Madina Gerasimov likely felt a bit more trepidation than most others in her position yesterday as she opened the envelope that would tell her what hospital program she “matched” to.

At 41, she is closer in age to most attending physicians than residents. Although in a few months she will graduate from New York University Medical School, Ms. Gerasimov is already a mother, a wife, and a scientist. She was born in Russia and had a career studying drug addiction.

In the months before “Match Day,” when medical school graduates find out where they will be residents, Ms. Gerasimov found herself pulled between her career and family members around the country, including her son in Chicago.

Ultimately, she matched for the anesthesiology program at the University of California, San Francisco, which she had been seeking. “UCSF is the most demanding program in the nation,” she said yesterday, minutes after opening her envelope. “I don’t have many years left. I want to make the best of it.”

For graduating medical school students, the months and weeks before “Match Day” are filled with similar anxiety over where they will be spending two to six years as residents, honing their specialties. Since 1952, the National Resident Matching Program has matched residency candidates and programs using a computer algorithm that takes into account the applicant’s ranked preference and the preference of residency programs. All of the applicants found out yesterday where they matched. This year, 27,944 candidates applied for first-year residency programs, including a record number of medical school seniors: 15,206. According to the NRMP data, 84% of medical school seniors matched to one of their top three choices.

Just before noon, Ms. Gerasimov arrived at NYU Medical School on First Avenue in Manhattan, where a table was set up with envelopes bearing each student’s name. As students jostled for space in line, she landed in the middle of the crowd. Outwardly calm, she accepted her envelope, and with a flick of her finger loosened the unsealed flap. When she saw her match, she smiled. The waiting was the worst part, she said, likening it to pregnancy. “You know it’s going to happen,” she said, “but you’re still really nervous.”

As other students opened their envelopes, some yelped with joy and hugged each other. “You can hear it in the pitch of their voices,” the senior associate dean for education and student affairs at NYU Medical School, Veronica Catanese, said.

“It’s crazy,” a student at Albert Einstein College of Medicine, Casey Barbaro, 32, said. “It’s one day, you get one envelope, and it’s going to dictate five years of my life.”

Ms. Gerasimov said she hardly slept in the weeks before Match Day. Early yesterday morning, she considered calling her 66-year-old father in Russia as a distraction, although she stopped herself. “What am I going to tell him, ‘Dad, I can’t sleep’?” she said.

Yesterday afternoon, she said she was waiting until it was morning in Russia to call him with the good news. For the rest of the afternoon, she said, she would celebrate with her classmates, and then tell her landlord she would be breaking the lease on her Manhattan apartment.