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Dr. Chan: What is it like to become the first official couple in your class? How soon do you start thinking about couples matching for residency when dating? What is the most important aspect when couples matching? Finally, how does it feel to have your parents meet for the very first time on match day? Today on Talking Admissions and Med Student Life, I interview Madison and Noah, a successful couples match and recent graduates here at the University of Utah School of Medicine.

Announcer: Helping you prepare for one of the most rewarding careers in the world, this is Talking Admissions and Med Student Life, with your host, the Dean of Admissions at the University of Utah School of Medicine, Dr. Benjamin Chan.

Dr. Chan: Well, welcome to another edition of Talking Admissions and Med Student Life. I've got two great guests today, Madison and Noah. Hello.

Madison: Hey.

Noah: Hi, Dr. Chan.

Dr. Chan: Fourth-year medical students, soon to be full-fledged MDs. So let's start from the beginning. There's a reason why I'm having you both on today. You met in medical school. We were just talking about that. Where did you guys meet for the first time?

Noah: So we didn't really know each other at all. I think the place where we really first started to get to know each other and really started to bond is we were just kind of coincidentally put in the same anatomy lab group and that was where everything started.

Madison: Yeah. The first time we ever spoke was at this bar downtown during orientation week, but it was just like a really . . . I asked you about having Celiac disease because you were drinking a cider instead of a beer and it was like a two-second conversation. Then the next day, we found out our anatomy groups and we were both group eight along with two other of our classmates. We both grew up out West. I'm from Salt Lake City originally. Noah's from Boise, Idaho. We bonded about going away for undergrad and then coming back here to the West for medical school.

Dr. Chan: So, when you say anatomy lab, what does that mean for people that aren't familiar with that?

Madison: Yeah.

Noah: Yeah. So for most people when they enter medical school, I think most medical schools do it. Sometime within your first year, usually within your first semester at The U, for the semester that you're here, they kind of do this intensive anatomy education to give you a baseline in anatomy. You're paired off into groups of four or five-ish, and everyone's assigned a cadaver body that they dissect together and they kind of work from the outside in and kind of go by organ system. And it's just a really great way to have hands-on learning and learn together as a group and get to know your classmates.

Madison: Yeah. Our cadaver, we had one of the few female cadavers. I don't know what it is, but it's mostly male bodies. Ours was female, and we named her Beatrice. I think Chaz D. maybe named her Beatrice, I don't know.

Dr. Chan: One of your fellow . . .

Madison: One of our fellow classmates who was in our group. We called her Miss B. and she was an awesome lady. I think we still talk about her all the time and kind of what a gift she gave us by donating her body. She had bright pink nail polish on, which is something I'll never forget. It was really cool to get to know her.

Dr. Chan: And now, did either of you have anatomy before, or was this kind of leading up to it? When I go out and talk to premedical students, there's this perception that anatomy is really different, it's really hard. Like what was your experience?

Noah: I had not had a lot of anatomy. The only thing I'd ever dissected was a cat and a shark in undergrad, which is pretty different. I don't know about Maddie.

Madison: Yeah. So Noah and I both went to schools that actually didn't offer anatomy. They had other pre-med requirements, but it wasn't something he got, which I know is very different from BYU and The U, where you do have these amazing anatomy courses. So I was nervous I was going to be behind, because people had TA'd these classes and stuff for years, but it ended up being fine. We weren't quite as good at the dissecting. Dr. Morgan, he goes around and he pins like different structures on different bodies, and the very first quiz, our body was wrapped up in plastic because there was nothing identifiable.

Dr. Chan: You did not have the most precise dissection.

Noah: We did not. We found out way after the fact, because we were still friendly with a couple of the TAs that helped us out, that secretly they would make fun of our body and our horrible dissection job after the fact when they'd all pow-wow.

Madison: Disclaimer, we're not going into surgery.

Dr. Chan: Good to know. I think that will be the first question our listeners will think of. So you meet in the gross anatomy lab. You're table mates. You're having this really cool experience together. Were you together right away, or did it take a while? Or were you the first couple in your class? How would you define that?

Noah: To put it on the record, we were the first couple in the class. Very proud of that.

Madison: It was a little scandalous, actually.

Noah: We got a lot of warnings from upper classmen, "Don't date your med school classmates."

Madison: There was actually a pact in our class of people who were like, "We're not going to date or have anything with anyone in your class," because it was supposed to be like a really bad idea.

Noah: Everyone said, "Don't date your classmates because then when you inevitably break up, it's going to be really awkward because it's not a very big class." I think the first thing that we kind of bonded over is we had a really similar sense of humor. I think we noticed right away that we were laughing a lot in anatomy lab.

Madison: The other groups hated us, I think. We were very loud.

Dr. Chan: It sounds like you're having a lot of fun.

Madison: And it's a very serious task. You're dissecting this body of someone who has passed away, and it's a gift in that sense, but we also kept it very light. And you deal with a lot of bodily fluids and a lot of bodily functions in anatomy lab, and we accidentally perfed our colon, which was not a great thing to happen. So, yeah, we had a lot of fun and would come in the weekends too to like study extra. We'd hang out then, and then we just started studying a lot together.

Dr. Chan: So, Noah, you talked about how upper classmates warned you there could be significant drawbacks for dating a classmate, but it sounds like there are significant strengths as well. What are some of those? It sounds like you studied together?

Noah: Yeah. I have to be honest. I can't think of a single negative part of our relationship that came from the fact that we were classmates. I struggle to really think of a single one. It's really nice to come home to someone or to hang out with someone, if you're not living together, who gets it. You can have really supportive significant others, husbands and wives who you can tell them what med school is like and they can do their best and they can say, "I'm here for you 100%."

But at the end of the day, it's really nice to have someone who's going through the same crazy experience and so they just get it. They know that you need to study. They know that your hours are going to be crazy. If you have a question about a topic that's really confusing to you, maybe it's something they're really good at. I think that was kind of one of the other reasons why Maddie and I started studying a lot together is I'm terrible at the things that she's really good at and I think vice versa is true in a lot of cases.

Dr. Chan: So you complement each other well.

Madison: We always joke that we would have gotten like a 280 on boards if we could take it together, which was not our real score at all.

Dr. Chan: That's a very novel strategy.

Madison: For those who haven't take boards yet, 280, I don't even know if you can get that score. Probably you can, someone can. But yeah, in terms of how the logistics, Noah was in a really long relationship in undergrad that ended right before medical school. So even though we were hanging out all the time, I didn't know if he was like damaged and hung up on this girl and . . .

Dr. Chan: Do they still use the term rebound, rebound relationship?

Madison: Yeah. I have a very awesome group of very protective girlfriends from undergrad, and they were very wary of this. One of my friends in particular, Kelly, I went and saw her for a couple days during the fall. And I was telling her about Noah, and she was like, "No, you're going to be his rebound. Don't go there. It's going to be really terrible." You can talk about this. I don't want to steal your thunder.

Noah: No, there's no thunder to steal. It's true. You were a rebound, but you were like a forever rebound.

Dr. Chan: Oh, I love it, the forever rebound.

Noah: Yeah. I think I definitely took my time as far as actually establishing it as an official relationship. I think we both knew that we liked spending time together and that we were a really good pair, but I wanted to make sure that I wasn't turning her into a rebound. I wanted to make sure I was ready.

Madison: He went on a practice date with another girl. Tell him about that. It was a [inaudible 00:09:01] date?

Dr. Chan: Was this with another classmate?

Madison: No, it wasn't a classmate. It was just like this rando.

Noah: It was an OkCupid. She was a really nice girl, and I felt really bad for her because I really was kind of using her to see if I was over my ex, which was not super fair.

Dr. Chan: So, if you still had skills, could you still have conversation, if you could go on a date?

Noah: If for the entire date, I was thinking about my ex, then that would be . . . I hope she found someone. She was a nice girl.

Madison: Yeah.

Dr. Chan: All right. So let's jump back a few years. I'm excited to have you here today because I remember distinctly talking to both of you on the phone, welcoming you to our medical school, and I was beyond delighted that both of you chose to come here. I know both of you got into other schools. Looking back, obviously it was the right decision. You met each other and you're headed towards very wonderful fields, which we'll get into, but thoughts about coming to Salt Lake City. Madison, you used to live here, so coming back from the East Coast, Noah, you're from Idaho, coming here, what were your thoughts about your decision and from there?

Madison: Yeah. It was a really hard decision for a couple reasons. I grew up here, literally blocks away from The U's campus, and I went all the way to Philadelphia for undergrad. Most of my friends just stayed in that area, so moved to New York or down to D.C. or stayed in Philly. I kind of saw myself wanting to like go back out there. I had the option to, but when I kind of looked at . . . people define value as different things, right?

When I actually kind of sat down and looked at the financials with my parents, I was still in state at Utah and just kind of like the quality of education, I wasn't able to convince myself that paying for a private medical school when I had a really good in-state option was going to be the right choice. I didn't want to feel financially pressured to pursue something really lucrative, and then I went to second look date here and we heard from Dr. Morton and some of the other main educators here.

I felt confident that I was going to be able to succeed coming out of here, and I also saw where the fourth years are going, and they had really impressive institutions that they were going to and I didn't feel like just because I was going back to Utah, I wouldn't be able to get back to the East Coast or the West Coast for residency.

Noah: I don't have a lot to add. Mine was pretty similar. I went to undergrad in St. Louis, and so I was in a similar situation of going somewhere kind of out in the other areas of the country or whether to come back home. I remember when I came here for my interview day, it was just a really positive experience overall, both at the school, and then I also had some friends who were in the city, in the area.

Graduating from college is kind of a hard thing, especially when you go away, because the chances you end up in the same way as the people you've bonded with is really low. So I wanted to make sure that I was going to be in a place where I felt like I had a support system both within the school and outside of the school, and I wanted to go somewhere where I would feel comfortable. Salt Lake City just felt a lot like Boise to me. It kind of felt like home, but it was still away. It just ended up being the right fit.

I second everything Maddie said about you look at the match list and people are able to do incredible things out of this medical school. So I didn't really have any concerns about getting to where I wanted to go out of here.

Dr. Chan: All right. Well, let's talk about where you're headed. So when you started medical school, did you have an idea that you would choose the fields you ended up choosing? Help people understand how you came to the decision. Again, for people in the process of applying or maybe in the middle of medical school, it's very mysterious. Like how do doctors choose their fields? What were your journeys?

Noah: For me, I came into medical school and I . . .

Madison: I'm just like laughing, because what he wanted to do was like so not right for him, and I think he feels the same way about me.

Dr. Chan: What did you start with?

Noah: For some reason, I had it in my head that I was going to be a pediatric oncologist, that I was going to treat kid cancer and that that was what was what I was going to do for the rest of my life.

Madison: He wanted to be a chick magnet. Like curing little kids with cancer, just like . . .

Dr. Chan: I don't know if pediatric oncologists have higher rates of attracting members of the opposite sex.

Madison: I'm sure they do. We can do a study. That can be my residency study project.

Dr. Chan: You can do a double blind.

Noah: Yeah. I was so sure that that was what I wanted to do. I did the pre-clinical stuff. The cancer science just didn't really excite me the way that I thought it would, and then I hit clinical rotations. Peds was not a good fit.

Dr. Chan: What happened? What was your experience? Was this a rotation on pediatric oncology or just pediatrics in general?

Noah: Just pediatrics in general.

Madison: He didn't make it to oncology, just like nixed it at the kids level.

Noah: Stopped right there. Yeah, they say that especially when you hit your third year of medical school is when you start to get a feel for the different tribes of medicine, where a lot of the stereotypes you hear about the specialties, they came from somewhere, and it's because a lot of these specialties attract certain personality types. Most people, I think, pick their specialty . . . they have to like the science. They have to like the day to day, but more than anything, they have to like the people and you have to find "your people."

Peds just wasn't my people. I just felt like I wasn't connecting with them the way I wanted to and I wasn't connecting with my colleagues the way that I wanted to. So I kind of had a crisis, and I wasn't sure what to do. I thought I was going to be a surgeon during surgery. I thought I was going to be an orthopedic surgeon for a week. I ended up settling on anesthesiology.

Dr. Chan: Settling.

Noah: Settling because it's the best field and I fell in love with it. The people were great. It was a perfect fit for my personality type. It was all the science I wanted in a field. It was all the procedures I wanted in a field. I for sure was not settling, but that was the specialty that I found was best for me.

Dr. Chan: Were you able to do a rotation in anesthesiology during third year, or did you have to wait until the beginning of fourth year? Or how did that work out? Or just during surgery, were you just kind of more focused on what was going on near the head?

Madison: You kind of found it during OB first.

Noah: Yeah. I found it during OB. I remember peeking around the curtain and being like, "I wonder what that guy or gal is doing."

Madison: He looks way better than the guy pulling out the baby.

Noah: They're having fun back there. Then I kind of paid attention to them during surgery. And then at the end of third year, when I thought that anesthesiology might be a good fit for me, I did the rotation here, and it was kind of like a confirmatory.

Dr. Chan: So you found your tribe?

Noah: I did find my tribe.

Dr. Chan: Really positive experience?

Noah: Absolutely.

Dr. Chan: Wow. That's great. Cool. Madison?

Madison: Yeah. Oh, I was all over the place. Holy cow. I wrote my med school admissions essay -- this is something that all my college friends still give me like major crap for because they all read it -- about like wanting to be a primary care doctor in a small town, which is hilarious because I don't want to do primary care. Literally, being in a tiny town gives me so much anxiety I don't know where I came up with this idea.

So then I worked for an orthopedic surgeon for a year during my gap year, and I thought surgery was really cool, orthopedics was really cool. They're dealing with these healthy patients for the most part. It's pretty happy medicine. I came into med school thinking maybe I want to do that. I did a summer of orthopedic surgery research at Hospital for Special Surgery in New York and decided then that I thought it was a really cool field, but I didn't necessarily want to do the surgery part of it.

Dr. Chan: It was like standing in the OR for long periods of time?

Madison: Yeah. It was kind of like at that level of orthopedic surgery, you're so specialized that you're not even like . . . it's not even that you just take care of all joints, it's like you only take care of knees or you only take care of hands or you only take care of shoulders, and I wanted to be more of a generalist. So then I was like maybe general surgery would be a good fit, because you get to be a little bit more wider in your scope of kind of what you're dealing with in the body.

I went into third year -- Noah will tell you -- being like gung ho about surgery. I had found awesome surgical mentors here at Utah, shout out to Dr. Fenton and Dr. Penucci in plastics. They were incredible. I got some really great research opportunities with them. I actually hit my surgery rotation and I realized that even though I liked the research of surgery and I liked the idea of it, I was not happy in the OR. I was not thriving. I started to like try to avoid cases by like volunteering to do like busy work.

Dr. Chan: The floor work.

Madison: Yeah. There was a great intern who I worked with, who actually graduated from Utah as well, and I just saw how excited she was to go to the OR for like anything. It didn't matter the time of the day or how tired she was.

Dr. Chan: Is this Ryan?

Madison: Yeah, who also was a couples match.

Dr. Chan: Yeah.

Madison: I looked at her and I was amazed by her, and I also realized that I wasn't like her, which was a scary thing to realize. But then the backstory to all this is that, here at Utah, we have these groups called CMC groups and it's this kind of tribe that you get your first year. And these are all led by a physician. Dr. Chan leads one. My CMC leader, who kind of teaches you about how to do physical exams and things like that, was an ER doctor named Jerry Doyle. He and I always got along really well.

Dr. Chan: He loves it when students shadow him and come in for shifts.

Madison: Yeah. He was like so welcoming. So I think, little known to me, I was kind of being indoctrinated with emergency medicine from day one of medical school. I just didn't realize it. So after I did surgery, I sat down with Dr. Doyle at the hospital Starbucks at The U. I had a list. I listed . . . this is what I would suggest to do if people have questions about what to do, what specialty they're going to choose is I wrote down on a piece of paper everything I hate about medicine in general, like these are the activities I don't like. I don't like rounding. I don't like clinic. I don't like all these things.

And then on the other side, I wrote what I love. I love taking care of marginalized populations. I love doing a gazillion things at once. I like procedures. I love being part of a team. I don't like the OR. I found that out. I sat down and I just read this to him. He was like, "That was me when I was a third year." So I just started shadowing more and more in the ER, met Megan Fix, who's been an incredible mentor to me as well, as well as Katie Wells, who's now a PGY3 here. I can't say enough good things about the ER mentorship here.

Dr. Chan: It's a very strong program.

Madison: Yeah. It's an amazing program, amazing residents. I've never looked back. I was like, "This is home."

Dr. Chan: Emergency medicine.

Madison: Emergency medicine, all in. Yeah.

Dr. Chan: We've got emergency medicine and anesthesiology. When on your radar did you starting about the couples match? When did that kind of start entering your consciousness? Third year?

Madison: Before we were dating.

Dr. Chan: Before you were dating?

Madison: Just kidding.

Noah: That's a really good question. I think as soon as we started dating. If you start a relationship in medical school with someone else who's in medicine, I think you can't help but your first thoughts go to couples match.

Madison: Everyone in med school is like a planner. You plan years in advance for stuff.

Noah: So I think as soon as we realized that this was something serious, which was not super long after we started dating, we started thinking about it. As far as logistically when we started really thinking about how this is going to work and how we were going to do this, I would say probably third year is when things started to get really real as far as like, "If you do this and I do this, what is that going to look like?"

Even before we had officially settled on what we're doing, like the week that I wanted to do orthopedics or like, "Would you be okay coming with me wherever I match?"; Or when Maddie wanted to do plastics, it was like, "Would I be okay going wherever she wants to go?" because those are two super competitive specialties. So you start kind of thinking about what that would look like and if it's okay.

Madison: There were also like major logistics that we chose to do differently from other couples in our class I knew. Noah and I knew that we were both pretty competitive people with ourselves and with other people. So we made the decision not to share our Step scores with each other.

Dr. Chan: Oh, wow.

Madison: Yeah. That's like a big deal, right?

Dr. Chan: So the entire time you've been together, you don't know how each other did?

Madison: No.

Noah: I think that we could like guess a range just based on the conversations we've had, but I have no idea of what the number is.

Dr. Chan: I remember my classmates, and it was not just Step scores. It was just grades overall. Some were just I would say over-sharers. You just knew exactly what they do.

Madison: Yeah, and we never wanted to be those people. I know, from Noah's past relationship, they were both pre-med, and it was a little competitive between them. We wanted to stay out of that, and we wanted to be like only supportive. We would still study together and all that jazz. We just never wanted to open our envelope and have the feeling of like, "Well, if Maddie only would have scored five points higher . . ."

Dr. Chan: If she only studied for five more hours.

Madison: Which isn't even true, but it's just like you never want to have those lingering questions in your brain. So we sat down with Dr. Stevenson here, and we wrote them on a little sheet of paper and slid it across the table to him.

Dr. Chan: Wow.

Madison: He literally lifted them up and he just was like, "We're good. You guys are okay." And we applied very broadly too.

Dr. Chan: Before we get to that, so creating your fourth year schedule, did you do away rotations together? Walk us through that.

Noah: It was a little different for both of us. Maddie, because she decided to do emergency, she's required to do a couple of away rotations. So we knew right off the bat that no matter what, she was going to have to go and do them. So we kind of thought this is a perfect opportunity for us to kind of get our foot in the door in some of the bigger cities that we were hoping to maybe match in.

Madison: Compared to a lot of classmates, we really didn't want to stay in the West. So we didn't apply anywhere around here. We didn't apply in most western states. We were really focused on California and the East Coast and a couple dots in between.

Dr. Chan: Did you interview here?

Madison: We applied here and everything. But we were pretty up front with our departments too about wanting to move away.

Dr. Chan: I think it's always a good move to interview with your home institution.

Madison: Oh, yeah. I mean it's a slap in the face if you don't, and they're obviously the people who helped you find your specialty. We also applied and did our away rotations. I did one in New York City and one in Los Angeles, and Noah also did one in Los Angeles.

Noah: Yeah. It was actually just kind of by luck. I got my third choice of date range for my away rotation in Los Angeles, and Maddie got maybe her second choice. I don't think it was her first choice. But either way, just as a fluke, they ended up overlapping perfectly. So we were able to actually go out to Los Angeles and do our away rotations together and survived a real estate scam and a totaled car.

Madison: It was a low point.

Dr. Chan: Real estate scam, did you have like an Airbnb disaster?

Madison: Well, Noah can talk about this.

Noah: I'm going to put this all on myself because it was 100% my fault. It was a situation where it was like a Craigslist thing.

Dr. Chan: I didn't think your generation used Craigslist anymore.

Madison: We've had good luck. I found my housing for New York via Craigslist, and we've done it in the past when we did research and have had really good luck, except for this time.

Noah: I went to L.A. during the summer between first and second year to do research, and I did it exactly the same. It all worked out great. It was going the same way this time. It turned into a thing where we were leaving to drive out there and I had been trying to contact this guy just like, "Hey, we're going out there. Just wanted to make sure you're going to be there."

Madison: Driving 11 hours.

Noah: Radio silence the day before we were leaving. I was like, "That's kind of weird, but what we can we do now?"

We stopped over in Vegas overnight, and we woke up the next morning, the day we were supposed to meet him and move in and he goes, "I was waiting for you all day yesterday, and it's now going to cost you $700 more and you can't move in for another week." I just remember looking at Maddie and being like, "Ruh-roh." So we got to the apartment complex. We showed this guy's picture around. No one had ever seen him before.

Madison: It was bad.

Dr. Chan: You have these Utah license plates. People think you're like these little country bumpkins.

Madison: Yeah. I was literally scheduled to start the next day in the ER, and we were homeless in Los Angeles.

Dr. Chan: Well, you had a car.

Madison: We did. We had two cars at this point.

Noah: We booked a few days at the Gardena Terrace Inn, #DontStayThere.

Madison: I like went on this app on my phone, it's like Hotels Tonight. It's actually a great thing. You should definitely download it for interview season. But I found like the cheapest one closest to the county hospital I was working at. It was like $70 a night. I was like, "That's mostly in the budget." It was really bad.

Dr. Chan: Is this big county?

Madison: This is Harbor.

Dr. Chan: Harbor County.

Madison: Noah slept with this like hunting knife under his pillow.

Noah: My inner-Idahoan came out.

Madison: It was really not great. I got up in the morning and put on my scrubs and went to work. We stayed there for three nights.

Noah: I will say to our credit, despite all of this, we were never really at each other's throats. We got frustrated with the situation, but I don't think we ever took it out on each other. To this day every once in a while, Maddie will be like, "Hey, Noah, it would be really nice to have that $1,000 back." I'll pay her back for it eventually.

Dr. Chan: You sent this individual that you never saw again $1,000?

Madison: $2,000.

Noah: Yeah. That's kind of the point of contention. We paid upfront, which was a bad choice.

Dr. Chan: Well, I won't dwell on that because both of your faces are . . .

Madison: Sad.

Dr. Chan: It sounds like, and I've gathered this from talking to other people who went through the couples match, you targeted large cities with multiple programs, so just in case one of you matched in one program, there may be a neighboring institution.

Madison: Yeah. Given what we're looking for, if anyone's familiar with emergency medicine, emergency medicine is a little different than other specialties in that you have . . . all specialties have community, county, and academic programs. Those are three different flavors of style. The interesting thing about EM is that you have hybrid programs that are county and academic, which is kind of what I was interested in.

Then you also have really, really amazing just straight county or straight academic or straight community programs. So places that might not be as "desirable" for specialties like anesthesia are actually really awesome training experiences for emergency medicine just given that you want to be in a place that has a lot of acuity and a lot of diversity . . .

Dr. Chan: A lot of diversity in patient conditions, illnesses, trauma . . .

Madison: Socioeconomic status, all of the above. You also want to be in a place where you don't necessarily have tons of other services trying to necessarily . . . I don't want to say hone in because they're always valuable and you can always learn a lot from them, but that you are able to kind of like direct your learning when opportunities arise in the ER for that learning. So, basically, getting back to the point, we were looking for places with multiple programs, that would be both beneficial to what we were looking for in a residency program, which was hard.

Noah: I don't have a whole lot to add. But it was kind of interesting when we were trying to build our list of places to apply to and interview at, because the programs for anesthesia that are maybe less desirable or ones that are not super competitive are the ones that Maddie was super excited, and then a lot of times kind of like the bigger, powerhouse academic programs that tend, not always, but tend to be stronger for anesthesiology were the programs that oftentimes don't have a great emergency reputation.

Dr. Chan: Interesting.

Noah: So we were looking at kind of like opposite things. In a lot of ways, that was nice because it gave us a lot of permutations of programs within bigger cities.

Dr. Chan: Would you only interview at a program where the other person was also in there to interview? Or did you just kind of if you got an interview in New York or Philadelphia or Boston, you'd just immediately interview there? What was your strategy?

Noah: So it kind of gets into playing the game of the couples match. You kind of have to play the game for residency application in general, but especially in the couples match it's all about communication. So whenever one of us would get an interview offer at an institution, they would immediately send an email to the department saying, "My partner is Noah, and he's applying in anesthesiology. He hasn't heard back yet."

Madison: And he loves your program, most important part.

Dr. Chan: Emoji smiley face.

Noah: Then there are also sometimes where the other person would send out an email to all the programs within the city that they had applied to that the other person had been offered an interview saying, "My partner is interviewing in the city. I haven't heard back from you and I'm interested." Just really any concrete excuse to reach out to program directors and say, "I'm interested in your program."

Dr. Chan: Do you feel that was successful? Did the programs respond to that?

Madison: Oh, yeah.

Noah: Hugely successful.

Madison: I can only think of a couple ones where it didn't work.

Noah: Like 80% to 90% of the time it was successful.

Dr. Chan: So there was definitely, you feel, communication between the anesthesiology department and the ER department about what was going on?

Madison: Yeah. I think it was happening, for sure. I also think that those two departments are departments that play really well together. EM residents across the country rotate on anesthesia for airways, and anesthesia rotates in the emergency room at least for a couple months during residency. So they're in contact, and I think that was really helpful. The other thing that was good was to play up any and all connection to the area, to the school, to anything.

Noah and I were both successful in getting interviews at our alma maters and getting each other interviews at our alma maters, which was really fun. I have family in the Midwest. I really tried to play that up to help get interviews in Chicago. Noah has long lost relatives in New York City. He played that up. So just anything that you can say to say, "Yes, I'm coming from University of Utah. It's a little bit of a medically isolated area in that we're the only game in town, but please, please, please look at me. I'm willing to . . ."

Dr. Chan: Move to the East Coast.

Madison: Yeah, move to the East Coast, move the West Coast, move wherever.

Dr. Chan: Awesome. So leading up to your match list, was it a negotiation between the two of you, or did both of you just kind of know independently, kind of came to the same conclusion? How did that work?

Noah: So I think what we ended up doing is we both built our own independent rank lists as we were going on interviews, but we were talking to each other all along the way.

Madison: Like after every interview we called each other.

Noah: It wasn't like a big secret, but we were still trying to rank them semi-independently. And then when all was said and done . . . maybe not when it was all done, but towards the end of interview season, we started to kind of sit down and get an idea of what our picture would look like as far as our rank lists. I think that our main goal was to find a few programs that we both liked enough that they could be our top programs. We kind of addressed those first, and we said, "We would both be happy with these. These are both strong training programs for us"

Then we kind of worked our way down to ones where we had to make some compromises where either I liked a program and it just wasn't a good fit for Maddie or vice versa and really tried hard to make it as fair as we could, where if we did one that was unfair to me, we did another one that was unfair to Maddie and just built our rank lists in a way that felt fair, so that not one person was getting everything they wanted and the other person not getting anything they wanted.

Madison: Yeah.

Dr. Chan: Awesome. All right. So you submitted your match lists. What was it like between that day and then match day? That's a month, right?

Madison: Yeah.

Dr. Chan: What were you going through? What were you thinking?

Madison: I started on the ICU.

Dr. Chan: Kind of second thoughts?

Madison: So it was pretty . . . I don't know. I was kept really busy, so I think that definitely helped. We kept it a secret from everyone, what our official ranking was, which was really hard because I tell my mom everything and she was actually really mad.

Dr. Chan: Hello, Madison's mom. Hope you're listening to this.

Madison: We also made . . . so on the interview trail, I knew that this was probably the most we'd ever be traveling in such a short amount of time probably in our entire lives. So Noah and I, we took these little like felt letter boards around with us to every single -- they're like just really small, like a placard size -- to every interview and we made a different sign for that location. And then we had my friend, who works at BuzzFeed Video, she turned it into a YouTube video that was like 15 minutes long. So that was really fun to kind of just build up the excitement and remember. We both sat down and watched it when she sent it to us, and we were like, "I can't believe we made it."

Noah: We're BuzzFeed celebrities.

Madison: Not quite.

Dr. Chan: Can we publish that? Can we do a link?

Madison: Yeah, sure.

Dr. Chan: All right. Well, I'll get that afterwards, yeah.

Madison: We were just like . . . watching it, I was just like, "I can't believe that we did that many interviews." I did 20 interviews.

Dr. Chan: Twenty, wow.

Madison: Noah did 25, 26.

Noah: Twenty-five.

Madison: Twenty-five.

Dr. Chan: That's a lot.

Madison: It was a lot.

Dr. Chan: How much did you budget? What does that look like?

Madison: With or without the L.A. money wheel? No, I'm kidding.

Dr. Chan: Using Craigslist or not using Craigslist.

Madison: Sallie Mae does residency relocation loans. Because we were doing double the interviews, we probably took out double what our single application classmates took out. So I took out $10,000 to pay, and that's probably . . . I don't think I could have done it cheaper. I really don't. I surfed on so many couches and ate so many turkey cheese roll-ups, I don't know if I could have done it much less expensive.

Noah: Mine was about the same. As we were going through the process after the match lists were submitted and we were just kind of looking back on everything that happened, we were like, "Man, where did all of that money go?"

Madison: Oh my gosh, this was a good story.

Noah: It goes to flights. People would guess that flights are just expensive. But when we added up between the two of us Lyft and Uber, we took 298 ride shares.

Madison: No, no, 198.

Noah: Wasn't it 200?

Madison: No, it was 198. That's still a lot though.

Dr. Chan: That's still a lot.

Madison: 198, like that's insane.

Noah: We were like, oh, that's where all our money went.

Madison: At the time, we're like, "It's really cheap. It's only $8 here, $9 here," and then it adds up so fast.

Dr. Chan: Aside from airfare, Uber and Lyft were your biggest expenses.

Madison: Uber and Lyft. There's this credit card now apparently that you can apply that gives you like 4% back on Uber and Lyft. You should consider getting that for your interview season. This is not a sponsored post, but yeah.

Dr. Chan: I'll talk to the Dean's Office. So match day, the night before match, slept like a baby, nervous?

Madison: I slept great.

Noah: Yeah, I think we actually both slept. Yeah, we slept fine.

Madison: Noah was one of our class presidents. So he was like really busy with the actual like logistics stuff of setting up for match day.

Noah: Which was really nice. It also kept me distracted. I had to get there really early and just set things up and do the decorations and stuff, which really helped to just kind of dampen the anxiety a little bit.

Madison: I think Monday was actually a bigger deal for us, because anesthesia does . . . you can either do a one plus three program, where you might be separated for your intern year, or you can do an all-inclusive four-year program. So we had three and four-year programs ranked, so there was a small possibility that he would either be separated for our first year in a different area, or he would not match for that first year. So Monday we found out that he was fully matched.

Dr. Chan: That gave you a hint or no?

Madison: No, it didn't. It meant that he didn't have to scramble somewhere.

Noah: Yeah, I would agree with that. Monday was probably the most anxiety provoking, because I had this nightmare that I would have to scramble for my preliminary year position or whatever. So once we knew that we had both fully matched, we knew that it was super unlikely that we had gone really far down our list, and we knew that . . . I don't know what I'm saying.

Madison: That's okay.

Noah: We knew that we had been fully matched.

Dr. Chan: You'd be together. You wouldn't be separate.

Noah: We wouldn't be separate for probably more than a year was what we knew from that.

Dr. Chan: When you're setting up match day, you see the envelopes on the table, no temptation. Isn't there someone guarding them?

Noah: Yeah.

Dr. Chan: You were there early enough, though.

Noah: I was. Yeah, I had to watch them like put them in each of the individual things.

Dr. Chan: Yeah, alphabetical.

Noah: It was definitely nerve-wracking. I didn't really want to get tackled by student affairs, personnel, and get taken out on match day, spend it in the hospital and find out later where I'd matched.

Dr. Chan: So your families were both there?

Madison: Yeah. It was actually the first meeting of the parents.

Dr. Chan: Really?

Madison: Yes.

Noah: As if the anxiety wasn't high enough.

Dr. Chan: Did you do like a dinner the night before?

Madison: The night after match day we did.

Dr. Chan: Okay. So the parents met for the first time?

Noah: They did, yeah. Everything went well. Everyone got along great.

Madison: Then my little sister was there, and then Noah's best friend was there.

Dr. Chan: All right. So they have all those little speeches. They're kind of delaying it, delaying it. They cut the little red ribbon. Was there a red ribbon this year? I couldn't tell, I was near the back.

Noah: I think so.

Dr. Chan: They cut the red ribbon. You go up there and get your envelopes. What happens next?

Madison: I refused to open my envelope.

Noah: Oh my god, she was driving me crazy.

Madison: I like got it and I was like . . . I didn't know this, but someone was filming it unbeknownst to be and they like put it on the University of Utah total Instagram page, and there's just me doing this nervous dance like I have to pee being like, "I can't open it. I can't open it."

Noah: It took Maddie like three minutes to open her envelope. I was going nuts.

Madison: Some really mean person commented, "Has she ever opened an envelope before?"

Noah: That is the sane question.

Dr. Chan: Was that person Noah?

Madison: No, it wasn't. It was some other meanie.

Dr. Chan: Did you open your envelope before Madison?

Madison: He did.

Dr. Chan: So it was not a simultaneous event.

Noah: Thank god you were matched with an anesthesiologist where you have to be patient.

Madison: I eventually opened it, and we did look at it at the same time, but it just took me a little extra time.

Dr. Chan: So where are you going, and how does it feel?

Noah: We both matched at the same hospital.

Madison: In the best city in the entire world.

Noah: We're going to NYU in Manhattan.

Dr. Chan: Wow.

Madison: Yeah.

Dr. Chan: Fantastic. So I assume that was near the top?

Madison: Yeah.

Noah: Absolutely.

Madison: It has been on my bucket list my entire life to live in New York City.

Dr. Chan: New York City, yes. Awesome.

Noah: NYU was actually my very first anesthesia interview of the entire season. I went there, and I absolutely loved it. I remember I called Maddie after and I said, "I love everything about it. This is exactly what I want."

Dr. Chan: Let's talk about why did you like NYU? What attracted you to their program?

Noah: It was the people. It all comes down to the people. Obviously, it's an incredible medical institution with a great reputation, and even within the anesthesiology world NYU has a great reputation as well. But, for me, it came down to the people. I didn't appreciate it as much until I got further into the interview season, but you can tell so much about a program by how many residents you see in the hallways who are smiling.

So as I went on, I started to keep like a mental tally of how many residents I saw smiling during my interview day, because it's a really good indication of when people aren't really focused and kind of in the intense part of their work day, are they happy? Do they like being around the people that they're around? I'm pretty sure I told Maddie this on the phone after I left NYU. Everyone I saw was smiling. Everyone was happy. People seemed like they had a great quality of life.

Madison: The attending-resident relationship was you said . . . I remember you telling me it was a really good one there.

Noah: Yeah. The program leadership could not have been warmer. My interviews were very warm. It was very casual, and they wanted to get to know me. I was . . .

Madison: In New York, you think of it's more fast-paced, of course, but it's also East Coasters are a little different.

Noah: I also had these kind of talking points locked and loaded, where I would have to convince them about why I would be willing to go to New York, and I was ready to kind of sell that to them. I never really had to. Everyone was very open to it, and they said this was a great time to try something new and exciting. It was just a great . . . I feel like my entire interview process I was always comparing programs back to NYU.

Dr. Chan: Wow. Cool. Madison, why did you like NYU? Is it a three or four-year program?

Madison: Oh my gosh. It's a four-year program.

Dr. Chan: ER is kind of weird. It's like the only field I know that there's not really a [inaudible 00:43:31].

Madison: Yes. That really comes down to how much elective time you get. So NYU is a four-year program, which I actually wanted a four-year program because Noah's program would be four regardless. NYU Bellevue, what drew me to it was the history. I'm someone who has always believed that places hold meaning. That's why I picked the college I did. The history of Bellevue Hospital, it's the oldest public hospital in the United States.

There's actually a book that was recently published that I read about it before I matched or anything, but the history of Bellevue taking care of the most marginalized members of society in the most diverse city is just incredible. They were on the forefront of the AIDS crisis. They took care of immigrants, all the way to when Hurricane Sandy hit, how staff was carrying patients down in stretchers to evacuate them. I'm just so honored to now hopefully be starting my journey as an MD at such a storied hospital that everyone is so proud of the mission and the service to New York City.

Dr. Chan: The history and the legacy.

Madison: Yeah. So when I was talking about the programs before, like the academic and county hybrids, so at NYU, you get Bellevue, which is a true county program, but you also get Tisch, which is a private NYU hospital. So you get two very different populations there. Tisch gets more of the very complicated transplant cancer patients. Then Bellevue you get more of your bread and butter, emergency medicine, trauma. It's the only level one trauma center in Lower Manhattan.

I interviewed actually the day after the New York City subway bombing, and we toured the ICU, and there were people marching through the ICU with assault rifles, because the person who committed it as well as the victims went to Bellevue. It's a crazy, exciting place to be. It's where the Ebola patient went. So I'm excited for what's coming. It's going to be a cool place to train. Noah will get to be there too. We'll actually get to rotate on each other's services because we'll be at the same hospital.

Dr. Chan: That's fantastic.

Madison: Let the battle of the airways begin.

Dr. Chan: Battle of the airways. Who can intubate the best?

Madison: We intubate under worse conditions, I feel like. You do it more, though.

Dr. Chan: Tale as old as time, anesthesiology versus ER when it comes to intubation.

Madison: I still have a lot of friends there, which will be really fun to get to reconnect with them.

Noah: My dad actually grew up in New York, and he lived in New York for a long time. Even though he might not admit it, I think that somewhere deep down inside of him there's still that inner New Yorker that's transplanted in Idaho who's a little bit proud to have someone temporarily going back to the big city.

Dr. Chan: That's fantastic.

Madison: So many bagels. We're so excited.

Dr. Chan: Great restaurants. That's what I tell people. I've never lived in New York. I've visited New York a few times. I used to live on the East Coast. I lived in Washington, D.C. The thing about New York City that I love, if you want sushi on top of pizza at 2:00 in the morning, you can find someplace like that. Literally, the city never sleeps. There's just so much fun stuff to do.

Madison: If you're in a specialty that's 24 hours a day, what better place to be than a city that never shuts down?

Dr. Chan: Fantastic. Well, I'm so excited for both of you. We have graduation coming up in a few short weeks, and then you're off for your medical training. I can't believe you're going to be full-fledged MDs and practicing medicine.

Madison: They sent the offer letter. We have to have the letter that says like, yes, you're going to be a resident physician, this is your salary in order to show that to landlords to qualify for housing. And they sent me my letter and it said, "Madison Hunt, MD," and I was like, "Who's that person?"

Dr. Chan: It's so official looking.

Madison: I'm going to be looking over my shoulder for the next four years.

Noah: I don't know how long it's going to take before we actually feel like we've earned the MD title.

Madison: Never.

Noah: I think it's not going to be soon.

Dr. Chan: Well, I'm excited for you guys.

Madison: Thank you so much.

Dr. Chan: I'm so glad you came here to Utah. I'm so glad you guys found each other. I'm glad you found a field that you're passionate about. It's very obvious. I'm excited for your future patients because you guys are going to be great doctors.

Madison: Oh, thank you, Dr. Chan.

Noah: Thank you. That's nice to say.

Dr. Chan: We'll talk later.

Announcer: Thanks for listening to Talking Admissions and Med Student Life with Dr. Benjamin Chan, the ultimate resource to help you on your journey to and through medical school, a production of The Scope �ǿմ�ý Sciences Radio online at thescoperadio.com.