The residency doctor exam is likened to a "firewall" that only the most outstanding can breach. A prerequisite to sit for the exam is maintaining a 6-year university GPA of 7.0 or higher.

Even now, Master and Residency Dr Bui Van Quang from the Andrology Center at Viet Duc University Hospital (Hanoi) still remembers the heavy pressure on his shoulders in the summer of 2015. At that time, candidates registered for specialties before stepping into the exam room, based on personal interests, capabilities, and goals.

Those registering for Internal Medicine (including General Internal Medicine, Cardiology, Dermatology, Anesthesiology and Resuscitation) had to undergo multiple-choice exams in basic subjects including Anatomy, Physiology, Biochemistry, alongside Probability & Statistics and English. The basic subjects and Probability & Statistics required scores above 5.0.

Internal medicine and pediatrics were the only two specialties tested through essay-based exams, with candidates required to score at least 7.0 to qualify for admission consideration. For surgical candidates like Dr. Quang, the essay tests covered surgery and obstetrics, in addition to the multiple-choice tests in basic subjects.

“Competition was extremely fierce at the time. In 2015, I took the exam alongside 80 doctors who had also applied for a surgical residency, but the school admitted only the 15 highest-scoring candidates,” Dr. Quang recalled.

Those ranked 16th and below had to accept failing to secure their first-choice specialty and wait for opportunities in other specialties that still had vacancies for second-choice applicants.

Compared with the previous system, Dr. Quang said the resident doctor entrance examination has undergone significant changes. Probability and statistics is no longer tested, while the method of choosing specialties has been completely revamped: candidates now take the exam first and choose their specialty afterward based on their overall ranking, from highest to lowest.

“Doctors will put all their effort into studying and try to achieve the highest score possible,” Dr. Quang said.

However, based on how the system works in practice, Quang said the new approach creates several problems. The shortcomings are most apparent among lower-ranked candidates. Once the specialties they want and those that best match their preferred training environment have filled their quotas, they are forced to “pick” whatever specialty left unchosen, so they do not miss the opportunity to enter a residency program.

“Choosing a specialty that does not match one's strengths and passion can lead to declining enthusiasm and a lack of motivation throughout the long and difficult training journey that follows,” Quang said.

In reality, only a very small number of candidates are willing to give up residency training if they fail to secure their preferred specialty. Most choose one of the remaining specialties. In the minds of generations of medical professionals, the title and degree of resident doctor from Hanoi Medical University still carry strong brand value and considerable appeal.

Quang believes that resident doctors should not be recruited on such a large scale as they are today. The competition needs to remain intense so that the program can select doctors who are truly outstanding, dedicated and passionate.

He also noted that residency is not the only path to improving professional skills. Doctors who fail to secure a residency position can still work and continue their education by pursuing a master's degree.

Pham Dang Bang, a former lecturer at Hanoi Medical University, commented that Matching Day may generate considerable media attention but also reveals several shortcomings, potentially encouraging candidates to chase “hot” specialties rather than choose fields that match their strengths.

The FOMO syndrome - Fear of Missing Out, or the anxiety of missing an opportunity - is most evident among high-scoring candidates.

Once they step onto the “Matching Day floor,” crowd psychology and the fear of “missing a good opportunity” can push many talented doctors to quickly register for “hot” specialties such as obstetrics, plastic surgery, otorhinolaryngology, and dentistry simply because these fields have strong brand value or are highly sought after.

Choosing a specialty based on crowd psychology can cause candidates to overlook fields in which they actually excel or that better match their core interests and passions.

When large numbers of high-scoring candidates flock to “hot” specialties, basic medical sciences and more demanding clinical specialties risk being left without enough high-quality trainees.

More concerningly, when an outstanding doctor chooses a “hot” specialty because of FOMO rather than personal strengths, they may eventually lose passion or become professionally stuck. This could result in a waste of talented human resources in the medical sector.

N. Huyen