Arkansas' 'Firstborn' Osteopaths Near Graduation

Rance McClain, dean of Arkansas College of Osteopathic Medicine Fort Smith.
Rance McClain, dean of Arkansas College of Osteopathic Medicine Fort Smith. (Allison Kyrouac)

Shane Speights will feel like one proud papa when he watches 100 or so of his medical students graduate this May.

Speights is dean of the New York Institute of Technology’s College of Osteopathic Medicine at Arkansas State University in Jonesboro, and the school’s first graduating class is scheduled to walk in May. For Speights and many others at NYIT, building the school up from a notion to a brick-and-mortar facility has been memorable.

“It is almost like a parent watching their kid graduate high school,” Speights said. “It is a very personal endeavor for many of the staff and faculty that have been here from the very beginning. We were here in this building when we first started, and we just had the one class so we got to know them very, very well.”

NYIT’s Jonesboro campus was approved by the Commission on Osteopathic College Accreditation in December 2015 and the school opened in August 2016 with 115 students. The medical school proved popular from the start, with many more applications than available slots. When the Arkansas College of Osteopathic Medicine opened two years later in Fort Smith, it proved equally popular, with more than 4,000 applicants for 150 slots.

“We couldn’t be more excited. It seems like just yesterday we were in the planning stages and here we are all ready to get that first class out and into residencies,” Speights said. “That first group is so special. They are such a unique group anyway. It takes a special individual who wants to jump out there and say, ‘Yeah, I want to go to a new medical school.’ They are our firstborn.”

Over in Fort Smith, Dean Rance McClain is a year away from watching his school’s first class graduate. McClain became dean of ARCOM a year ago after Ray Stowers was promoted to provost and vice president of academic affairs for the Arkansas Colleges of Health Education, which runs the medical school.

More than 160 students enrolled in ARCOM’s first class three years ago, and McClain said nearly 150 are on course to graduate next year.

“The majority of potential roadblocks are behind them,” McClain said. “Most attrition happens in the first two years.”

Dr. Shane Speights, dean of the New York Institute of Technology College of Osteopathic Medicine at Arkansas State University
Dr. Shane Speights, dean of the New York Institute of Technology College of Osteopathic Medicine at Arkansas State University

Setting Up Residency

Graduation is just the first hurdle an aspiring doctor of osteopathy has to clear.

After having spent their third and fourth years doing clinical work at hospitals, graduate D.O.s have to find a residency program to continue their training for licensure. In Arkansas, there were 281 residency slots in 2019, according to the National Resident Matching Program.

Of those 281 slots, 16 were filled by graduates of osteopathic medical schools; the rest were filled by the more traditional M.D. graduates.

A main reason two osteopathic medical schools set up shop in Arkansas was to address the glaring physician shortage in the state and surrounding region. The goal was to have local graduates, joining M.D.s from the University of Arkansas for Medical Sciences in Little Rock, find residencies in the state.

“It’s not simply good enough anymore for us to have a medical school and graduate doctors if we don’t have places for them to train,” McClain said. “We need more residencies for [D.O.s], more rural training where we need them. Arkansas is one of the states that is in the bottom 10 of the country in access to health care.

“If we graduate students and ship them all over the country, it dramatically reduces the chances they return back to this region to practice. We have to be on the forefront of developing graduate medical education in that same region.”

NYIT and ARCOM have been as active in scaring up residencies in the state as they have been in educating their students. Both schools have announced partnerships with hospitals for graduate medical education training.

For medical graduates, March 20 will be Match Day, when they find out which hospital has accepted them for their three- to seven-year residencies. A year ago, the National Resident Matching Program announced that, nationwide, 37,103 graduates had applied for 33,167 residency positions.

U.S. Sen. John Boozman, R-Ark., cosponsored a bill that would create funding for an additional 15,000 residency slots in the next five years. A federal cap on Medicare reimbursement — how hospitals afford to pay and train their residents — has been in effect since 1996, discouraging hospitals from adding new slots that would have to be paid for out of other revenue.

The cap does allow hospitals that had no residencies before the cap to create slots. The Association of American Medical Colleges said the Medicare reimbursement cap is one reason there will be an expected shortage of as many as 120,000 physicians nationally by 2030.

‘Desperate Need’

McClain said Arkansas’ poor ranking in access to health care is even worse when one considers that status is taking northwest Arkansas and Little Rock into account.

The River Valley around Fort Smith and the Delta region of east Arkansas are that much weaker in physician numbers, McClain said. The Arkansas Department of Health reported that life expectancy for residents in 17 counties of the Arkansas Delta is 10 years shorter than for those in western Arkansas.

“There are a few little pockets of Arkansas that have borderline sufficient access to health care,” McClain said. “Once you get outside of those two metropolitan areas, where access to care is a little bit better, the rest of the state becomes a significant issue. This region is in desperate need of physicians.”

Speights said NYIT has held summit meetings with hospital executives and administrators in the Delta to drum up interest in creating new residencies.

“There is still an opportunity for growth in the state of Arkansas,” Speights said. “We expect to continue to see growth as hospitals investigate and see the benefits of having a residency program. This truly is a pipeline if you grow them within your state.”

NYIT also sent its third- and fourth-year students into needed areas, 30 counties statewide, to do their clinical work.

“We had strategic planning from the get-go on where we wanted to be and how we wanted to help shape the face of health care in this state and region,” Speights said. “We do that because we know that giving them that firsthand view of what medicine looks like in a town like Mena can forever change their perception. They say, ‘Wow, what a great way to make a difference in the lives of people.’”