the match streamlines what would be a (even MORE) convoluted job search for the 30,000 medical graduates that are being primed. there are 20 medical specialties you can match into, so i guess its kinda analagous to picking a major in college, only its actually pretty much your life plan.
residencies last from like 2 to 7 yrs depending on what individual program you match to (ie, some emergency med programs have 3 yr programs, some have 4 yr programs, and others have a 2-4 program). your first yr of residency you are an intern. you can modify your plan of action somewhat by pursuing fellowships after you do your residency. why is there so much pressure surrounding the match?
1) students often go all over the country to interview at programs theyd like to match into, while going to school at the same time
2) it reflects, to a degree, how well you performed in medical school, esp via board scores, grades, and general reputation
3) some programs are more competitive than others. just like a communications major is harder to get into than agricultural butt studies at any college, and just like more people wanna go to UCLA than podunk u, surgery programs are going to be harder matches than FP matches, and more people wanna go to UCLA than u cinncinatti ... hence lots of work required to get a good match
4) where you match is usually the single biggest predictor of where you practice, and therefore where you live for the rest of your life
5) basically no school can really do a good job of preparing you what life is REALLY like as a doctor, just like no school can do a good job of preparing you what life is REALLY like as a medical student