I confuse my family and friends all the time with the process of medical training. For example: we have landed a prime fellowship position, but it won't start until the summer of 2012. That's an eternity. Who else applies for a program 18 months to two years before they ever have any hope of starting it. Only medicine. The next move is searching for a job. Same thing, looking 18 months to 2 years before they are even available to practice. It is a strange thing. So many variables potentially could change over the course of a year.
My husband tried to justify the process to me by citing the sheer number of people involved in the review of applications, CVs, and then coordinating schedules so that all the big players are available on the same day to conduct the all day, all night, interviews. Then they all have to get together and decide who they are going to select. I will admit that logistically it may be a nightmare. Do you know what job you will have 18 months from now? Do you know where it will be located? Would you even consider accepting a job that wouldn't start for that long?
The business of medicine works almost completely opposite of the way it does in the business world. When the employer I worked for wanted to hire someone, they wanted them now - not next year! I will give it to these doctors, they must really be a future thinking group. Proactive instead of reactive. Is it possible that they can be so sure of a decision so far in advance? I hope so, we are gambling on it.