Clerkship Lottery: The Great “Sorting Hat” Ritual

The clerkship lottery "in action."
The 2103 clerkship lottery “in action.”

One of the greatest things about starting your second year of med school is that you are not starting your first year of med school.  After the eight weeks of summer spent relaxing, resume-building, or trying to avoid the pitfalls of medical tourism somewhere on the Indian subcontinent, you cruise back to the cozy confines of MedEd 200 for the now-predictable rhythms of lectures, labs, libraries and tests.  The first days of the previous year seem a world removed and you can watch with smug pity as a new batch of students struggle with the awkwardness of introductions, the ratcheting increase in workload, and the emotional, social, and physical challenges of the anatomy lab.  People are looking for advice and somehow you have advice to offer.  In a moment of confidence you may even feel like you have this med school thing “figured out.”  But the window of comfort is brief and soon you can’t ignore the signs that you will soon be pushed from the security of the academic nest.

First comes registration for the Step 1 board exam, the looming specter that has cast a shadow over the past year and half, and then—it’s no longer avoidable!—the clerkship lottery. The event which will determine your schedule, social circle, and perhaps even your destiny…at least for the next 18 months.

At UVM, the process for determining students’ schedules during their third year (their “rotations”) is the lottery.  All second-year medical students are assembled in the stadium seating of Carpenter Auditorium and one by one paper slips are drawn from a fish bowl, a name is called and the named student proceeds to the front of the room to type their name into one of the seven flight groups projected onto the wall.  There is some aspect of the Harry Potter sorting hat ritual (our Associate Dean of Students Christa Zehle would make a wonderful Prof. MacGonagle), and some aspect of Shirley Jackson’s short story “The Lottery” (though usually without the whole stoning affair). The whole experience is exciting, anxiety-producing, and dramatic.

There are many different ways people prepare for the clerkship lottery, usually somewhere along the spectrum from scrupulous planning, back-up planning, and contingency back-up planning to laissez-faire, go-with-the-flow apathy.  I like to think I fell somewhere in the middle: I reviewed the different schedules, made a brief mental list of priorities (backloading of difficult rotations, a vacation week in winter to ski, hearsay advice from friends in the class ahead; in that order) and resolved to leave the rest up to fate.  However, when the first classmate’s name got called and immediately chose a rotation schedule that I had placed at the bottom of my list, I couldn’t avoid the pangs of panic—what did they have figured out that I didn’t?

For better or worse my name wasn’t called until somewhere in the 80s.  At that point, only one of my original top three remained and my choice was easy, but the wait did give me plenty of time to appreciate the elephants in the room: What group is filled with gunners? Why is that group all girls? Which couples picked in together (and what does that mean about their relationship)? Will having surgery first, before I know what’s going on, ruin my chances of getting a letter of recommendation? Does any of this really matter?  Somehow, an event that only took a half-hour was filled with a surprising number of emotional peaks and valleys, whispered rumors, panicky recalculations, and at least one courageous act of love and selflessness.  In the end, perhaps the only thing known with any certainty is that the next step in medical school journey is coming up quick. We might not know exactly what to expect; we can only hope that we’ve been sufficiently prepared, and either way we better get ready because come March we’ll be across the street, on the wards, and there’s no turning back now.

Oh yeah and for being the last one picked Jenna won like a hundred dollars. I bet that was pretty nice…

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