“Can you make Moana sing,” my four-year-old daughter begs as she widens her dark brown eyes. (My husband insists those are my eyes.)

Apparently, the Disney toy was involved in an accident. A button on the wrist that makes the doll loudly blurt out “See the line where the sky meets the sea!” has become separated from her plastic body. Pink wires stick out instead of forearm bones. I’m a doctor. I should be able to fix this.

It’s 8:15 p.m. 45 minutes are left to change my certified rank order list. My hand is twitching. Is my list long enough? Is it good enough? Am I good enough? 44 minutes.

While prepping the patient for the necessary operation, I begin musing over the match process. It’s doubtlessly stressful for everyone involved, from program directors to med school advisors, but the fulcrum tilts the balance for the U.S. grads. The vast majority of them match, it’s merely a question of where and perhaps specialty if they ranked more than one. The few who will not match will have a team of paid support doing their best to secure them a spot in the SOAP. Faculty and advisors calling programs with unfilled spots on their behalf, whether that’s officially allowed, is a different thing and done routinely. There’s no genuine need to explain why. Foreign grads — and I don’t mean Americans with degrees from diploma mills in tropical zones — but foreign-born and trained doctors, on the other hand, are left to their own devices. SOAP does not work in their favor, and the match seems already overcrowded.

Through a certain lens, foreign doctors are the uninvited guests who stay till the end, an extra competition the U.S. grads don’t need. Less than 50 percent will match — way too many quite a few people think.

To obtain better access to the wound, I made an incision at the elbow, then attached conductive strings made from Valentine’s day candy wraps with self-adhesive paper. Upon their contact, Moana sang her theme song. Now the wrist reattachment. As I was sticking a minuscule piece of hay between 1 millimeter long pieces of wire in the wrist to electrically isolate those, I was counting the scars left by the road to residency process. How did go from an ambitious medical student who knew her potential to an Ivy-educated doctor who had to sift through a pile of rejections from residency programs, stare at a mind-boggling cipher on the credit card bill with the word “ERAS” next to it, while knowing my dreams would crash. I’ve taken and passed all the exams, no repeat attempts. I’ve done top-notch research, published, presented, taught, observed, networked and volunteered. My CV is 12 pages long, single-spaced, 10-point font. I’ve proven my worth countless times.

Yet at 8:32 p.m., rechecking my rank list, I knew that statistically, I was facing a very real prospect that all this was in vain. Statistical genetics — that’s what I do extremely well. If it were the normal way, I’d be board-certified by now, starting my own lab. Instead, I’m starting over.

No single U.S. graduate of equivalent credentials was having the same thoughts at that moment. Their thoughts were, or should have been, “Have I impressed enough to match to my 1st choice?” Foreign graduates aren’t a real competition in most instances and don’t come anywhere near to endangering their turf, mostly serving as “fillers” for seats the U.S. grads and DOs leave vacant. Many (not all!) of the same people are scavenging for what is left in the system would be matching to top programs in competitive specialties had they gone to U.S. schools. But they haven’t. On top, most require visas to come to the country and given recent extempore travel bans encompassing even green card holders, none of us is certain what the future holds. I’m a European with a green card. I don’t know what the future holds. 8:47 p.m. Thirteen minutes to change my mind.

During the match process, I wished there was a single application for a specialty. An application where one could specify regions/states/cities/hospitals — or not — where s/he’s willing to go. The programs would then select from the pool of applications, rather than me randomly clicking programs in regions I vaguely knew I could function in, second-guessing whether they’d be interested in me. I’m a foreign doctor, I know I need to apply to 100+ programs. I’m not going to “diligently research” those. There isn’t even any data to base such search on! All I care about is, “Do they consider foreign grads?” That’s rarely on their websites, as technically, they must. In reality, they often don’t.

Pooling the applicants rather than have them apply to every-single-program separately would make everyone’s life easier in the long run. There, I just made myself useful. Or plain crazy, I can’t tell anymore.

9:01 p.m. The hand is re-attached with duct tape, and Moana is singing. No more changes to my rank order list. May the match have mercy on my career. Or I can always fix dolls.

The author is an anonymous international medical graduate.

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