Heidi Witherell may have skipped the typical path of a medical student -- premed immediately followed by medical school -- but she didn't miss out on one medical school tradition: Match Day. Witherell was one of 80 Stanford medical students partaking in an event that will define the next three to seven years of their lives.

Amanda Risser, center, shows her joy upon learning she was matched with her first choice, Oregon Health & Science University, where she has already begun residency in family practice and preventive medicine.

On March 21, Witherell, along with medical school seniors across the country, learned where she would do her residency -- a program required before medical doctors can provide direct patient care. Each year, the National Residency Matching Program pairs students and residencies, allowing schools to announce the matches at a predetermined time.

Years ago, Witherell had no idea this morning would be so significant. An economics major, it wasn't until she pursued a master's degree in education at Stanford that she became interested in medicine. She worked in the clinics at Lucile Packard Children's Hospital as part of her coursework and "knew from my first day at the hospital that I wanted to go to medical school." More than a year of pre-medicine courses followed before she entered medical school.

A white envelope contained Witherell's future that bright Thursday morning, when she and her father, who flew in from Florida, came to the medical school lounge to pick it up. The lounge was full of nervous energy: boxes of frosted chocolate donuts went untouched as students fidgeted anxiously, checked their watches and listened to Philip Pizzo, MD, dean of the medical school; Julie Parsonnet, MD, senior associate dean for medical student education; and Elliott Wolfe, MD, associate dean for clinical advising & professional transition, take turns addressing the group.

"This is an important passage in students' lives -- every physician remembers this day," said Wolfe.

When the designated hour of 9 a.m. arrived, students were called one by one to the front for their envelopes. "You can do with it with what you wish," said Wolfe before the first name was called. "Some people open it immediately -- we do have CPR standing by -- and others take it and run out screaming, never to be seen again."

OFF THEY GO: Most grads were matched not only to their first choice, but chose to stay in the Bay Area. The above graphic shows the local centers where 42 will begin their training, including 19 at Stanford.

Nervous laughter melted into claps and squeals of joy as each name was called and envelopes were opened. Witherell was one of the first, and her envelope contained good news: Scripps Mercy Hospital in San Diego for a one-year internship and then back to Stanford for a residency in anesthesiology (both were first choices). Classmate Sue Ann Wee learned she'd be going a bit farther -- the dermatology program at New York University after a year at Santa Clara Valley Medical Center.

"I was really nervous about my internship year, and I'm really happy with how it turned out," said Witherell, who was one of 44 students to choose a program outside of the primary care specialties. "It was a difficult decision. Part of me wanted to stay local, but I felt it would be best for my career to experience somewhere different."

Wolfe said students typically rank institutions based on a variety of factors, including quality and geographic location. Although the National Residency Matching Program no longer provides statistics on students who get matched with their top choices, Wolfe estimates that 90 percent of Stanford students matched with one of their first three.

"Stanford students do well because of their personal achievements -- without any question," he said. "They also benefit from the quality of medical education at Stanford and the faculty members behind them. Coming from Stanford is a powerful boost."