this one a little differently. Here’s the exchange:
Larry: He broke his wrist one time, and he was afraid to tell me. Playing basketball. … You don’t remember that? Kids came running to me to tell me.
Maurice: Nah, I broke my collarbone playing football.
Larry: Is that what it was? You were sitting on the curb when I got there.
Maurice: Yeah, that was my collarbone. Playing tackle on concrete.
Larry: I knew you broke something. You was afraid to come home.
Maurice: Cause you’d be like ‘What are you doing playing tackle on concrete?’
Larry: I wasn’t mad. I picked him right up and took him to the hospital.
Maurice: Uh … I walked to the hospital.
Larry: Well, whatever. You got there.
Maurice: I got there, yeah. I walked. Tough love.
Maurice is laughing. Larry is grinning. He says he doesn’t have a favorite child. But you’d be forgiven for thinking that if he did, Maurice would be it.
“He says he hopes God spares him to see me graduate,” Maurice says. “You know, he’s 74 now, so he feels like he doesn’t have much time left. I think it’ll be a big day for him.”
For Maurice, Match Day is an even bigger deal than graduation. “Graduation is more like a closure to a long chapter. Whereas Match Day is the beginning of a new one, you know. The title page.”
Five years into her relationship with Evan, Kelsie is about to turn a new page too. But making her rank list has meant facing a choice: Which comes first, her career or her relationship?
“Do I want to be with my fiancé,” she asks, “or do I want to be at a really awesome program because of its caliber or its name, to further my career, my dreams, my aspirations, or whatever?”
The stakes have gone up since August, when Evan picked a romantic spot on a footbridge at a college campus near his Virginia hospital, got on one knee, and proposed.
A stream of thoughts went through her head, all at once. Had he asked her parents for their permission? She didn’t like the dress she was wearing, and her nails weren’t painted! Were there people watching?
There were actually. A gaggle of college girls cheered and clapped when she said yes.
“My friends and I joke that we know why he proposed back in August,” Kelsie says. “He needed to lock it down.”
Meaning: get her to rank his hospital at the top of her list.
Some of Kelsie’s classmates say ranking residency programs should be easy for her, because Evan is in Virginia. But she says it isn’t that simple.
“Even right after I got engaged, I was like Miss Independent,” she says. “I was like ,’I would never follow a man wherever he goes. I’m not one of those girls. He can follow me, and I’m my own person.'”
After Evan proposed, Kelsie still interviewed at programs around the country. She knew that if she matched into one of them, she and Evan would be long-distance for three more years.
“Sometimes I’d be like what’s three more years?” she says. “We’ll be done at the same time and then we can celebrate our marriage as the center of our relationship, instead of our careers at this point.”
But then it would hit her.
“What am I saying, what’s three more years? Do I want to just put this relationship on hold again? I gotta start making decisions on a we basis and not so much on an I basis anymore,” she says.
Kelsie kept her rank list a secret from Evan until February, when she wrote her top choice in his Valentine’s Day card.
“I really wish I had remembered to grab my phone to take a video or a picture of his face. I’m not going to put him on blast and say that he almost cried but … I kinda just did,” she says, laughing.
“When he proposed and I said yes, I feel like that reaction, this topped it,” she says. “Him seeing my rank list. That emotion was so real, so raw from him.”
Kelsie’s second choice is another program in Virginia, then one in North Carolina. And then she ranked programs around the country, including one in California.
So there is a chance that come Match Day, Kelsie will land a spot thousands of miles away from her fiancé.
The final preparations
On the Tuesday night before Match Day, Kelsie is sitting on the couch in her apartment. The walls are plastered with posters from romantic movies like The Notebook and Sixteen Candles. Kelsie says they’re holdovers from her undergraduate days.
She and Evan are video chatting. He’s getting on a plane to Philadelphia the next day.
“Did you start packing?” she asks him.
“Uhh, a little bit,” he says. (So…not really.)
“I mean I have my suit, which takes up so much room.”
She tells him to bring blue jeans or khakis, and not to show up wearing scrubs. They say goodbye.
Evan got to Philadelphia on Wednesday, with his suit in tow. He’ll be with Kelsie on Match Day to find out what the algorithm has to say about their careers and their love story.
And Maurice Hinson, who once wandered around his neighborhood doctor’s office in a white coat, will find out whether he scored one of his top choices. His dad Larry is waiting by the phone to hear what God — and the algorithm — have in mind for his son.
Epilogue (AKA happy ending)
Maurice Hinson was breathing heavily, like he just finished a workout. He hugged his girlfriend, Jasmine.
Kelsie Persaud jumped out of her seat and hugged her fiancé. They were both crying.
At noon on Friday, March 20 (AKA Match Day), after an interminable 20 minutes of drama-building ceremony, Drexel University’s fourth-year medical students found out where they would be spending their medical residencies.
The computer algorithm’s verdict was sweet for two of them:
Maurice got his first choice, Weill Cornell Medical Center in New York City.
After a few minutes, he went outside to call his dad.
“I just got my match results,” he said. “I’ll be in New York! Yep. That was my number one choice! So now you can come visit.”
Kelsie got her top choice, too: Eastern Virginia Medical School, at the same hospital as her fiance, Evan.
“I really feel like my heart’s so full now,” Kelsie said. “This long distance is coming to an end. And we finally get to start our lives together.”