On Match Day, medical students learn where they’ll start work as doctors. Four at Jefferson offer an inside look at the process.

A champagne toast is in store Friday for 275 aspiring physicians at Thomas Jefferson University’s medical school. A few miles north, their counterparts at Temple University will join in a boisterous 10-second countdown before ripping open their envelopes. At the University of Pennsylvania, rituals include pinning tiny flags on a giant U.S. map.

March 17 is Match Day, when thousands of medical students nationwide learn where they will work as residents after graduation, and in what specialty, completing their training as physicians.

As this year’s fourth-year students await their fate, a new analysis offers the first national look at the changing demographics of who is pursuing the various fields of medicine.

The study, by the National Resident Matching Program, the nonprofit that manages the annual process, included results for 30,000 medical students who applied for the top 10 specialties in 2022.

Among the findings:

The findings provoked a lively discussion among physicians on social media, with some attributing various imbalances to personal preferences, the culture of certain specialties, and discrimination. Authors of the analysis said it was important to compare physician demographics with those of the populations they serve, as disparities can negatively affect patient care.

For more on how the months-long matching process works, the appeal of various specialties, and the agony of the long wait, we spoke to four students at Jefferson’s Sidney Kimmel Medical College about what fields they picked and why:

Some medical students have a specialty in mind on the first day of school, said Gardner, who hails from Warren Township in northern New Jersey. Others wait to pick until they’ve rotated through the disciplines during their third year of medical school.

They have to commit by the fall of the fourth year, when application season begins. Because most hospital residency programs use the same standardized application, students often apply to dozens of hospitals, sometimes in more than one specialty.

That can get pricey. After a flat $99 fee for the first 10 applications, students pay more for each additional one in the same specialty, on a sliding scale. (For 30 programs in one specialty — a typical number — the total comes to $519.)

Hospitals then offer interviews to a subset of applicants, in most cases conducting them via video. On March 1, students and hospitals rank their top choices, and an algorithm comes up with the best possible match.

“This whole year is basically applying for a job,” Gardner said.

Maddie Sunday’s father is a general surgeon, and she noticed at a young age that most of the partners in his practice were male. That didn’t deter her from following his path — attracted by the opportunity to make a dramatic, immediate difference in patients’ lives.

“He basically told me that I could be whatever I wanted, and encouraged me to dream big,” said Sunday, who grew up in Clarks Summit, Pa., north of Scranton.

Vervilles, of Bowling Green, Ky., is applying for joint programs in internal medicine and pediatrics, drawn by the chance to care for patients as they transition from adolescence into adulthood. He cited the influence of a mentor who practices in that combined field, ChristianaCare physician Himani Divatia.

As is often the case, all four Jefferson students have family members with medical expertise, so they were aware of the challenges of embarking on this multiyear journey.

Pando’s father is a rheumatologist, and her mother is a nurse, both of whom spoke of dealing with insurance companies and the rising costs of medicine.

“They were definitely encouraging, but they also wanted me to think critically about the decision,” said Pando, who is from the Lewes, Del., area. “They wanted to make sure that I loved the work, and that I wasn’t just doing it because they were doing it.”

On Monday, students get the answer to a blunt, yes-or-no question via email: Did the algorithm match them with a program or not?

If the answer is no, students have three days to scramble in a supplemental second round, quickly scheduling virtual interviews with any programs that have leftover spots.

If successful, they learn the outcome on Friday, along with all those who were matched in the first go-around.

But since more than 45,000 students are applying for 37,000 residencies each year, many students end up matching nowhere. They may opt instead to get a job in industry, or perhaps pursue additional studies in a related field, such as public health.

(A few specialties, including urology and ophthalmology, conduct their own separate matching processes, which were completed in February.)

At noon Eastern time Friday, students who have secured matches learn their fate.

When asked what their non-medical friends find surprising about the process, the Jefferson students all said it was the binding nature of the agreement.

It’s not like applying to college or even medical school, where the applicant may have more than one option. Nor is it like applying for other jobs, where you can negotiate the terms, perhaps using an offer from another institution as leverage. What it says in the envelope is what goes.

“You don’t get multiple choices,” Gardner said.

That called for some careful planning by him and Pando, who are a couple. The matching system allows spouses and other couples to submit their rankings in combination, so the pair decided to rank more than 200 options.

At the top, they ranked hospitals where both would want to work. Then they listed pairs of acceptable hospitals that are located in the same city, followed by those that are within a short drive of each other, then still others that are separated by a long drive.

Both will have family present at the ceremony, in Jefferson’s curved-front, redbrick Hamilton building, at South 11th and Locust Streets.

“We’re going to open our letters together so we know at the same time,” Pando said. “And hopefully we’ll go out and celebrate afterward.”