PHOTOS: UAMS' 158 seniors land residency spots

For the past nine months, Wilson Alobuia prayed.

The 28-year-old native Ghanaian knew he wanted to get into a residency program for general surgery, but he worried his board-exam scores weren't high enough, he said. Others had encouraged him to apply for another field, but Alobuia was adamant.

On Friday, he went to the podium at the Embassy Suites hotel in west Little Rock, took his sealed envelope and tore it open. He leaned back and covered his mouth before shouting out his match: Stanford University.

"Whew," he said. "It's so surreal. It's been a very long process for me at least because there were so many things on the application that I ... was worried about. But I believe that that was what God wanted me to do. All I prayed for from the very beginning, all I prayed for was for somebody to give me that opportunity to show what I can do and what I have to offer."

Alobuia was one of 158 University of Arkansas for Medical Sciences graduating seniors who took part in Match Day, an annual national event held the third Friday of March at 11 a.m. CDT. Graduating medical school seniors nationwide find out at the same time where they will be "matched" for their postgraduate residency training.

This year, 35,969 applicants to the National Resident Matching Program vied for 28,849 first-year positions, according to the program's website. Matches are not guaranteed because there are more applicants than there are positions, and the positions draw applications nationwide and even internationally.

But, for the first time in about a decade, all UAMS graduating seniors participating in the match program will attend a residency program. Program participants first learn on the Monday before if they will be matched, but they don't know where until Friday. Eight UAMS seniors had not received a postgraduate position Monday, but by the end of the week, everyone had a spot.

"This is the first time since 2006 that we've had a situation where we have had the match rate that we had this year," said Dr. Richard Wheeler, executive associate dean of academic affairs at UAMS. "It was a very good match rate."

Medical school students need postgraduate education, typically a residency, before earning a license to practice.

Nationally, 94 percent of the 18,539 U.S. graduating seniors matched to residency positions, the program said.

Medical schools across the nation have increased enrollment by nearly a quarter since 2002 as a response to an impending physician shortage. A study commissioned by the Association of American Medical Colleges estimated that by 2030 there would be a shortage in primary-care physicians of between 7,300 and 43,100, and in specialty areas of between 33,500 and 61,800.

In Arkansas, the shortage looks even starker, said Dr. Barbara Ross-Lee, the founding dean of the New York Institute of Technology's College of Osteopathic Medicine's campus at Arkansas State University.

"Arkansas' shortage is getting shorter because the shortage numbers are calculated based on where we are today," she said. "And based on where we are today, Arkansas ranks 48 out of 50 states in the number of physicians per 100,000 people. But that doesn't even include those physicians in Arkansas who will be retiring over the next five to 10 years. About one-third of physicians will be retiring."

The campus at Arkansas State University in Jonesboro opened with its first class of 120 students last fall and is planning a 115-student class this fall. Arkansas College of Osteopathic Medicine in Fort Smith will open to its first class of 150 students this fall, according to its website.

But residency slots haven't kept up with the increase in medical graduate students, Wheeler said.

There are enough postgraduate positions for seniors graduating from medical schools in the U.S., Ross-Lee said. The problem arises when former graduates want to change specialties and when international students or personal preferences are thrown into the mix.

For example, there may not be enough residency slots for all the students who want to pursue orthopedics, Ross-Lee said, or students may want to match in a particular state.

Both Wheeler and Ross-Lee said they try to counsel students in applying for what is right for them.

"When you are a student getting ready to get into the National Residency Match Program, it's wide open. It's up to you how many places to apply," Wheeler said. "You've got to balance with how competitive you are with how competitive the programs are. We've spent a lot of time the last couple of years trying to make sure students are rational at what they are looking at and looking at lots of programs."

The problem also is exacerbated by the bottleneck from a federal cap placed on fiscal support of the programs.

Residents' salaries are paid by the hospital, which later can be reimbursed through federally funded Medicare. Salaries depend on the resident's year and specialty, but an average salary for a first-year resident at UAMS is $51,289, said spokesman Leslie Taylor.

Congress placed a cap on federal fiscal support more than 20 years ago, limiting the number of residency positions across the nation, according to the medical college association. The association has called on Congress to raise the cap, which would increase the number of residency programs and produce more doctors at a time the population grows and gets older, said association president and CEO, Darrell Kirch.

Still, both UAMS and the institute in Jonesboro have gotten creative to start more residency programs in Arkansas.

UAMS currently has 66 programs statewide with 800 positions. It has added five first-year slots in a revived one-year transitional program to help students who didn't match get some postgraduate experience, Wheeler said.

The academic medical center and institute also have helped "virgin hospitals" -- those which never have had residency programs -- get the postgraduate training off the ground. Such hospitals are eligible for federal reimbursements and do not have a cap.

UAMS also helped White River Health System in Batesville start a 30-slot internal-medicine program, with 10 residents per year, Taylor said. White River also is planning for a family-medicine residency program of 18 slots, with six residents per year.

The institute in Jonesboro has helped to open 200 residency slots in the state and is working on another 200, Ross-Lee said. As a new campus in the state, the institute had to prove to accreditors that it was actively trying to increase the number of residency slots, she said.

St. Bernards Healthcare in Jonesboro had a federal cap, but recently decided to self-fund new residency spots.

NEA Baptist Memorial Hospital in Jonesboro had been training residents from UAMS, Ross-Lee said, so it had a "really, really tiny cap." She said the hospital appealed to the federal government, won it and earned more spots.

Friday's Match Day will send 63 seniors to residency programs in Arkansas, and 95 to programs in 31 other states. Of the class, 61 percent got residencies in primary care, including internal medicine, family medicine, pediatrics and obstetrics/gynecology.

For some students, the choice of a residency program was personal.

Paul Drake, 26, of Little Rock matched with a child-neurology program at the University of Arkansas at Little Rock.

"I have a younger sister who was involved in a car accident when she was 16," he said. "And she suffered a brain injury, so that kind of spurred my interest in neurology. Tried to keep an open mind, but at the end of the day, that's what I wanted to do."

Danielle Tchoungang, who was the last to be called, said she was following in her aunt's footsteps. Her aunt, Dr. Mimo Lemdja, is a family-medicine doctor in Camden.

"It's been a long process, really hard, really tough," she said. "I'm just happy, and I got my No. 1 choice. I can't believe it."

Tchoungang giggled in delight afterward as she talked about her residency match in family medicine in Bon Secours Health System in Virginia, where her fiance lives. The Cameroon native said her aunt, from the same country, graduated from high school and immigrated to the United States without knowing anyone.

She made her way through medical school, a residency program, life.

"She's just been an example to me," Tchoungang said. "And I really wanted to be like her when I grow up. So I hope I make her proud today."

For Alobuia, the match left him incredulous. He moved to Conway eight years ago to attend the University of Central Arkansas.

"I remember sitting in my first college class at UCA and could not understand a single word that was coming out of this professor's mouth because the accent was just so different," he said. "I just could not understand anything."

That left him in a tailspin, doubting whether he could finish college alone. But he persisted.

After graduating though, he didn't initially get into medical school and turned to a job as a surgical assistant.

"It was during that moment that I decided, 'This is it. This is what I'm supposed to do. It has to be surgery,'" he said. "It's pretty much literally what I prayed for ... because I knew it was going to be very rough to get a spot somewhere. I prayed a lot. My girlfriend prayed a lot. A lot of people have prayed, and so this is just God's work. I'm just grateful to God that he answered prayers."

A Section on 03/18/2017