Kenedy Dawson, a fourth-year medical student and a passionate advocate for her peers, takes us behind the scenes of her journey through the 2025 Match process, offering candid insights into what it’s like navigating this pivotal moment in her career.

Are virtual interviews enough to truly evaluate residency programs? What changes could make the Match process more student-friendly? Kenedy and Dr. Jerkins compare their experiences, exploring the challenges and opportunities faced by the 40,000+ medical students who embark on this life-changing path every year.

Here are four takeaways from Episode 10 of the podcast featuring Kenedy Dawson:

1. The Residency Match Process Is Complex and Costly

Kenedy Dawson highlighted the financial burden of applying to residency programs, spending nearly \$2,000 to apply to 70 programs. Despite the deterrent pricing model, students often feel compelled to apply broadly to secure their future, underscoring the need for reform in application costs and transparency.

2. Virtual Interviews and Preference Signaling Have Changed the Game

Post-COVID, most residency interviews are virtual, which has altered how applicants assess program fit. Preference signaling—using gold and silver signals—has become crucial in securing interviews, with non-signaled applications having very low success rates. This has added a strategic layer to the application process.

3. Fit and Culture Are Harder to Gauge Virtually

Kenedy emphasized the difficulty of evaluating program culture and resident dynamics through virtual socials and interviews. In-person rotations and hospital tours remain valuable for assessing whether a program feels like the right fit, making travel and additional rotations a necessary supplement for many applicants.

4. Dual Degrees and Leadership Aspirations Are Shaping Future Physicians

Kenedy’s pursuit of both an MBA and MPH alongside her DO degree reflects a growing trend of physicians preparing for leadership roles in healthcare. Her evolving perspective on hospital administration shows a shift toward more nuanced views of healthcare leadership and the importance of physician voices in decision-making.

Transcript

Kenedy Dawson:

I think it should cost less. I applied to 70 programs and I spent just under $2,000 because it gets more expensive the more you add, which is supposed to be a deterrent, but it’s not—because I’m going to spend any amount of money to secure my livelihood.

Michael Jerkins:

Welcome back to another episode of the podcast for doctors, by doctors. I’m Dr. Michael Jerkins, your host for today. Unfortunately, we do not have Dr. Ned Palmer with us, but I’ll try to make do without him. We are very excited about this episode because I want to understand what’s happening with a very important season for doctors—the Match—and what it takes in 2024 and for the class of 2025 to apply, interview, and end up matching.

It’s also about understanding what the “scramble”—which isn’t called that anymore—is like. I know what it was like in my day, but it’s very different now with things like signaling and preferences, which I clearly, as you’ll hear me describe them, don’t fully understand. I’m joined by a special guest today, someone who is actively going through this process, interviewing, and hopefully matching in the next several months. I’m sure I’ll learn a lot—and also feel very old—as I hear what it’s like for today’s medical students.

Kennedy Dawson is a fourth-year medical student at Kansas City University, completing her Doctor of Osteopathic Medicine degree. She’s also pursuing an MBA in healthcare leadership and holds an MPH from the University of North Carolina at Chapel Hill. She’s passionate about leadership in medicine, mentorship, and medical education. Currently, she’s applying to anesthesiology residency programs and has spent the past six months traveling across the country for rotations.

Originally from Kansas City, she now lives in Oklahoma City with her husband, Britton, and their golden doodle, Blue. Kennedy, welcome to the podcast.

KD:

Thank you. I’m so excited to be here. Thanks for having me.

MJ:

I also have to say—my brother, who’s also a physician, has a golden doodle named Blue. That’s pretty crazy. I know it’s not the most important thing to start with, but I had to share that.

I went through the residency match back in 2013–2014, and things have changed. One big difference is that most interviews are now virtual. Another is preference signaling—I kind of understand it, but not completely. From your perspective, what’s new for the residency match this season?

KD:

A lot has changed post-COVID. Like you mentioned, most interviews are virtual. Some specialties have gone back to in-person, but for anesthesia—which I’m applying to—all but one of my interviews are virtual. You meet on Zoom for half a day, and even the social events are via Zoom.

Pre-pandemic, you’d have dinner with residents, get a tour of the hospital, and see things in person. Now, you might have a virtual “happy hour” or evening social. It’s different, but we’ve adapted.

The other big change is signaling. In anesthesia, we now have gold and silver signals. Gold means the program is in your top five—you only get five of these. Silver means top 15—you get 10. It’s meant to help you stand out in a big application pile.

MJ:

That’s great—keep going.

KD:

With gold, you’re telling a program, “You’re one of my top five.” It’s a strong indicator to try to secure an interview. Silver says, “You’re in my top 15.” The strategy comes in deciding who gets which signal, and each program reacts differently. Some value silver highly, others only focus on gold.

MJ:

Right, there’s a lot of strategy there. What if you don’t signal a program—could that actually make them want you more?

KD:

Honestly, in anesthesia this year, almost every program wanted or accepted signals. If you didn’t send one, your chance of getting an interview was maybe one to two percent. There were only a handful of programs that didn’t care about signals.

MJ:

So when do you send them—before or after interviews? Can you change them?

KD:

They’re locked in when you submit your ERAS application—pre-interview. You can’t change them later. The only extra insight you might get is from doing rotations, open houses, or Zoom socials before submitting.

MJ:

Interesting. On the social side—virtual happy hours, virtual dinners—how do you handle group dynamics? Everyone’s met a “gunner” who dominates the conversation.

KD:

Yes, I’ve seen it happen, but programs often mitigate it. Some use breakout rooms with smaller groups, or even one-on-one chats with a resident. Others give presentations first to answer common questions, so one person can’t take over.

MJ:

Before virtual interviews, you had to travel everywhere, which was stressful and expensive. Now, with the lower cost, are people applying to or interviewing with more programs?

KD:

I think more people are accepting all interviews offered. There’s been talk of “interview hoarding.” On the flip side, signaling has made people apply to fewer programs because your odds without a signal are low. I signaled 15 programs and have gotten 11 interviews—all from those signals. I haven’t gotten a single interview from a non-signaled program.

MJ:

That’s fascinating. Now, fit is one of the most important predictors of residency satisfaction, but it’s a gut feeling that’s easier to gauge in person. How do you figure that out virtually?

KD:

Yeah, I have found it very difficult personally. And I think it’s a benefit of going and still rotating at programs. I went to five different residency programs and did rotations at each of them, which—that’s a lot. That was a lot. And that kind of almost evened out the expenses of saving money on virtual interviews because I was traveling every month.

In the interviews when I haven’t rotated at a program and I’m trying to kind of figure out if I vibe with them—like, are these people I could be friends with?—it is a lot harder. And I would say the social is more helpful than the interview, in my opinion, because there’s a difference in kind of the attitude of the residents. You have to be really, really aware. And I feel like I’m kind of analyzing them at the socials because I’m thinking, okay, are they all hanging out together?

Do they look like they’re having fun? Does everyone seem tired and kind of worn down? And you’re kind of trying to figure out, the questions that they’re answering—do you feel like they’re just feeding you lines that the program director told them, or does it feel sincere? And the more you do, the better you get at kind of fleshing that out a little bit, but it’s hard.

MJ:

I can’t imagine—I don’t envy that situation. I remember a lot of my data that I processed on how to rank was really from not just the social, but the tour of the hospital too, because you would inevitably run across another resident who’s on rounds or in the workroom that they weren’t prepared necessarily for someone to come by. So you’re really seeing them in the moment and what they’re like.

Do they look super unhappy and exhausted? Of course, residency is exhausting and you can be unhappy sometimes, and that’s okay. But it really gives you a better vibe, I think, actually touring and seeing the other residents, even residents from outside of your program and talking to them about their attitude. So, I’m med-peds, and I would ask a lot of categorical internal medicine or categorical pediatrics residents, “Tell me about med-peds,” and that was always interesting.

I’m sure in anesthesia, talking to the surgeons and surgical subs would be a good data point. They probably give you some very honest feedback whether you wanted it or not. That’s hard. Do you find a lot of people are going to visit after the interview just to get a sense?

KD:

I think so. Yeah. I have a lot of classmates that I have talked to throughout this process who have maybe interviewed somewhere where they didn’t rotate and they were very pleasantly surprised. And because of that experience of how much they enjoyed their interview, it kind of moved up on their rank list. And so now they’re more motivated to go check out the program and just go visit it and see.

A lot of hospitals or residency programs are really, really good about offering a tour if you can make it. Not everybody can—it’s not feasible for everyone—but a lot of them say, “Hey, if you’re in town, let us know and we’re happy to give you a quick tour,” which is nice to do.

MJ:

Totally. That’s a great opportunity to take if you can afford it. Honestly, what really limited my interviews was just cost and travel. I went to med school at University of Tennessee, and it was very hard for me to get to West Coast programs, so I just didn’t get to go—which I’m glad about now, because I ended up matching where I matched. But I like that it’s more accessible now.

There’s some other things we’ve already talked about. So—walk us through why anesthesia. Why did you choose anesthesia? Now this is probably a question you’re getting on every interview, but walk us through that and what you’re wanting to do long term with that training.

KD:

Yeah, I’m prepared for this one.

MJ:

Yeah, you’re really prepared.

KD:

I did not realize I wanted to do anesthesia until about the beginning of my third year. I had focused my preclinical time exploring a lot of different specialties. I was interested in sports medicine and was thinking about avenues to do that. Then, my very first rotation in third year was general surgery. I was terrified because, fresh off Step 1, I thought, “I’m going to break sterile field, nobody’s going to like me, everyone’s going to yell at me.”

But I fell in love with the OR during that rotation. It gave me a bit of a crisis—do I want to be a surgeon? Do I want to be an anesthesiologist? Whatever I do, it has to be in the OR. That was my first step toward anesthesia. I had a really good general surgery attending who noticed how much I was enjoying myself. He encouraged me to chat with the anesthesiologist before cases and ask about quality of life.

On my second day, he told me, “You’re enjoying this way too much. Not everyone likes the OR, so you should consider specialties that keep you in here.” That made me rethink everything. I scheduled an anesthesia elective pretty quickly after that. I didn’t know the full scope of what they did, but once I learned more, I loved it—the procedures, how hands-on it is, the instant gratification of fixing problems like blood pressure changes in real time.

I also enjoyed the short, high-impact patient interactions. Even though I don’t follow patients long-term, the brief moments I do have feel meaningful—telling someone as they drift off to sleep, “We’re going to take really good care of you,” is the best feeling. After day one of my rotation, I was sold. I found my people.

MJ:

That’s cool. I’m not a proceduralist, but I love everything you said. Anesthesia is a great mix of physiology and procedural, hands-on work. In med-peds, I get interesting physiology, but it’s not instant gratification—often the opposite. I’m glad there are people for every kind of work. I imagine the anesthesia versus surgery debate was an interesting one with colleagues.

KD:

Oh, yes. It was actually a very difficult decision because I worried about choosing anesthesia just because I was scared of surgical residency. I had many conversations with people. What it came down to was picturing myself as a tired third-year resident on call at 2 a.m.—what would I still be interested in doing? For me, it wasn’t a laparoscopic cholecystectomy at 2 a.m. or getting faster at suturing. It was making a patient more comfortable and fine-tuning my anesthetic plan. That still felt satisfying even on the hard days.

MJ:

Makes a lot of sense. Where is anesthesia right now in terms of competitiveness?

KD:

Since COVID, anesthesia has become increasingly competitive—more and more each year. The match rate has been decreasing because more people realize what it offers. The “secret” is out, as attendings joke. People like the work-life balance, variety, and procedural nature. It’s essentially shift work, and since COVID, many people want specialties where you don’t take a lot of work home.

MJ:

Makes sense. Shout-out to previous guest Dr. Brian Carmody, who has an amazing blog, Sheriff of Sodium—he covers specialty trends and match rates. As a DO student, what’s the match process like for you compared to MD students?

KD:

In some ways, it’s similar; in others, very different. I feel I’ll be just as well trained as any MD, but my experience as a DO student has given me both advantages and disadvantages. For example, I don’t have a home program in anesthesia, which is a big disadvantage. I had to network on my own, which is difficult.

Anesthesia is DO-friendly, and I’ve never had negative pushback for being a DO. But the DO match rate is substantially lower. The most recent NRMP data (fact-check me) had MDs matching at ~85% in anesthesia, while DOs were around 58%.

I felt I needed to do more away rotations than most MDs to strengthen my application and increase interviews. I also had to take both COMLEX and USMLE, which is essential for anesthesia but not fun. Those were rough years.

MJ:

That’s rough and more money and more time. I mean, that’s no joke. That’s no joke. And what struck me recently on the match is the number of research publications people have to do now versus when I was going through the match—it is insane. I look at it and feel like there is no way I could have matched. I had like one—maybe two if you really loosen your definition of research—in medical school. But now, it’s nuts. What’s the average for anesthesia as far as research and publications?

KD:

I think the average for anesthesia was somewhere between two and four. It’s actually pretty low compared to other specialties.

MJ:

Okay, still, that’s a lot.

KD:

Yeah, I mean, I think it’s almost an expectation that you’re going to come out with some sort of publication from med school—at least one. It’s very rare to meet people who truly have zero publications. I don’t have very many—I have two poster presentations, so I don’t have a paper necessarily, but I chose to do my master’s in business administration instead of a lot of extra research time.

MJ:

Yeah, to me that makes way more sense. It is way more valuable. Actually, it’s a great transition. Walk us through—so you’ve had a lot of educational experience already, and it sounds like from your intro you’re pursuing your MBA. As someone with a bit of a business background in medicine, I love meeting people who are actively pursuing this because we need so many more of us in healthcare to be smarter on the business side. Why did you choose to get your MBA?

KD:

Yeah, this is a residency interview question I get all the time. My school, Kansas City University, had a dual degree program, and I was really interested in doing that before medical school started. I’ll graduate with both my DO and MBA in four years—no added time. It’s been a lot of extra work, but I didn’t want to delay graduating.

Part of why I chose it was because I wasn’t sure what specialty I wanted, but I knew there were specialties where owning a private practice would be feasible. I wanted to be knowledgeable about that. My MBA concentration is healthcare leadership, and now that I’m doing anesthesia, my goals have shifted somewhat—not necessarily to owning a private practice, but perhaps an anesthesia group.

Combined with my master’s in public health, which has a leadership and practice concentration, I want to set myself up for residency program leadership, department leadership, or hospital administration. I want to be able to sit in meetings about budgets and understand what’s being discussed so more physicians are at those tables—not just business people without patient care experience.

MJ:

I love that. We need more physicians in leadership positions making decisions. We’ve supported a lot of physicians who want to maintain independence and build, grow, or buy a practice. I think a lot of people don’t see that as a possibility, but it feels like it’s gaining traction as people are tired of other practice settings after 20 years of consolidation. Maybe it’s my own echo chamber, but I feel like more physicians are now trying to go out on their own and practice the way they want. Are you seeing that too?

KD:

I think so. In anesthesia, it’s usually private practice contracted to a hospital, or academics. But I’m seeing private groups starting mobile anesthesia services for dental, plastic surgery, or dermatology offices—minor in-office procedures. I think more physicians are heading that way to create the life and practice they want.

MJ:

To have control over their life—that makes sense. Another thing, I want to go back to the match real quick. What used to be called the Scramble is now SOAP. For those listening who don’t know, the process is years in the making: undergrad, maybe post-bac, four years of med school, maybe a PhD, hundreds of thousands in loans. You apply for residency, get interviews, submit your rank list, and programs do the same. The algorithm runs, and out pop the matches. Unfortunately, some people don’t match.

Before SOAP, the Scramble was chaos—phones, emails, deans trying to find open spots. SOAP was meant to make that more organized. Walk us through what happens now if you don’t match.

KD:

Match week starts Monday, when you get an email saying whether or not you matched. No details—just “congratulations” or “we’re sorry.” If you didn’t match, you basically have two hours to cry, then you revamp your entire application.

It’s like doing the whole residency application process once a day until you get an offer. You rewrite your personal statement, adjust your application, then you get the SOAP list of open programs—could be any specialty. Some specialties, like anesthesia, often have zero open spots. In that case, you might apply for a PGY-1 year and reapply, or switch specialties.

Tuesday morning you submit applications, and by that afternoon programs review and call you for interviews. At the end of the day, you either get an offer (which you must take) or you don’t. Then you repeat Wednesday, Thursday, and hopefully by Friday you have a spot. It’s horribly stressful—I wouldn’t wish it on my worst enemy.

MJ:

Yeah, it seems more organized now, but still intense. Match Day ceremonies vary—at my med school, we got an envelope and opened it with friends and family. My residency program’s med school had each student go on stage, play a walk-up song, and read their match out loud to the entire med center. That sounds fun for some, but terrifying for others—especially if you didn’t get your first choice or even your specialty.

KD:

I’ve seen that—thank goodness my school doesn’t do it. It’s such a vulnerable moment. Even if you got your specialty, what if it’s your fifth choice? That’s a lot to share publicly.

MJ:

Yeah. Nowadays, you see all these happy reaction videos and photos on social media. I’m glad people are happy, but I always think about those for whom it’s not the best day.

KD:

No, it is. It’s a thing. Yeah, I mean, it’s a thing because everyone wants that big reaction moment—like everyone’s going to be filming you and your family now. You want to have that great moment to share with your family and friends. But you definitely run the risk of filming it and then realizing that all you see is the disappointment on your face, which I’ve seen. I mean, I’ve seen people be vulnerable and post that too.

I’ve seen how they reacted to getting their third choice, just as kind of an opposite to the typical match videos—saying that it’s okay if it doesn’t go exactly the way you thought. It’ll work out is the message, which is a really good one. But it’s a little stressful because I think, as someone with a decently sized Instagram following, I know that if I don’t post pretty quickly on match day, everyone is going to assume that I didn’t match.

I know a lot of people listening might think, “You shouldn’t care,” but it’s hard. I’ve worked my entire life to be a doctor. This has been my dream since I was six years old. This is the culmination of years and years of work toward a goal I want very badly. For there to be a risk that I can’t get that—and then to have to share it with 13,000 people—that could be really hard. I obviously hope for the best, but it’s tough with the internet presence people have now.

MJ:

Yes, a lot more pressure. Knowing what I know about you, any program would be very fortunate to have you train with them. They’ll be very lucky wherever you match. I have a couple of last questions. One is: if you could change anything about the match process, what would it be?

KD:

Yeah, I think that’s a great question. Honestly, I think the cost should be very different. The cost of applications is insane. People are going to pay what they need to, but it’s just so expensive to send in as many applications as you feel comfortable with. That impacted me the most.

I also wish the match results came out faster. If we submit our rank list, it shouldn’t take weeks for the results to get to us. I’m sure there’s a reason someone could explain, but I still think it should cost less. I applied to 70 programs and spent just under $2,000 because it gets more expensive the more you add—which is supposed to be a deterrent, but it’s not. I’ll spend any amount of money to secure my livelihood.

MJ:

I agree, and I’ve talked about this with a lot of groups. It makes no sense. I know why it happens—because a company can make money off the application—but like you said, it’s a decade of your life. Are you really going to save $50 at the risk of not matching? No.

When I applied, I had a quarter-million dollars in student loans. It feels like you’re being taken advantage of. I like to think the best in people, but it’s hard to stomach that cost. There’s no other product I can think of where the more you order, the more it costs instead of less. It just doesn’t feel good.

KD:

It doesn’t. When I applied to anesthesia this cycle, I knew that outside of my 15 signals my interview chances were 1–2%. But I couldn’t stomach the idea of not giving it everything I had. At this point, I’m also hundreds of thousands of dollars in debt. Is this the time to be skimping? Probably not. There are other things we can save money on—this isn’t one of them.

If I match, great. If I don’t match, I want to be able to tell myself I did everything I could. That’s really important to me, and I think a lot of people feel the same.

MJ:

Exactly. Every year, thousands of us aren’t going to skimp on those last few applications. I used to do a depressing thing in residency—calculate how much interest was accruing on my debt during a noon conference. Not healthy, but it was reality. If you’re living off debt, all these hoops—applications, interviews—just add to it.

I wish they’d make it cheaper so we don’t have to keep incurring debt. I totally second your point. Now, one last question we ask all our guests: What’s one thing you’ve changed your mind about recently?

KD:

That’s such a good question—great interview prep! I don’t think anyone’s ever asked me that before.

MJ:

They will now.

KD:

This might be a hot take: I don’t think all hospital leadership is bad. We often look at department chairs, administration, and leadership and think, “They’re not helping us.” But in my limited experience in academic centers, I’ve seen some bad decisions, yes, but also a lot of good.

So my general attitude toward hospital leadership has changed. Things are much more nuanced than I once thought.

MJ:

It is a hot take—and I appreciate it.

KD:

Maybe that’s my MBA talking. I think there’s a method to the decisions leaders make. The more I learn, the less I feel I know. Many things I once thought were simple are actually much more complex.

MJ:

That makes sense. Sometimes it’s doctors versus leadership, but there can be good decisions made. In my experience, good hospital leaders do exist—but turnover is fast. Reforms get started and then abandoned when leaders leave in two or three years. It’s tough.

I hope people like you get into leadership positions. We need more physicians in those roles. Best of luck. Where can people find you?

KD:

Mostly on Instagram. I have a TikTok but I’m not as active there. On Instagram, my handle is @kenedydawson. I post about what fourth year is like, what I wish I knew in med school, study tips, and an inside look at my residency application process. Follow me and we can chat over there.

MJ:

That’s awesome. Soon-to-be Dr. Dawson, thank you so much for joining us today.

KD:

Thank you for having me.

MJ:

Wow, what a great conversation. It was eye-opening and a reminder of my own residency application days. I’m glad she was open and vulnerable about the costs and debt involved. It’s sad that medical students, already deep in debt, face even more costs just to advance to the next stage.

Every hoop costs money, and when you’re already numb to the debt, it can be overwhelming. I hope the system moves toward lessening the debt burden—not just for physicians but also for dental and veterinary colleagues. Less debt means doctors can practice in a way that’s better for them and their patients.

It’s also clear to me that I’m old—some things have changed in the last decade, some haven’t. Trying to figure out program fit via Zoom is tough. I hope applicants can still meet people in person when possible.

Either way, best of luck to Dr. Dawson and everyone going through the match process. Hopefully you learned something today and found a sense of community.

We love helping those going through the match with resources on our website. Thanks for joining us for another episode of the Podcast for Doctors by Doctors. You can find us on Apple, Spotify, YouTube, and all major podcast platforms.

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