Fourth-year medical students enjoy a strange state of limbo. Third year medical students live a wet-behind-the-ears, wide-eyed life, worrying more about the locations of the bathroom, cafeteria, and where to procure the correct sized scrubs during their month-long clerkship rotations. Interns clock 80-hours-a-week, answering every fifteen-minute pages, hoping two hours of sleep straight might help just a little. Somewhere in-between those two extremes exists a senior medical student. Caught between despising the stigma of wearing a short white coat and the dread of owning the responsibility that accompanies the title doctor, I am more likely to hear, "What are you still doing here?" than the shrill chirp of my pager. Everyone seems to think I should be spending more time interviewing, filling out online applications, or whatever it is that I as a soon-to-graduate medical student do at home that I'll be far too exhausted to appreciate as an intern. I remember one of my mentors, Dr. Binder, announcing to the class during lecture as a first-year, "fourth year is the best of your professional career."

This year is not without its challenges. The pressure of application deadlines, transcontinental interviews, hoping to find a spot in one of the more competitive residencies, and anxiety about finally earning a paycheck mounts for both me and my classmates as the year drags on and March quickly approaches. For me, the interviewing and match process has extra intensity as I attempt to earn a position in a competitive residency in the same city as my wife.

In a lot of ways Dr. Binder is right. I am not saddled by the backbreaking responsibility of internship, and do not have to lug three pagers on my belt at all hours of the day. Overnight call requirements are nonexistent or minimal at worst. Long gone are the worries of being capable of seeing all of my patients before rounds. I've written hundreds of notes, begun to learn the art of storytelling that alleviates the stress of verbal presentations. Little things are big until you've done them before, and by now I've accumulated enough experience to address the majority of my insecurities. I'm transitioning from begging to be allowed to matriculate at medical school to being wooed by residency programs hungry for residents to fill their programs during the magical fourth year match. "THE MATCH" is a national system that pairs residents with open program positions with a hocus pocus-like combination of lists, interviews, formulas, and one terror stricken day in March when everyone finds out where they work day and night for the next three to five years. All of the sudden I hear a lot less of "Medical student, get me some coffee!" and a lot more "You'd be an excellent addition to our program. Have you looked at our benefit package yet?"

Something deep down inside remains worried about the motivation for such kindness from my senior colleagues. There's just one thing that makes me think all this is simply the proverbial calm before the storm. It's the phrase they often mutter as justification for their kindness, coyly smiling. "Get all the sleep you can. You'll need it." I guess I better sleep now. The call beepers and patient list may not be so kind to a lowly intern.

Andrew Jacques ('05)