Match season begins innocently enough, but for a raging sense of insecurity. The first step is deciding the number and location of programs to which to apply. Geographical preferences usually weigh heavily in the decision, and several initial top choices are selected.

But then, like an insidious and heavy creeping fog, comes the thought, “What if it isn’t enough? Which programs will like my application? What if none of them does?”

According to mentors and family, things have really changed in the match. It used to be that applying to several programs was enough. Now, we are being told by advisors that we should apply to around 35 programs. (And if not “competitive,” even more.)

The goal is to interview at 10-15 programs so that one can have the “mean number of ranks associated with a successful match,” which is 10. For most people I know, 10 is a minimum, and there is a great deal of anxiety associated with not having this number of interviews. Interviewing at 20 programs, all around the country, is not at all unusual. If you are pursuing “couples matching,” multiply all of the numbers above by two or more. It’s out of control.

Some programs begin screening applications immediately. Many of the interview slots are already filled by the time the dean’s letter comes out. Other programs will not look at any applications until they are complete.

As an applicant, you want your file at the top of the heap, so getting everything in at the earliest possible time is crucial. This means hounding letter writers and perfecting the personal statement at a very busy time. All of this is happening during board exams and subinternships. It also means that any obsessive-compulsive tendencies and type-A behaviors roar into gear.

Most applicants are starved for information about when interview invitations are going out and to whom. This allows one to gauge how competitive one’s application is. If things look good, it is an ego booster; if they look bad, it is surely quite distressing.

Internet sites such as Student Doctor Network are abuzz with this kind of information, and it is scoured daily by many applicants. It also requires checking e-mail many, many times a day, because interview slots fill quickly, and one must respond immediately to interview invitations in order to make the schedule work. I would have given anything for a Blackberry or iPhone so that I wasn’t literally tethered to my computer during those months.