When Michael Butler fulfilled his longtime dream last June and graduated from medical school, he was 62 — an age when many of his contemporaries begin to think about retirement.
Instead, Butler started thinking about his medical residency.
The three-year graduate training program for newly minted physicians is required before licensure as a doctor.
He’d missed last year’s “Match Day,” the annual day of destiny when more than 40,000 applicants from US and international medical schools learn whether they’ve been accepted into a US residency program of their choice.
This year’s Match Day loomed on March 18. He knew the result would determine whether — after four years away from his family at a university in St. Vincent and the Grenadines in the Caribbean and at clinical-training sites stateside — he could actually become a practicing physician.
Butler applied to 51 residency programs in family medicine, internal medicine and pediatrics. He volunteered as a scribe with the Bergen Volunteer Medical Initiative. He resumed work as a volunteer EMT, riding the ambulance in his hometown of Ridgewood.
And he braced for failure, vowing in September that if he wasn’t accepted into a residency program, he would use his medical degree in another way. He’d still be satisfied helping younger doctors to develop skills in interviewing and taking medical histories. “If I can’t do it,” he said at the time, “I’d like to help train the next group to do it.”
Butler keenly understood the unusual nature of his application, as someone whom medical-school administrators call a “non-traditional student.” Just 6% of medical school graduates in 2019 were older than 32. And while many physicians continue to practice well into their 70s, it is rare for a doctor to start practicing in his mid-60s.
But after an undergraduate degree in mechanical engineering, a stint in the US Navy piloting nuclear submarines, a masters’ degree in business administration, three decades in corporate America and helping raise two kids, this is what Butler wanted to do.
He also knew he was reducing his chances of a residency match by limiting his applications to programs in the Northeast. Graduates of US medical schools applied to 70 residency programs, on average, in 2020, while international medical graduates — like Butler — applied to an average of 139. But Jessica Butler, his wife, had already sacrificed enough because of his months-long absences , he said. He wanted to stay within driving distance of home.
For doctors-to-be, the third week of March—culminating in Match Day—can be stressful.
It begins with notification on Monday, the first day of that week, as to whether — but not where — they have matched. Those who haven’t matched get three days in which to scramble to apply for a position in a program that still has a few slots to fill but wasn’t on their original list of preferred programs. All of the matches are then announced on Friday at noon.
The suspense mounted after Butler learned on Monday morning he’d been accepted — somewhere.
Jessica and their two children — Alex, who is in his first year of a pediatrics residency at Boston Children’s Hospital and Becca, who is in a psychology doctoral program in Keene, New Hampshire — had helped him through his four years as a student with encouragement , moral support and study aids. “I could not have done it — I would not have done it — if my family didn’t support me,” Michael said.
It was therefore only fitting that they all gathered to “open the envelope” — virtually, around the kitchen table of their Ridgewood home — on Friday, March 18.
And so, the Butlers learned that Michael was accepted in the family medicine residency at St. Joseph’s Health, which has hospitals in Paterson and Wayne and a family medicine clinic in Clifton.
When his contract begins on July 1, he will be one of four first-year residents and one of 12 in the overall program. He’ll rotate through training periods lasting two weeks to two months in various medical specialties, from obstetrics and pediatrics to cardiology, surgery and palliative care. He’ll spend the first year caring for patients at St. Joseph’s University Medical Center in Paterson and the second and third years in more office-based treatment settings, with more responsibility and more of his own patients.
From ‘Why?’ to unity
Dr. Shideh Doroudi, the program director for the Family Medicine Department at St. Joseph’s, said it was natural to think about Butler’s age when the admissions committee looked at his application.
“But we are St Joseph’s Health,” she said. “Diversity and inclusion is our mission. We are very inclusive. Age would not be a main concern.”
Her main question, Doroudi said, was simply why: Why did he want to do this? Was this a box he wanted to check off for a resume that already included myriad accomplishments? Was it a childhood dream for which he wanted to say, “There, I did it!”? Or did he have a passion for serving patients?
“It was very important for me to understand if that passion was there,” Doroudi said. “We are serving a large under-served population here with a high demand for primary care.”
So at his interview, she asked that single question.
“Within 10 minutes’ time, I was convinced,” she said. “It was clear. It fits the values for the future of this community.
“We have a committee, and [the decision to admit Butler] was unanimous.”
Family medicine doctors treat patients across the lifespan. They are generalists, prepared to handle whatever the needs of the patients who walk in the door, from preventive screenings to treatment for conditions that commonly include diabetes, hypertension, high cholesterol, anxiety and depression.
At 63, he’s embarking on three years of long hours and high pressure. He’ll be part of a new cohort of doctors-in-training, with peers half his age, in a demanding environment at a busy medical center.
“I’m very proud,” he added. “I think it took a little courage for them to choose me.”
And he says he’s ready.
“This is exactly what I had hoped for,” he said. “The nature of the program, its size, the community focus, the breadth of the training — it’s all that I wanted.”
Even better, he doesn’t have to move.
Lindy Washburn is a senior health care reporter for NorthJersey.com. To keep up-to-date about how changes in health care affect you and your family, please subscribe or activate your digital account today.