It’s Almost Here. Learn to Calm Your Match Day Nerves

Match Day is now just around the corner, scheduled for March 21. That means thousands of fourth-year medical schools are thinking of little else — in fact, it’s a good bet that most students participating in Match Day are a bundle of nerves. That’s a totally natural response when you’re invested in an outcome like this one.

Take heart, however. When you dig into the numbers, most students do make a match. According to the National Resident Matching Program (NRMP), in 2022, 92.9% of US MD seniors matched, whereas 91.3% of DO seniors matched. For those who didn’t, the NRMP offers the Supplemental Offer and Acceptance Program, which aims to fill unmatched positions.

Knowing this may help, but the nerves are still there. Now is a good time to develop and use top-level coping mechanisms.

“The anxiety that builds up over Match Day is valid,” said Markesha Miller, PhD, a South Carolin–based licensed psychotherapist. “It’s important to acknowledge that. Anxiety stems from wanting to be in control but not having that control.” 

Another layer of this anxiety is that it may be somewhat distorted, according to Lauren Farina, LCSW, based in Chicago. “This is adaptive because it’s your body’s way of helping you prepare for a challenge,” she said. “But it’s often amplified and distorted in a way that doesn’t reflect reality.” 

There are ways to manage that anxiety, so that you don’t spend the next month or so tied up in knots.

Develop a Toolkit

For most students, there’s a sense that the Match Day envelope contains the keys to the trajectory of their lives. It may alter where you live, which hospital becomes your eventual long-term employer and even place you in a specialty that turns out not the right fit. Evangeline Matley, a fourth-year student at Western University in Monmouth, Oregon, feels all of this and more.

“I’ve applied to programs all over the country and getting into one vs another could change the course of my life,” she said. “My biggest fear is that I have too much expectation surrounding where I should and want to be.”

Matley recognizes her anxious state, however, and is trying to “witness” it rather than become it. “The unknowns are pretty big,” she said. “I’m trying to sit with my emotions and trust that match day ultimately isn’t about my worth, but another step in who I am becoming.” 

Miller is a fan of this approach, and recommends recognizing you cannot control the outcome, but you can control your response. That means preparing for two scenarios: The first is that you will get your desired results, and this is now the direction of your career. The second is that you probably won’t get your desired match, and you need a plan for adapting.

A good exercise, according to Miller, is going through the “decision model.” “You can play this out in your mind or even draw it,” she said. “Allow yourself to visualize the outcomes and where they might lead. ‘If I get a match to relocate somewhere unfamiliar, I have to do A, B, and C.’ Rehearse it in your mind — it will make you feel as if you have a plan.” 

As Farina — and the data — reminds, the odds are you will get matched. And if not, you will manage that scenario, too.

This is where self-care tools can come into play. Taking time away from the rigors of school and work, socializing, and practicing your favorite hobbies is important. Cultivating mindfulness can be helpful, too. “The definition of mindfulness is nonjudgmental, present-moment awareness,” said Farina. “Your mind and body cannot determine the difference between now and later. Ground yourself in the peace of the moment.” 

You might consider working small bits of meditation into your day. Box breathing is a simple way to gain a sense of calm. Practice inhaling for four counts, holding it for four counts, and exhaling for four counts. Alternatively, focus on your five senses — even if walking into a classroom, said Farina — what are you hearing, smelling, and seeing?

Getting outside in nature can be a helpful tool in this, even if just for a short walk. Living in the outdoor playground that is Oregon, Matley has grabbed any moment she can to hike, one of her favorite pastimes. “It has allowed me to detach from anything academic and get into my body,” she said. “As a fourth year, I’ve had a little more time for my hobbies, which is nice. It really helps me put things in perspective.” 

Tap into your social network, too, both inside and outside of medicine. “We know stress is mitigated by social connection,” said Farina. “When we are with people we trust, it can lend perspective around your myopic focus.” 

Find friends and family who can uplift you and lend that perspective. Having a mix of friends who are in the medical trenches with you — and those outside it — is essential. Matley has been comparing notes with her fellow students. “We have diverse interests and it’s helpful to see how the process is different for each of us,” she said. “We’re going through it together and holding onto the excitement of where we will end up.” 

If You Don’t Match

A small percentage of students will indeed not match the first time through. Because this is likely your biggest fear, it’s important to address it and manage it. This is where you control your response, according to Miller. “I’m a huge advocate of seeking out counseling and therapy when you need it,” she said. “You’ve come to a fork in the road, and you need to figure out what’s next.”

A therapist might help you step back and take in the bigger picture. “Self-doubt might be seeping in,” said Miller. “Now is the time to re-evaluate, figure out what this moment means, and where to go from here.”

It can also be a good time to refocus on your core values. Consider what medicine means to you, and why you pursued this career path. “Values driven work is protective against burnout and self-doubt,” said Farina. “I encourage developing a mission statement to lend some perspective. That allows you to continue living your core values whether you match or not.”

Also avoid what Farina calls “fortune telling.” This involves getting ahead of yourself and creating imaginary, sometimes doomsday scenarios. When you stay in the present moment, you can better get on top of your emotions and shift your focus, without biased thinking, she said.

For her part, Matley is doing a good job with staying in the moment and preparing for the big day. “I have confidence in how I’ve been grounding myself,” she said. “I’m the first in my family to pursue higher ed, and being here now is already a huge accomplishment. Wherever I end up, I know I will be a great doctor and find my belonging.”