Raymond Cook is charged with murder and death by motor vehicle.
The victim, 20-year-old Elena Shapiro, was a dancer with the Carolina Ballet.
Police say Cook was driving more than 80 miles an hour just before he crashed into Shapiro's car. She was on her way to a party with fellow dancers.
An eyewitness at the scene described what he saw.
"It's probably one of the most horrific things I've ever seen in my whole life," Adam Wright told ABC11 Eyewitness News. "I even told people that night when I went in to work that I thought he was intoxicated."
Investigators say Cook's blood alcohol level was twice the legal limit after the crash.
He gave up his medical license, left positions he once held at WakeMed and the UNC School of Medicine and spent time at an alcohol treatment center.
Before jury selection Monday, the judge allowed a defense motion that would give Cook the option of admitting guilt to involuntary manslaughter or another less serious charge.
The motion says Cook realizes that it may be in his "best interest … to bolster the argument I am not guilty of second-degree murder."
The defense has also asked the judge to exclude some evidence in the case - in particular any mention of a radar detector in Cook's black Mercedes.