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story.lead_photo.caption University of Arkansas for Medical Sciences students (from left) Shannon Petrus, Caitlin Claridge and Jasmine Haller celebrate their matches Friday in Little Rock. Petrus’ general-surgery residency will be at UAMS. For their residencies in obstetrics-gynecology, Claridge is going to Case Western MetroHealth Medical Center in Cleveland and Haller will go to the University of Missouri-Kansas City. - Photo by Thomas Metthe

Grant Cagle wiped away tears Friday after he announced he was headed to his dream program: Brown University.

The Bernie, Mo., native had interviewed for several residency programs, but the Rhode Island school remained at the top of his list. Cagle, 28, appeared incredulous immediately after learning his destination and thanked his parents.

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Photos by Polly Irungu and Thomas Metthe

"It's an Ivy League, and I grew up on like a little farm," he said. "And I'm doing internal medicine there with my [medical degree] and [master's in public health] in health care law and policy. I'm really passionate about lower socioeconomic classes and health care rights and [gay and transgender] health issues. I'm really interested in finding better ways to deliver health care to people who can't afford it. And Brown is the best program for that."

Cagle, who is also the class president, was one of 155 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 seniors across the nation simultaneously learn where they will be "matched" for their postgraduate residency training.

Matches aren't guaranteed because there are more applicants than there are positions, and the positions draw applications nationwide and even internationally. The problem is exacerbated because the number of residency slots is growing at a slower pace than the number of graduating seniors, said Dr. Richard Wheeler, executive associate dean for academic affairs at UAMS.

This year, 37,103 applicants -- a record high -- vied for 33,167 positions nationwide, the most offered ever in the match, according to the National Resident Matching Program. Of the total positions, 30,232 were first-year posts, and 1,078 U.S. seniors did not match.

At UAMS, nine graduating seniors initially failed to match, though four of those had been accepted into programs starting next July and still needed a first-year position, Wheeler said. Earlier this week, the nine got a list of available residency programs nationwide and went into the Supplemental Offer and Acceptance Program, in which they can apply for vacant spots.

Four earned first-year positions, as did another three. That left two UAMS graduating seniors with no position at the end of match, Wheeler said, though they can still pursue residency positions. Typically, those will go into a transitional one-year program or a research position before entering the match next year, he said.

Residency 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 Leslie Taylor, vice chancellor for the Office of Communications and Marketing.

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 Association of American Medical Colleges. The association has called on Congress to give "a modest increase" in the number of federally supported residency positions at a time when the nation is facing a physician shortage and as the population is growing and aging, its president and CEO Dr. Darrell Kirch said in a statement.

One way around that is "virgin" hospitals, or those which have never had residency programs before and have about five years to build them until they are capped.

UAMS and other medical schools, including the New York Institute of Technology College of Medicine at Arkansas State University in Jonesboro and the Arkansas Colleges of Health Education, have worked to help facilitate new residency programs across the state.

Baptist Health -- in coordination with UAMS -- is creating 100 more residency slots in its North Little Rock hospital over time, Taylor said. The institute in Jonesboro has helped open up more than 150 residency positions, including those at NEA Baptist Memorial Hospital and St. Bernards Regional Medical Center, both in the same city, said Dr. Shane Speights, dean of the college at Arkansas State.

Speights credited Ray Montgomery, president and CEO of Unity Health based in Searcy, for creating four new residency programs with more than 70 positions all at once.

"It's a model for sure that we wish other hospital CEOs would recognize and look at," Speights said, adding that Unity Health was a "virgin" hospital, of which there are "quite a few" in Arkansas. "Here's the key: not every hospital can necessarily support a residency program."

The institute has received a grant from the Delta Regional Authority to test out a consortia of hospitals in several rural towns, including Pocahontas and Kennett, Mo., in pooling residency programs, he said. The project is still in progress.

Friday's Match Day will send 66 UAMS seniors to residency positions across Arkansas and 89 to programs in 33 different states. Of the class, just more than half will enter residencies in primary care, including internal medicine, pediatrics and obstetrics/gynecology.

For many, Friday marked the end of a lot of nerves.

Bailey Barnes, 26, of Fayetteville, had her first interview for a pediatrics residency program at the University of Florida in Gainesville in November, she said.

"I loved it so much," she said. "You just get like a gut feeling when you go somewhere that you like. You just click with all the people. The program was awesome. The place was cool."

She opened the envelope bearing her name, learned that she got her top choice and did a little dance.

"I was so excited," she said.

Elissabeth Martin, 25, of Little Rock said she grew nervous at the start of interview season, but it wasn't as bad as she'd feared. Then rank day -- when graduating seniors get to rank their choice in programs -- came along, and the nerves came knocking again. She switched and switched, she said.

On Friday, she also learned she will continue her studies at her top choice: Carolinas Medical Center in Charlotte, N.C., in emergency medicine.

"Today I'm on Cloud Nine," she said. "I'm glad that we finally made it.

"I wouldn't be here without the support of my family, my fiance, my mentors, especially Dr. Billy Thomas. I'm incredibly excited about the journey, and I'm really excited to see how the residency goes and where it takes me."

Metro on 03/17/2018

Print Headline: UAMS seniors meet matches

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