SIOUX FALLS, S.D. (KELO) — San Chandra and Sawyer Stevens found their match. The two graduates of the Sanford School of Medicine at the University of South Dakota have secured residency placements to continue their path to be doctors.

Chandra is headed to the University of Iowa’s health care system. Stevens will go to the South Baldwin Medical Center system in Foley, Alabama.

The search to find a residency placement is called a match process. It’s a competitive process in part because as the number of medical students has increased, the available residence programs has not kept pace.

While USD graduates do well in residency placements, the process is demanding, said Dr. Lori Hansen, the dean of medical student affairs at the Sanford School of Medicine at the University of South Dakota.

“It is daunting. There are a lot of expectations because of the competitiveness,” Hansen said.

March was match month, as students at USD and thousands of other medical school students learned on Monday, March 13, if they were matched to a residency program. Less than a week later, on Friday, March 17, they learned the program with which they matched.

“I was very, very happy that day,” said Chandra.

“It was very relieving. After struggling through four years of medical school and all the tests, and clinical obligations and having to work on applications and interviews. and going through the whole match process. It was very stressful leading up to it,” Stevens said.

The two students are among the 65 students who secured matches this year. That’s all of the students who applied, Hansen said.

Residence programs are usually three to seven years, depending on the field. There is not necessarily a medical practice field that is easier to find a match in than others.

Students start the match process by first selecting a specialty.

Hansen said USD wants medical students to choose a specialty they are passionate about, one they know they want to practice. A medical school instructor helps students select their specialty.

“First you have to pick your specialty; that’s one of the most important pieces. What career do you want for your future?” Chandra said.

Stevens chose family medicine. Chandra chose internal medicine.

But selecting a specialty is not a guarantee a student will get placed.

“Some students chose an alternate program in which to match. Meaning that it wasn’t their first choice of specialty, but they found a position and a location that they thought they would be happy in,” Hansen said of the USD students who were matched this year.

Preparing for a residency match starts long before the fourth year

Hansen said medical students not only need to get good grades, they must do well in clinical experiences in order to improve their chances of getting matched.

Resident programs will also evaluate a student’s research experience, published material, community service and honors and awards they receive, Hansen said.

The expectations are high, Hansen said. “It’s very stressful,” she said.

Stevens said opportunities are available to medical school students.

“Being a good program like USD, they build in organic activities you can get involved in,” Stevens said.

Although she loved medical school, “I like doing things outside of medical school. Whenever I could I was seeking opportunities to get involved outside of (lecturing) portion of medicine,” Chandra said.

Stevens has been involved with Special Olympics since he was a high school student in Minnesota. He continued his involvement during his undergraduate work and medical school.

“You have to find things you enjoy doing…,” Stevens said.

Medical students must also know that there are times they will be too busy for anything else but studying, he said.

Where do I want to work?

“Everyone has kind of different things they are looking for in a program,” Chandra said.

Chandra said she had heard from other students in residency that “‘Where your residency is is where you will likely get your job.’”

Stevens said he focused on a places where he wanted to live and work after the residency was completed.

Medical students are encouraged to apply to programs and locations they believe will be a good fit.

Chandra, of Sioux Falls, wanted to stay in the Midwest. She applied to programs in the Midwest including her placement in Iowa.

She applied to 40 or 41 programs.

Stevens wanted a warmer climate and he applied to 20 programs in states warmer than South Dakota, including Alabama. He has family ties to the Foley, Alabama, area where he was placed.

“I feel like I was at the lower end (in application numbers). I know people who applied to 100s,” Stevens said.

Chandra wanted the Midwest but also programs that had USD students. She wanted mentorship in her program.

“I also chose some programs that I knew were just good internal medicine programs,” Chandra said. She wants to sub-specialize. She will need to complete three years in internal medicine and additional time to sub-specialize.

“That was something that I was looking at too,” Chandra said of programs that offer fellowships in sub-specialties.

Hansen said 23%, or 15 students, stayed in South Dakota. There are many specialty residence programs available in the state, she said. “Depending on the specialty, they may need to travel to other places,” Hansen said.

Interviews can follow soon after applications are sent. Or not. Some students may wait months for interviews. In other cases, it can be several weeks.

The man behind the curtain?

Both students secured interviews with multiple programs.

“The first couple are stressful,” Stevens said. Once a few were completed, he got more comfortable.

Stevens had two in-person interviews including in Alabama. The others were online.

Chandra did all her interviews online. She was uneasy at first because in an online interview, she could see the timer and how long she had left after each question.

Each interview session involved multiple sessions over at least one day. Some interviews were 15 or 20 minutes long.

“By the last interview, I felt I could interview with my eyes closed… it became easier,” Chandra said.

When the interviews are completed, the algorithm piece kicks in.

Students must rank their choices of residence programs. The programs also rank them.

The format is that a student’s ranking preferences will be matched with a program’s ranking for a student.

The National Residency Match Program (NRMP) describes the algorithm as “… a computerized mathematical algorithm, the “matching algorithm,” to place applicants into the most preferred residency and fellowship positions at programs that also prefer them.”

Chandra said she thinks of it somewhat like the movie “The Wizard of Oz” and the scene where the wizard is behind the curtain in secret.

“You are basing people’s futures on this algorithm that exists,” Chandra said. But it’s a tried and proven system, she said.

Although the two students were confident they did well in their interviews, “Nearly everybody has that thought…’What if I don’t get placed?’” Chandra said.

Unmatched students can also participate in the Supplemental Offer and Acceptance Program (SOAP). Eligible unmatched applicants in the Main Residency Match apply for and are offered positions that were not filled in the first process.

Chandra said knowing that the USD medical staff would help if she didn’t get placed relieved any fears she had.