Carolina Montaño and her family came to Miami under political asylum from Barranquilla, Colombia about 17 years ago, leaving behind violence and potentially her dream of becoming a doctor.
She had completed only about half of a six year program for medical students, and didn't understand English or the costs or path to practicing medicine in the United States.
But on Friday, Montaño, 37, joined with hundreds of medical students graduating from Johns Hopkins University and the University of Maryland to learn where they will do their medical residencies and transform themselves into practicing doctors. Thousands of students around the country also took part in the annual celebratory ritual of "Match Day" and found out the names of the hospitals where they would do three to seven year residency programs required of all physicians in the United States..
"My family decided to leave and I had no choice but to come with them, but that was pretty devastating to me," said Montaño, who plans to be a pediatrician and is due to deliver her own baby about 10 days before her May graduation from Hopkins with a medical degree and a doctorate in human genetics.
"I decided I would do it step by step," she said.
Montaño learned that she would be going to Boston Children's Hospital.
The ceremony is a rite of passage for medical students, but is also watched closely by the medical profession for trends in the field.
This year, 35,969 U.S. and international medical school students and graduates vied for 31,757 positions in more than 5,000 programs around the country, according to the group. There were more than 1,000 more positions offered this year in specialties including internal and family medicine and pediatrics, as well as psychiatry and emergency medicine.
The students and hospitals each make picks after a lot of paperwork and interviewing. The nonprofit group National Resident Matching Program uses a computer program to make assignments based on those preferences. About 80 percent of students were matched with one of their top choices this year. Those who didn't match had a chance to apply to positions left open.
There were 161 graduating from Maryland and almost all matched, according to the university. At Hopkins, 104 matched this year.
Montaño had several favorites, including hospitals for children in Baltimore, Philadelphia, Boston and Houston. Her husband, who is completing an internal medicine residency program in Florida, planned to apply for jobs where ever she landed.
"I wanted a job where I never stopped learning," she said about why she wanted to pursue a career in science, either as a doctor or engineer.
That path included English classes at a community college. A teacher there advised that she leave South Florida, where Spanish speakers were common, for someplace that would force her to better learn the language. With the help of Mormon missionaries, she ended up at Brigham Young University and then Johns Hopkins for medical school. She picked up experience at the National Institutes of Health and U.S. citizenship along the way.
Living in a diverse community and serving Latino families is important to her.
Others sharing the day with Montaño also have specific patients in mind. Jessica Caffkin, a 26-year-old from New York, wants to serve prisoners and others in the criminal justice system as a forensic psychiatrist.
Before college at Georgetown University and medical school at the University of Maryland, she visited a maximum security prison with a family friend teaching a parenting class to incarcerated fathers. She felt inspired by opportunities she saw to improve their care and lives, and learned that a great many people with mental illnesses end up in jails and prisons.
Caffkin also saw disparities in who was entangled in the criminal justice system, an understanding made more clear to her in the aftermath of the death of Freddie Gray in police custody in 2015. She became active in a group called White Coats for Black Lives and other social and racial justice efforts in Baltimore and around the country.
"It's hard to ignore the racial disparities when you're talking about criminal justice," she said. Racial and social justice and health, she added, "are all very inter-connected."
She applied to programs at Yale in Connecticut, New York University and at Maryland.
During a ceremony at the Hippodrome Theater, Caffkin waited behind 144 of her classmates to take the stage and read from a letter that she'd be going to Yale New Haven Hospital in Connecticut.
Dozens of students will also stay in Baltimore at Johns Hopkins Hospital or the University of Maryland Medical Center or other hospitals in the city.
Caffkin said she was thankful for the mentoring she received at Maryland and vowed to do her part for the disadvantaged as a doctor.
"I will absolutely continue pursuing all of this no matter where I go," she said.
E. Albert Reece, vice president for medical affairs at the University of Maryland and dean of the school of medicine, said he was impressed by the abilities and diverse interests of this year’s class. He noted some of the prestigious programs where graduates were headed, including Yale, where Reece taught for about a decade.
“We do this every year and people assume this is just what happens,” Reece said after the match ceremony. “This is extraordinarily competitive and these are people are of high quality and intellectual capacity applying to programs like those at Maryland, Hopkins and Yale. To get into prestigious institutions year after year speaks volumes about the quality of the students.”