In a scene that combined the envelope-opening excitement of the Academy Awards with the destination-determining drama of the nfl draft, more than 90 fourth-year medical students gathered at Marigolds on March 20 for Match Day, the annual ritual that decides where students will start their careers.“I’m not too stressed, but I’m very, very interested to find out where I’ll be spending the next three or four years of my life,” said Gabe Simon. (His equanimity paid off as he got into his first choice, the emergency medicine program at the University Health Center of Pittsburgh.)Marta Rivera said Match Day was even more stressful than the day she was accepted to medical school because “it affects more than just you. Other people are involved as well.” In Rivera’s case, her parents, her fiancé and his parents all hoped she’d match to an internal medicine residency at New York Presbyterian Hospital-Cornell because it is near the home of her future in-laws. (She, too, had her wish granted.)Surveying the cafeteria, which was rapidly filling with students clutching cameras, bouquets and cell phones, Rivera said, “It’s nice to be able to share this with so many people going through the exact same thing at the exact same time.”The scene at Yale was replicated around the country as more than 14,000 U.S. medical school seniors learned which residency programs they will be entering. The National Resident Matching Program was established in 1952 to create a mechanism for filling residency slots and promote fairness in the selection process. Applicants list their program preferences, program directors indicate their choice of applicants and a computer makes the matches. This year marked a record high in the number of applicants (23,965, including international medical graduates) and an all-time high in the number of residency positions offered—23,365, up 450 from last year. A record 575 couples participated in the Match as partners.At the stroke of noon students shouted and clapped as they pushed toward the door of the dining hall like fans at a rock concert. Nimi Tuamokumo tore open her envelope with shaking hands. Then she let out a loud scream and fell to her knees in tears—she’d been accepted into her first choice, Brigham and Women’s Hospital’s radiation oncology program.“It’s weird. This is all I’ve been talking about for the last four months,” said Andrew Cooper, who was pleased to learn he’ll be specializing in orthopaedic surgery at Jackson Memorial Hospital in Miami. “I don’t know what I’m going to talk about now.”Richard Breck, M.D. ’45, who was among several alumni on hand for a Match Day luncheon, said the emotional intensity of the scene in Marigolds was far different from when he was a medical student in the days before the match. “This is far more alive,” he said, gesturing toward several students in a group hug. “Of course the war was still on, so that was a factor, but my memory is that one by one we went to our mailboxes and opened our envelopes alone.”When the 2003 Match concluded, 94 Yale medical students knew what the next big step in their career paths would be. Nancy R. Angoff, M.P.H. ’81, M.D. ’90, HS ’93, associate dean for student affairs, said dermatology (always a draw at Yale because of the strength of the program) and radiation oncology were popular fields among students this year, with five and four placements, respectively.“Students think of them as lifestyle fields,” she said. “They don’t have a lot of emergencies, so their lives are a little more predictable.” A regular schedule also makes these fields more amenable to dual careers in clinical medicine and research, Angoff said. The salaries also tend to be higher, which is important to students, who leave Yale carrying an average debt of $100,000.Based on the “overall sense of happiness” in Harkness Lounge and the quality of the programs the students got into, Angoff called the 2003 Match “by far the best we’ve ever had.” She credits the current class of graduates as well as Yale alumni. “If they weren’t doing well in their residencies, the hospitals wouldn’t want our current students,” she said.