Cheers and applause erupted a few minutes before noon as the stack of envelopes made its way from the registrar's office into the mailroom in Edward S. Harkness Hall. Inside were residency assignments, keys to the futures of a throng of waiting fourth-year students.

As part of the National Residency Matching Program, medical students all around the United States learned of their placements simultaneously on March 18. According to Deputy Dean for Education Robert H. Gifford, M.D., 60 percent of the Yale students received their first choice of residency and 80 percent got one of their top three choices. Registrar Cynthia A. Andrien said only six of the 104 seniors didn't participate in this year's match. Three chose not to participate and three are entering the military, she said.

How important was the match? “Residency determines where you train, how you train, who trains you and what opportunities are available to you,” said Joseph Skowron, who placed in orthopaedics at Harvard.

Placements this year reflected a trend at Yale away from the most highly specialized programs and toward residencies in internal medicine and pediatrics. Forty percent of this year's seniors went into three-year medicine programs, up from 22 percent last year. Pediatrics drew 17 percent of the current graduating class, up from 8 percent last year.

“I do think there's a recognition on the part of students that there's more and more of a need for people in the primary care specialties,” Dr. Gifford said. “Some of the highly specialized areas are overpopulated. Managed care is using them less and using primary care doctors more.”

As noon struck, the waiting students cheered, hugged and otherwise released the tension and anxiety of the morning. Victoria A. Catenacci was thrilled to be staying at Yale in internal medicine. “I like the program. I like the people. I'm very happy here,” she said. Said Childsy Robinson before opening her letter: “I'm very excited. I've been telling myself over and over that I can be happy anywhere.” She got her first choice: pediatrics at Stanford.