"And the final envelope goes to. . ."

There I was. There we were, one hundred and fifty fourth-year medical students gathered together to find out where we would be living and working for the next three to eight years. Strange how our lives would be changed so quickly on this eagerly-anticipated Match Day. One by one, names were called, and students walked up to the stage to receive an envelope, the contents of which essentially said: "Congratulations! You have been entered into a contract to work for this hospital in this city… surprise!" As I looked around, my friends and classmates were nervously receiving and opening the seemingly ordinary white envelopes that held their futures. As they read the letters, some reacted with joy, others looked neutral, and a few started crying. I looked down at my hands, but there was no envelope. For me, there was no future -- yet.

Inevitably, people began asking me questions.

"Hey Charlie, where did you match?"
"I didn't hear your name called. Did you match, Charlie?"
"How come you didn't match, Charlie?"

The simple answer to these questions is that I did not match with the rest of my class. Instead, I chose to take a year off between finishing medical school and starting my residency. Why take a year off? There are many reasons students may choose to do so. A common one is due to personal reasons. Some decide this is the right time to start a family, and they take a year off due to pregnancy. Others may wish to travel or work abroad. There are also the unforeseen events, such as family emergencies.

Another common reason students take time off is to do research in their field of choice. Research is a popular option because it allows for one to take a break from medicine without leaving the field entirely. Many residency programs, especially those at academic centers, favor candidates with research experience; thus, doing research may strengthen a student's credentials and improve his chances of matching at the program of his choice. In addition, there are many research opportunities available in and outside the country, and in many cases, students can be paid for their work. For those who are interested in research but do not wish to pursue a PhD, taking a year off for research can be a very appealing and rewarding option.

Other students may choose to pursue another degree. For example, those interested in medical law may pursue a JD, those interested in medical research may pursue a PhD, and those interested in medical administration may pursue a MBA or MPH. Students may apply for these degree programs separately or apply for combined degree programs. For example, UIC offers a MD/PhD program as well as a MD/MPH program. These programs allow students to finish their second degree during the course of their medical school training, such as between the second and third year. The MD/PhD program also waives medical school fees and provides students with a stipend for the duration of the program.

So, why did I take year off? My reasons fall under the "personal reasons" category. Imagine this typical movie scenario: a guy is about to get married, and all his friends tell him he is losing his freedom and his life is about to be over. Thinking about it makes him scared, and he suddenly has second thoughts about the marriage. Although my situation is not exactly the same, those were basically the feelings I had as I started to apply for the match last year. I would match, do my residency, start work as an attending, and my life as I knew it would be over. I had a sudden, overwhelming feeling of impending doom. I thought to myself, "Whoa, wait a minute, is this what I really want for the rest of my life? Constantly working, being on call, never being able to really leave your work at work?" I realized it might be wise to take some time off while I could to think and make sure I chose the right profession – so I did.

Since graduation, I have done a variety of things. I have traveled a bit, and I have taken time to catch up on some things I didn't get much of a chance to do in medical school, which, among other things, include sleeping and lots of leisure reading. I have been enjoying myself and doing things that I probably will not have time for once I go back to medicine. Of course, I have also thought about my decision to go into medicine. After some deliberation, I have come to the conclusion that medicine is for me. It provides a level of satisfaction that I do not think I will find in any other career choice. In a sense, you could say that this year off has been my "bachelor party," my one last hurrah before I take the big plunge.

Currently, I am in the middle of my applications for the Match, and life is starting to become stressful once again. More specifically, the Match is the process by which medical students determine where they will do their residency. It is a bit more complex than other application processes. First, students submit an application that includes their medical school performances, exam scores, and recommendations to multiple residency programs. The programs then decide which candidates they wish to interview. After interviews are complete, the applicants submit a rank list of the programs they wish to attend in order of preference. The residency programs make a similar list of the students they would like to be in their program. Finally, a computer takes these lists and using a method called the "marriage algorithm," determines the best-fit matches for each applicant and program.

As I look back on the past few months, I have no regrets and am quite happy I chose to take this year off. Although taking time off may not be right for everyone, for those who have any doubts about the future, it may be a worthwhile decision. Match day comes around again in mid-March, and this time, I will be among the anxious students wondering what their futures hold. How will my life change that day? Only the white envelope with my name on it knows.