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          Somewhere in the crowd, sandwiched between the classmates and family members sharing beer and nervousness, breathing in air near to vibrating with anxiety and excitement and the threat of tears, John Emerson waits.

           Waits as classmates rip open envelopes and cheer and holler and call out programs: Emory, Orlando Health, Baylor.

           Waits some more, through shout-outs to those watching on Facebook: Mom, Dad, Grandma, even a couple of puppies.

           Oregon, SUNY, the Cleveland Clinic.

           And finally: “John Emerson.”

John Emerson

          Emerson walks past classmate Courtney Smiley and her fiancé, waiting to see which one of them would have to move.

           Past Mark Halsey, waiting to find out whether he would be able to pursue his dream of studying one of medicine’s most competitive specialties – and whether he and his girlfriend would be in the same city.

           Then Emerson takes the envelope.

           His future is hiding inside.

                                                                                                        * * *

          This day began, really, when he was born.

          Because John Emerson was not a perfect baby.  He had a birth defect, one that required him to have several surgeries as he was growing up in Brookville. He learned early what a hospital looks like from the inside.

           The defect – his bladder was located outside his abdominal wall – was repaired by the time he was 10. But those early experiences shaped who he is today.

          “It made me accept that you are who you are,” he said last week, as he talked about his hopes for Match Day. “You have to accept what your problems are in life.”

         And it sparked his interest in becoming a doctor. He believes he’ll be able to relate well to his patients.

         “It helps you understand,” he said. “You can put yourself there a little better.”

         Today, March 17, medical students across the country find out where they will go for their graduate medical education, or residencies. Careers and lives depend on how the computers of the National Resident Matching Program balance students’ preferences with those of the residency programs they’re aiming for.

         Match Day delivers dreams to some students and crushes others.

         For Emerson, it’s something more.

         “I’m very excited about Match Day,’’ he said last week. “You have a lot of goals – steps along the way, hoops to jump through – and all of it is to not only graduate, but to find a residency. It’s really a reflection of how hard you’ve worked.”

         Emerson has ranked five programs and believes he could be happy at any of them. He wants to do a family medicine residency with a focus on sports medicine. Each of his choices has a strong sports medicine program.

         Emerson’s interest in sports medicine also dates back to childhood. Sports were his outlet, the place where he didn’t have to think about his medical issues. Once his surgeries were complete, he threw himself into the game.

        “I wanted to have fun and not think about the hospital,” he said.

          Co-captain of his cross-country team at Florida Southern College, Emerson still runs competitively. On his hearth is a yard-long alligator trophy, the prize for winning a swamplands relay race. He swims, too.

          He’s known as a leader. Emerson is president of the College of Medicine’s student council, and was class president each year during the first three years of medical school.

          Now, he’s wondering where he will take those skills. His first choice is in Charlotte, North Carolina, but other programs on his list are here in Tampa Bay.  At this point, he just wants to know.

             “It’s healthy anxiety,” he said. “So much of your life is on hold.”

                                                                                                         ***
            Courtney Smiley’s life is on fast-forward.

            Today she finds out where she matches. In May, she graduates. In June, she gets married. Today’s envelope will determine whether she moves to Washington, DC, where her fiancé is in graduate school, or whether he has to transfer to join her somewhere else.

           “I don’t want to get into a situation where he can’t get a job here, and we’re married and can’t be together,” she said as she talked about her hopes. “It is tremendous, tremendous pressure.”

           Smiley ranked nine OB/GYN programs – all on East Coast metro areas that have a university where her husband could transfer. Her top choices are in DC, at George Washington University and the University of Maryland. Others would bring her back to Florida and her family, who live in Jacksonville.

          “My family is pulling for Florida,” she said. “He’s pulling for Washington.”

         Smiley knows and loves the DC area. She graduated from Howard University, where she was a star basketball player: her senior year she was the MVP. In 2007, she was named the Mid-Eastern Athletic Conference Woman of the Year, an honor that goes to a student who excels as a scholar and an athlete. She still plays basketball in a recreational league now.

          Like Emerson, Smiley’s interest in medicine stemmed from seeing medical problems as a child. In this case, the patient was her mother. Smiley’s mother was born with a pancreatic condition that got worse as she got older.

          When Smiley was about 8, her mother had to have half her pancreas removed.

          What Smiley didn’t know until years later was that doctors told her mother that she likely had only a few years to live.

Courtney Smiley

         This is what she did know: that doctors were the ones who could help – if anyone could.

           “It was kind of a little scary as a child, and I wanted the physician to be able to help my mother,” she said. “I wanted to be that person.”

          Soon, she will be. The wish to help comes through in the way she describes caring for obstetrics patients:

          “90 percent of it is really a party,” Smiley said. “But 10 percent of the time, when you have problems…You really have to check yourself and know you’re going to help this family get through this tough time.”

          Smiley and her fiancé have tried to prepare for whatever happens today. He’s already contacted USF and other Florida schools, finding out what it will take to transfer to another PhD program in education administration.

         So she has tried to stay positive.

         “I honestly feel blessed,” Smiley said. “There are so many things I’ve always wanted, and they’re all occurring together. It will be a new chapter.”

                                                                                                 ***
         You’d think Mark Halsey would have it made on Match Day.

          There’s a national shortage of pediatric dermatologists, and Halsey wants to become one.

         But some things just can’t be easy. The field of dermatology as a whole has become incredibly popular among today’s medical students. That makes snagging a dermatology residency one of the most competitive slots to win on Match Day.

          And to become a pediatric dermatologist, Halsey must first land one of those scarce and sought-after dermatology residency spots.

          If that’s not difficult enough, Halsey and his girlfriend, a medical student at Georgetown University, both are trying to match in Boston.

          “Maybe I should be nervous, but I’m not,” Halsey said. “I’m more excited. I feel like I’ve given it my best shot. The worst case scenario is that I try again. Because I know this is what I want to do.”

           Halsey decided late on a medical career. A math major at MIT, it wasn’t until his senior year that he took biology and felt pulled toward science. When he graduated, he didn’t know what path to take. He decided to do consulting work for a year so that he could sample different fields.

           “I realized that I needed a career that would combine my academic interest in science and biology with doing something that would be really fulfilling,” he said.

          Once he arrived in medical school, unlocking the puzzles of dermatology fascinated him. And once he started interacting with patients, he realized he loved working with children.

           That means he’ll have to match twice, probably in different places: first a year of pediatric internship, then three years as a dermatology resident. After that, he’ll still need to complete a fellowship in pediatric dermatology.

           Halsey, who is USF’s senior class president, is aiming high and staying quiet, telling few about his hopes. His top choice for his first year is Massachusetts General Hospital, one of the nation’s most selective programs.

           For dermatology, Halsey wants to go to the University of Massachusetts. He did an externship there and likes its large roster of pediatric dermatologists. It’s also near his sister, who just started medical school at Tufts. And, of course, his girlfriend.

           “It’s fascinating and it’s really rewarding work,” Halsey said. “It’s the perfect career for me.”

           All he has to do is match.

                                                                                               ***

             By this morning, Emerson is relaxed, greeting friends, introducing family members. Everyone dons shamrock necklaces and green T-shirts saying “Kiss me, I matched.” 

             By Match Day tradition, each student who matches drops a dollar into a box, and the last student called wins the kitty. This year, in honor of St. Patrick’s Day, the last student to match will take home a pot of gold wreathed in shamrocks.

            “Skipper’s is putting out a good vibe,” Emerson jokes.

            Smiley checks her watch, tells herself to be calm, checks her watch again. Her fiancé, Andrae Townsel, sits by her side.

             “I’m trying not to think about it,” she says. “I just want to find out.”

            Halsey is watching his classmates match when his phone rings. His girlfriend has just matched in Boston, at Tufts.

            Now it’s all up to him.

           By the time Emerson’s turn finally arrives, he’s no longer in a hurry.

           “This is the only time in my life I’ll ever be broadcast live on Facebook,” he tells the crowd.

           And then he reads it out: “Carolinas Medical Center in Charlotte!” His first choice. He fist pumps the air.

           Finally Smiley’s turn. She rips the envelope, then sucks in air.

           “George Washington UNIVERSITY,” she screams, jumping up and down. In the audience, Townsel is on his feet cheering.

           More names, more matches…two classmates bring babies up to read their envelopes. Dr. Stephen Klasko, dean of the USF College of Medicine, opens the envelope for new dad Lorent Duce, since his hands are full of infant.

            Finally it’s Halsey’s turn. He tears open the envelope, sees the words. Smiles.

            “This is good,” he says.

             Then his voice chokes as he reads out: Massachusetts General Hospital. University of Massachusetts.

             In a few moments, it’s all over, and it’s time for hugs and pictures and more phone calls and text messages and good-byes.

           “I’m just so excited,” Halsey says, his proud mother by his side. “I’m really thrilled and happy.”

Mark Halsey with mother Amy Halsey from Miami, FL

           Halsey had ranked 13 dermatology programs, hoping to land one somewhere in the competitive specialty. And now…to get both his top choices. And his girlfriend in Boston too.

             “It’s a dream come true,” he says. He can’t stop smiling.

            “I was so nervous,” Smiley confesses. “The tears just kept coming. I didn’t think I would get it. And I got it! I’m just so happy. It’s amazing.”

            “It feels fantastic,” Emerson says. “I’m almost more excited about my classmates. There are some who didn’t get what they wanted, but there are so many people who are so happy.”

             He waves his hand around Skipper’s.

             “And this is such a great way to celebrate. It’s just awesome.”

            In the 2011 class of the USF College of Medicine, 55 of the 112 students are going into primary care, with the largest number of students, 38, going into internal medicine. Ten more will be OB/GYN residents. 44 will do their residencies at USF, and 14 more will also stay in Florida. Others will scatter around the country, from the University of Texas Southwestern to the University of California-San Francisco to Harvard Longwood Psychiatry.

–  Story by Lisa Greene, photos by Eric Younghans and video by Amy Mariani, USF Health Communications