If you had asked me a year ago when I was prepping for P4 rotations if I thought I would have to go through the Scramble, I probably would have laughed in your face. I have known I wanted to do residency since the beginning of my pharmacy school career. I did everything I needed to do to prepare for getting a residency position, and not even because I thought I had to, but because I enjoyed doing it all. I built up my leadership skills by holding positions on a local, state, and national level, I presented numerous posters at conferences, I volunteered in the little amount of free time that I had, I worked every other weekend as an intern, and I even selected a hard P4 rotation schedule. My CV was 5 pages long, I thought my letters of intent were great, I thought I nailed my interviews, and I ranked 6 programs overall. I thought I was set.
Then Match Day came.
Thursday night, I was anxious because my future was about to be revealed to me in less than 24 hours. I didn't sleep well that night at all. Friday morning brought more anxiety. I could barely focus on working up my patients at rotation. Then, at 8:00am during morning report, I saw the email flash across the top of my iPad screen. I turned to the resident next to me asking if it was ok to open it. When I opened that email and saw "we regret to inform you...", my heart literally dropped. I had to reread the email. I thought it was a mistake. The whole time during morning report, I kept refreshing my email for an apology email that would tell me where I really matched. Spoiler alert; that email never came. I honestly thought all of my hard work was for nothing.
After crying in the bathroom for 30 minutes, I finally was ready to face reality and put together a game plan for the Scramble. Luckily, my school is very involved in the residency process. Our residency advisor put together a Scramble session on campus so I left rotation and went to school. The first hour of the session, we talked about how to put together a game plan for the Scramble process. This made the process A LOT easier. It helped me to understand the application process and timeline for how the Scramble worked. At 12:00, the list of programs was released. Some other classmates and I started our search through the programs that would be scrambling. It was nice to have other classmates there because we all understood what the other person was going through. It also helped to have classmates who knew my interest areas because they could tell me if a program was something I might be interested in. We also had faculty members who helped us make connections to out-of-state programs. It's always nice to have connections in other places.
After about 2 hours of researching programs, I finally had my list narrowed down. From there, I was able to send interest emails to program directors with my CV attached so they would know to expect my application. From there, all I could do was wait until Monday to submit my applications. This is where the Scramble gets its name. As soon as you are able to submit applications, you may be contacted for interviews within a few hours. While programs are technically not allowed to offer positions until the following Monday, not all programs follow this rule which means you can interview at a place on Tuesday and be offered the position the next day. Basically, the Scramble is quite literally the residency search/application/interview process all over again in the span of a week.
Overall, it was an intense and crazy process that comes with a whirlwind of emotions; depression and anxiety because you didn't match and you have to do it all over again, excitement when you get offered an interview, more depression when you don't get the spot you interviewed for, and panic when you feel like you're running out of programs with open positions. Which leads me to my pearls of advice;
1. Don't freak out. Ok, freak out for a little bit. I cried in the bathroom for 30 minutes while simultaneously texting my husband with exaggerations about how all of my hard work was for nothing and that I didn't want to be a pharmacist anymore. If you're going to freak out, lay out all of your emotions to someone who is thinking rationally, and who can be optimistic and "talk you off the ledge". It's a good thing to let go of your emotions in a situation like this, and even better when you have a strong support system who will tell you you're wrong about your work being for nothing, and who will push you to believe you can make it through the Scramble.
2. Have a strong support system. I don't think I would have made it through the Scramble without faculty and classmates at school. It would have been too overwhelming. There are a lot of programs that scramble and it gave me anxiety just looking at the long list trying to figure out which programs to research. Having a support system who can help you through the search process all over again in an expedited fashion will help relieve some of the stress of the Scramble. Plus, it doesn't hurt to have someone help you that knows what the Scramble process is all about.
3. Stay positive. I know this can be really hard to do when your future is on the line. Trust me. Been there, done that. You need to stay positive and focus so that you can keep your confidence level up. Attitude, focus, and confidence will make or break you in the interview process.
4. Take a break. Yes, you read that correctly. Take a break and do something fun, but still put aside a little bit of time for work. You can do all of your research and put together a program list Friday afternoon when the list comes out, and you can send emails to programs with your CV and/or letter of intent. However, most programs follow the rules of the Scramble process and don't accept applications until Monday. This could lead to a really bad weekend if you're sitting around and only thinking about residency. You need to take a break and do something you enjoy to get your mind off of things and help you destress. Destressing will also help with the positive attitude mentioned in #3. My husband and I went to Niagara Falls and did some winery tours/tastings. It was a perfect weekend. I didn't think about the residency process until Sunday. This leads me to the second part of this piece of advice. Set aside a little bit of time for work. I set aside a couple of hours Sunday night to write my letters of intent and upload them to PhORCAS so that my application would be set to submit come Monday at noon. It was less stressful to do it this way rather than wait until Monday morning because I wasn't scrambling to get the letters written.
5. Sometimes it's not about what you know, but about who you know. I have been fortunate enough to make a lot of connections through OSHP and ASHP. I texted one of my best friends from ASHP with my list of programs, and she instantly knew someone either within some of the programs or she knew someone who had a connection to the programs on my list. Not only that, but a lot of the faculty members at my school offered to contact people they knew at programs that were scrambling. This really helps get your name out there so you have a better chance at getting an interview. It also doesn't hurt to name drop if you know someone yourself within a program that is scrambling.
6. Budget. This may seem like a crazy piece of advice, but you'll thank me for it if you have to go through the Scramble. In order to apply to programs through the Scramble, you still have to pay the application fee like you did for the match. If you haven't used all of your "free programs" (you get 4 with the $130 PhORCAS fee), then you still get those "free programs" up to the limit. Once you go past the limit (in this case, once you apply to more than 4 programs), then you get charged the application fee for each additional program (this year it was $35 for each additional program). In my case, I had applied to 11 programs originally so I was already paying $35 for each of the 7 programs. This meant that for each program I applied to through the Scramble, I was paying $35. This is definitely a fee I was not anticipating.
The Scramble process was one of the most stressful times of my pharmacy career. With a little help, perseverance, and a positive attitude, I was able to make it through. I took it as a sign that I wasn't meant to leave Ohio just yet (most of my programs were out-of-state). I'm proud to announce that I will be starting my residency program in a hospital close to home, and I couldn't be happier.