At 7:45 a.m. on Thursday, under a foggy sky, Elsa and Sean Haloman exit their Pacific Beach home and head toward their destiny.

In a room about 6 miles away, there’s a pair of envelopes that will tell them where they’ll spend the next five years of their lives.

The Halomans are medical school seniors at the University of California, San Diego. They, along with 123 UCSD students and more than 16,000 students nationwide, will rip open envelopes at 9 a.m. and, for better or worse, their lives will change forever.

This is what’s known in the medical world as Match Day. Inside the envelope is a message: “Congratulations, you have matched …” followed by the name of a hospital. This is where, after their already extensive schooling, doctors-to-be go for their residencies. They could be staying put, right here at UCSD, or heading across the country, riding the subways in New York City or braving the snow in Chicago.

The application process is simple, but grueling. Throughout the year, students apply to programs around the country. If hospitals are interested, they get together for an interview and a tour of the program.

Then, students and hospitals alike make a list. The students list which hospitals they prefer. The hospital lists which students it prefers.

Sean, who plans to go into orthopedics, and Elsa, who will pursue psychiatry, have done what’s known as “couples matching.” This is a process that gives them certainty they’ll stay together, but they both have to qualify for a program to be accepted. That means one of them might have to miss the opportunity to go to a great school and settle on the best school that accepted them both.

The wait is nerve-wracking. And it’s amplified as Sean and Elsa wait at a light to turn onto campus. It doesn’t turn green when it’s supposed to. The couple waits for eight minutes at the light. Maybe, they wonder, it’s a bad sign. Cars are honking behind them. Sean is ready to run the red light.

Eventually, they make their way onto campus. Sean comforts Elsa on the way to the medical school building. They descend the stairs, inching closer to the envelopes.

The Halomans want to stay in California. They love the weather. There are great medical schools in Southern California. Most importantly, they want to be close to Elsa’s family.

While Sean moved here from Wyoming, Elsa’s never lived out of the state before. The most exciting words that could be inside the envelope are “University of California, Los Angeles.”

Whatever happens, earning a residency is an accomplishment in its own right, and family and friends often come along to Match Day to celebrate. Elsa and Sean came alone, but there’s a gift basket from Elsa’s parents, complete with champagne and a message.

Around 9 a.m., the students and families start piling into the room. They’re a bit off schedule and many students across the nation already know their fates.

As educators rattle off a few quick words of thanks, the tension builds in the room. Elsa can hardly contain herself.

Then, they all get the word. It’s time to open the envelopes.

Elsa tells Sean to open his — she’s too nervous, she says, to open her own.

He rips the end off the envelope, unfolds the letter and shoots a knowing glance at Elsa.

“Congratulations, you have matched …” he tells her.

“What,” she asks.

He hands her the envelope.

“Oh my god,” she says. “We’re out of the state.”

The room is filled with piercing shrieks, high fives and excited faces. There’s crying — the happy kind and the sad kind. A TV cameraman pushes his way through the crowd, quickly asking where people have matched. He pushes me out of the way and sticks his camera in Sean’s face.

“Where are you going?” he asks.

Sean answers, with mild enthusiasm, the question he’ll get over and over for the coming hours:

“University of Washington.”

The couple’s initial disappointment has nothing to do with the hospital itself. It’s a prestigious program, as their fellow students point out throughout the day. And Sean and Elsa had a great visit there. But their immediate thoughts turn to the rain and the fog.

“It was my favorite program,” Elsa says. “I just don’t want to move.”

Apart from the quality of the residency program, there are other silver linings about the University of Washington.

Sean’s best friend lives in Seattle. He gets on the phone to let him know that around June or July, they’ll be living in the same town.

And their medical school friend Aaron Rutman will move to Seattle as well in 2012, bringing along his wife and kids, including 3-year-old Seth.

Sean promises Seth that he’ll teach him to fish. A new life is already taking shape.

Most importantly, Sean and Elsa will be together. They met in medical school and married in September 2009. The couple agreed that no matter what happened on Match Day, they would be happy because they’d be going as a pair. Going to different cities “wasn’t an option,” Elsa says.

At the bar afterward, their spirits are a bit higher. Elsa moves to the middle of the crowd to chat with friends. Sean stands by the bar and takes a shot of Jagermeister to celebrate.

There’s a whole life waiting ahead of them, and a lot of work. But for now, they’re just enjoying the moment, and a few months of sun and friends before packing their bags for Seattle.

Please contact Sam Hodgson directly at or 619.550.5664 and follow him on Twitter:

Sam Hodgson is a freelance photojournalist and contributor to Voice of San Diego. You can contact him at and check out his work...

Leave a comment

We expect all commenters to be constructive and civil. We reserve the right to delete comments without explanation. You are welcome to flag comments to us. You are welcome to submit an opinion piece for our editors to review.

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.