University of Maryland School of Medicine senior Caitlin Carnell opened a white envelope at the Hippodrome Theatre on Friday and saw light at the end of a tunnel: the long-distance phase of her young marriage was coming to an end.
Carnell, 26, walked to the stage to the tune of Michael Bublé's "The Best is Yet to Come," took the envelope from an associate dean and stepped to the mic stage right, opened the envelope and spoke three letters, "VCU," for Virginia Commonwealth University in Richmond — her first choice for a residency in psychiatry that will allow her and her husband to live together for the first time in four years.
"It feels great," said Carnell. Raised in Frederick County, her husband, Hunter Davis, is a nuclear engineer working with a military contractor for the Navy in Newport News, Va. "I've been waiting for this for all of medical school. I'm just so happy everything worked out the way I wanted."
Carnell was one of 254 fourth-year medical students at the University of Maryland and the Johns Hopkins University School of Medicine who received assignments for their hospital residency programs in an a ritual known as "Match Day."
They competed in a pool of nearly 35,000 students from U.S. and international medical and osteopathic schools. More positions were offered this year than ever before in the 63-year run of the process conducted by the National Resident Matching Program — a reflection of efforts to address a physician shortage projected to be as high as 90,000 by 2025.
Medical school and teaching hospitals have been expanding enrollments and residency programs, but it's still not enough to meet the anticipated need, according to Dr. Darrell G. Kirch, president and CEO of the Association of American Medical Colleges.
He called for more federal aid for residency programs to train 3,000 more doctors a year, which would require Congress to lift a cap on Medicare support for graduate medical education that has existed for about two decades.
Nearly 140 programs taking part in the matching process offered 30,212 positions this year, up 15 percent since 2011. Nearly 60 percent of the added slots this year have been in primary care specialties, a development Mona M. Signer, president and CEO of the resident matching program, called a "very positive trend."
While the number of positions was the highest, there also were more applicants this year than ever before.
Figures compiled by the matching program show a range of competitiveness among specialties. Among specialties with more than 500 positions offered, for example, orthopedic surgery was highly competitive with 94 percent of positions filled. Family medicine was in the low range with 44 percent filled.
Among those pursuing family medicine will be Alexi Pappas, 29, a University of Maryland student from Baltimore. He was among 52 percent of students this year who were granted their first choice. In his case, it's Montefiore Medical Center in the Bronx, N.Y.
"It's real – OK," said Pappas, looking at the one-page notice. "It feels good. Relief, excitement for many of my friends who got where they want to be as well. I can plan my life a little."
He said he wanted Montefiore because its residency program suits his values of community engagement and social justice. After finishing his undergraduate work in political science at Harvard University, Pappas came back to Maryland and worked in health and social services policy for three years for the office of former Gov. Martin O'Malley and the City of Baltimore. Those experiences helped him decide to pursue medicine as a career.
Hopkins student Howard Choi, 30, of Toronto also found that he was drawn to medicine by experience after college. He took a six-month trip to Guatemala with a Canadian program similar to the U.S. Peace Corps, helping Guatemalan citizens develop civil rights leadership skills. He said he saw up close the country's gang violence.
Choi later earned a master's degree from the Johns Hopkins Bloomberg School of Public Health, then enrolled in the medical school, where he developed an interest in emergency medicine, and hopes to work on reforming that field.
He's headed to the emergency program at New York University School of Medicine and the NYU Langone Medical Center.
"I just loved their social justice commitment," said Choi. "They work for the poor. They have a long history of working with the Hispanic population of New York. It's a big honor to be a part of that history."
Also happy with the outcome was Veronica Hocker, 35, whose friends call her Wonder Woman. The single mother, former bartender and ballet dancer commuted to Hopkins School of Medicine from her home in Lancaster, Pa. She wanted to be in the South and got her second choice in a residency in psychiatry at Duke University Medical Center in North Carolina.
The school is "close to my son's family and it's an amazing program," Hocker said after the matching ceremony. "It's really rigorous. It has great research. I get exposed to so many different aspects of psychiatry. I'm so excited."
Her 4-year-old son, Brinson Broome, helped open the acceptance letter envelope. Hocker said she plans to head to the Durham area this weekend to visit family and look for housing.
Carnell and Davis started their housing search months ago as they checked out areas that would make a reasonable commute between Newport News and Richmond — hoping the matching program's computerized mathematical algorithm would place her in a spot in psychiatry at the Virginia Commonwealth University Medical Center.
They decided on a new subdivision in Toano, northwest of Williamsburg — about a 45-minute commute for both of them. Meanwhile, they kept driving the four or five hours to see each other at least once a month, a practice they've pursued since they both graduated from the University of Virginia, where they met.
They were married at the courthouse in Charlottesville in December and plan a more elaborate wedding reception in May. Now, with VCU match letter in hand, they also have construction plans to pursue.
"Now we start building a house," said Carnell, whose parents are both medical doctors who met at the University of Maryland School of Medicine, where they graduated in 1986.
Maryland student Amanda Bana Fernandez, 26, also has some history with the University of Maryland. At 2, she was diagnosed with a brain tumor that was causing seizures. Doctors at the Medical Center removed the mass in her left frontal temporal lobe.
"They took out a tumor the size of a golf ball," said Fernandez, who grew up in Dundalk. She was in the hospital for more than three months, an experience that she said forged her aspiration to become a doctor.
"At a very early age I knew I wanted to be like the doctors that saved me," said Fernandez.
She got her first choice for a residency in pediatrics at the place where she found the ambition 24 years ago. She walked down the aisle at the Hippodrome, took her envelope, stepped to the mic and said: "I'm staying home — University of Maryland."