As I watched this year’s NFL draft, I wondered what it must be like to be an athlete in the draft…the excitement of being drafted to your favorite team and realizing your childhood dreams, the validation of thousands of hours spent in the weight room, and even the possibility of going undrafted only to fall back on the dreaded “back-up plan.” Johnny Manziel sipped cup after cup of water, Michael Sam made his mark on NFL history, and hundreds of other athletes waited nervously by the phone for congratulatory calls from future coaches.
All of a sudden, like the ESPN Sportscenter’s “DaDaDa, DaDaDa” I realized this whole pro sports draft was for some reason very familiar to me, almost like I had experienced something extremely similar just recently. The ESPN-like sports ticker then flashed across my HDTV vision, reading “Breaking News…the NFL draft is just like the medical school residency match!!”
Here are nine ways your doctor knows all too well what it’s like to be in the NBA or NFL draft…
#1 – Draft Stock
Similar to athletes, medical students are constantly wondering what their “stock value” is on the residency market. Will their strong test scores and resume accolades get them interviews at the top-tier programs? Does their medical school have a strong reputation with sufficient academic rigor to allow accurate evaluation of their intellect and comparison to other applicants? Is one’s medical school resume strong enough to translate into future success at the residency and professional level? On the eve of the NFL draft, Johnny Manziel said he had no idea which team will pick him but that any quarterback-needy team that passed on him would regret it. We all know Johnny Manziel’s collegiate resume and ability for his game to translate to the NFL level was questioned leading up to the draft, leaving his draft stock relatively unknown. If he were in the residency match, would his resume and style of play on and off the field have raised or lowered his pre-match stock? Manziel ultimately matched at his No. 22 program, much lower than many experts projected based on his pre-draft stock.
#2 – Strategy
At the Texas A&M NFL pro day, Manziel did what no elite quarterback prospect had previously attempted to do: throw passes while wearing shoulder pads and a helmet. His decision was clearly strategic, and after asking his agent, ‘You think we can pull that off?’ Manziel said, “‘Shoot, now that you say that, I’ve been killing teams in pads all my life.'” He wasn’t the only QB to throw in pads, however, as Zach Mettenberger of LSU and Aaron Murray of Georgia did the same, largely to prove their recovery from knee surgery last season. Residency applicants ask themselves similar questions, such as who should write your letters of recommendation? Should you do away rotations at other programs or optimize research/clinical opportunities at your home program? And just like Jabari Parker and Joel Embid, who chose not to attend the 2014 NBA Draft Combine and instead depend on their already-demonstrated athleticism and dominance at the collegiate level, medical students must make a similar decision about when to take the USMLE Step 2 CK and CS exams, either before or after the application deadline, instead relying on their already-strong USMLE step 1 score to impress residency programs. Like potential pro sports draftees, medical students must consult with trusted mentors and friends to tailor their strategic approach to the match.
#3 – Poverty
Just like the soon-to-be-pro athletes, medical students may have relatively high earning potential, but their current cash-flow is anything but positive. All but the elite athletes invited to participate in the official NFL combine must pay for their own travel to and from team workouts. Residency applicants too can relate to this pre-professional impoverished form of discount travel, and given the recent news from University of Connecticut basketball player Shabazz Napier when he said, “there are hungry nights that I go to bed and I’m starving,” I’m guessing I’m not the only one that has taken an extra bagel or dried oatmeal from the Motel 6 continental breakfast to save a buck or two while traveling.
#4 – Interviews
NFL teams are allowed to invite 60 players for fifteen minute interviews at the NFL combine each spring, with some players interviewing with as many as twelve pro teams in one day. Interviews are performed by various members of the staff and are done in succession, with a horn sounding at 15 minutes signifying the end of the interview. Like any job interview, the interview questions posed to these future NFL athletes are at times random, occasionally question ethical boundaries, and rarely mention combine statistics or 40 yd dash times. Green Bay Packers exec Andrew Brandt is known to try throwing the interview-prepped athletes off by asking, “What do you do when you get up in the morning?” and continues to interrogate athletes with similarly inane questions until he can determine whether they are hard-working. Brandt states, “I was looking for the guys that did a hundred pushups before they brushed their teeth, the guys that woke up early for that last study before class.” Unfortunately, inappropriate questions occasionally do occur, such as when Jeff Ireland asked Dez Bryant if his mother was a prostitute, to which he later apologized.
Residency interviews are strikingly similar to these NFL combine interviews, with residency programs interviewing anywhere from 8 to 60 applicants in one day, and with 5-10 fifteen minute interviews for each applicant and with a similar timer or knock on the door to end of the interview. Questions may relate to applicant’s research, experiences mentioned in the application, career goals, or even questions that are plainly intended to rattle the applicant to see how they respond. I distinctly remember one interviewer challenging my activities in medical school, my ability to speak a foreign language with fluency, and even one PhD researcher who criticized my decision to pursue clinical medicine altogether. Like the NFL draftees, residency applicants must prepare for these interviews by knowing their application, characteristics of the program to which they are applying, and most importantly, these soon-to-be-doctors must know themselves well enough to answer questions honestly and candidly. Residency applicants should hope to be like Russell Wilson, who was said by Kansas City Chiefs GM John Dorsey to be “the most impressive interview I’ve ever had in the last 25 years.”
#5 Test Scores
NFL draftees must perform a series of athletic tests and workouts prior to draft day. Most workouts take place at the NFL combine, though others occur at individual universities. Workouts include the 40-yard dash, considered to be the marquee event at the combine, as well as the bench press, vertical jump, broad jump, 3-cone drill, and shuttle run. Athletes are ranked based on their performance, with each pro team creating overall rank lists based on combine results. Athletes also undergo thorough physical evaluations by team physicians, including tests of peripheral vision, hand-eye coordination, and visual acuity, with the difference in being drafted or not possibly even coming down to these vision tests as noted by Peter Kaiser, MD, an ophthalmologist at the Cleveland Clinic who works with the Cleveland Browns. Medical students are similarly scrutinized based on test scores, most notably the USMLE Step 1 and Step 2 exams. At one program medical students interested in ophthalmology undergo suturing practice under the microscope as well as observed practice on the Eyesi surgical simulator, presumably to detect any hand tremor prior to deciding to whom to extend interview invitations. As rumor has it, one interviewer often asked applicants to perform a series of difficult physical and mathematical tasks simultaneously while continuing the interrogation with personally intrusive questions. Fortunately, however, I am told this individual no longer performs residency interviews. Beyond the test scores are the subjective-but-still-important intangibles such as overcoming personal hardship, being particularly charismatic or demonstrating specific personality characteristics valued by a program. Just like the NFL draft, residents are ranked before they interview using various weighted scoring systems involving test scores, letters of recommendation, research, and other qualities, and after interviews the rankings are adjusted to create the final rank list. Test scores, interview performance, and other intangibles are carefully considered in both the draft and match processes.
Few topics are more hotly debated in pro sports than speculation and draft projections. Mel Kiper and various online blogs actually make a living as professional draft speculators, with Kiper touting as high as an 80% accuracy in his pre-draft projections. Which team will take who, what will happen if so-and-so gets picked first, and who is the next best athlete remaining on the board, are among the questions draft experts, pro scouts, talk radio hosts, and armchair quarterbacks debate ad nauseam in the days, weeks, and months leading up to the draft. While the residency match system seeks to mitigate much of the relevance of speculation by determining the utilitarian best-match system of matching medical students to residency programs, the speculation surrounding the residency match prevails nonetheless. I have personally sat in pre-match rank meetings where speculation much akin to the pro sports pre-draft speculation is debated. Despite the illogical nature of pre-match speculation, given the incentive to only rank applicants or programs based on ones own unique preferences, such speculation is hard to ignore. If you are preparing for the match or for the draft, be ready for the speculation. You will worry, you will lose sleep, and you may even lose a few precious locks of hair over such speculation.
You have seen the pictures of Johnny Manziel attempting to look as calm and confident as possible while player after player was drafted before him at #22 or the pictures of the many other athletes waiting nervously in anticipation of being selected. Unlike the residency match (and unlike other pro sports), the NFL draft is a three-day event, with many athletes waiting until the final day to be picked. In the majority of circumstances, athletes receive a phone call from their future coach informing them of their draft. The majority of medical residencies announce their match results on what is known as match day, with some students opening letters containing their match results in front of the entire audience and others opening the letters all at once. In ophthalmology, residency applicants almost always receive a phone call from their future program director on match day, in much the same way that athletes receive calls from their future coach. Watching the live video of the families of prospective NFL stars waiting anxiously around the TV on draft night reminded me of waiting anxiously by the phone until my phone rang and the caller ID and voice on the other end informed me of the location of my residency program.
Unfortunately, life doesn’t always work out the way we have planned, and disappointment is common both in the NFL draft and the residency match. Many athletes get drafted later than projected, and many more athletes don’t get drafted at all, leaving many still hoping to get picked up as a free agent in the weeks that follow. In terms of the residency match, the question is often asked as to how far down ones rank list you might expect to match. In 2013, US seniors who ranked 11 programs had approximately a 52.5% chance of matching at their #1 program, a 68.5% chance of matching in the top 2, a 78.8% chance of matching in the top 3, and an 85.5% chance of matching in one of your top 4 programs. Disappointment is still quite common, however, including that experienced by a friend of mine who was called by her #1 program to say she did NOT match there but that she did match at a different program. In her words, “To be honest, I was slightly disappointed initially, which I think lasted about a week or so. I realized I would be moving very far away and going to a program I didn’t know that much about.” Later, she writes, “I couldn’t be happier and things worked out great, despite being disappointed initially.” However, it must be pointed out that many of the best pro athletes were drafted later than expected and were likely disappointed at their initial draft selection. For example, Tom Brady was picked in the 6th round and “has proven to be one of the ultimate steals in NFL draft history, forging a Hall of Fame career that has produced five Super Bowl appearances and three championships after going 199th overall in the 2000 NFL draft.” As Tom Brady and many others have shown, it matters little where you are drafted or where you match. What matters is the type of professional you become from that point on.
After years of hard work and sacrifice, overcoming obstacles with pride and determination, and many dreams of becoming a professional athlete or doctor, the draft and match day celebrations represent the ultimate validation for their efforts and a much-deserved sigh of relief as they can finally say to themselves, “You did it. You earned it. You belong.” Some athletes celebrate at home with family and friends, some rejoice with songs of praise, and others still celebrate by buying everyone a round of drinks, but one thing is for sure, these athletes and these doctors have earned the right to celebrate.
While doctors may never hold up their name-embroidered jersey or shake the league commissioner’s hand on television, both doctors and athletes share one thing in common, they both know all too well what it’s like to be in the NBA or NFL draft.