JONESBORO -- Shelby Armstrong spent hours shadowing her dad when she was younger.
Always on the heels of the osteopathic neurosurgeon, the Fayetteville native took a liking to the field and never wavered in her decision to become a doctor. Armstrong will be part of the inaugural class of the estimated 115 students in the New York Institute of Technology's College of Osteopathic Medicine's newest campus at Arkansas State University this fall.
The new branch is opening in August in the renovated Wilson Hall in the center of the Jonesboro campus. It's the first osteopathic medical school in Arkansas, with another one to open in Fort Smith in the coming years. The new campus will join the ranks of at least 35 others across the nation, said Dr. Shane Speights, the associate dean of clinical affairs for the New York Institute of Technology in Jonesboro.
"We've got new schools kind of popping up all over the nation, trying to meet the demands and the needs of the physician workforce shortage," he said.
Arkansas is ranked 46th in the nation in the number of physicians per 100,000 people, according to the Association of American Medical Colleges, and it is among the lowest in the nation in health care statistics -- rates of high obesity, unimmunized babies and toddlers, teen pregnancy and premature death.
The dearth of physicians could grow worse in the coming years because demand is outpacing the supply, the association said.
For some, like Armstrong, the projected shortage is somewhat of a motivator.
"I thought it was really cool that [the osteopathic college] was wanting to expand into Arkansas," she said. "The reason behind it was just really great -- to improve the quality of health care. It's so important right now to foster that education for more medical students and to improve the access to health care, especially with the increasing physician shortage."
Armstrong -- now a senior at Baylor University in Waco, Texas -- had been looking at medical schools and had heard about the New York Institute of Technology developments in Arkansas from her dad. She had initially applied to the school on Long Island in New York in November but learned about a month later she could apply to the campus in Arkansas.
"I guess the biggest thing was probably location and just going to school in a place that would benefit the community I have grown up in and loved," she said. "It's an incredible opportunity."
The new branch is a result of discussions starting in 2012 between ASU and the New York school. A feasibility study in 2014 later found that an osteopathic school would help meet the state's demand for more primary-care physicians.
The difference between the Jonesboro campus and the University of Arkansas for Medical Sciences -- the state's longtime public academic medical center -- is the type of medical school.
The New York Institute of Technology is offering an education in osteopathic medicine, which emphasizes the importance of the musculoskeletal system and the body's ability to heal itself, and graduates earn doctorates in osteopathic medicine. UAMS offers an allopathic education focusing on health maintenance, and graduates earn doctorates in medicine.
The differences between osteopathy and allopathy are mostly philosophical, said Dr. Barbara Ross-Lee, who is the New York Institute of Technology's vice president of health sciences and medical affairs.
Many times, the phrase "the holistic approach" comes up in osteopathy, Speights said, adding that the field gives osteopathic doctors more tools on hand.
An example, he said, is if a patient comes in with high blood pressure, an osteopathic doctor will look at the patient's history and try to uncover what might be interfering with good health.
"Are there things that we can do, that we can talk about that may include lifestyle changes -- just better, healthier habits that would complement a medication?" he asked. "So, my goal for you would be, 'OK, if I had to use a medication, absolutely, I can write any medication needed. But I'd love to write at the lowest amount at the lowest effective dose with the least amount of side effects with the goal of getting you off that medication.'"
121 on school roster
The New York Institute of Technology branch will lease a renovated 86,000-square-foot Wilson Hall from ASU for about $300,000 a year, the university said.
The renovations cost $12.6 million, with both schools paying $2.3 million upfront. ASU took out an $8 million loan for up to eight years to help finance the rest of the renovation but the New York school's payments to the Jonesboro school will reimburse that cost, officials have said.
The New York school also will pay $50 per student for security services.
As of Thursday, the Arkansas branch had accepted 121 students, with 106 of them committed to attending in the fall, said New York Institute of Technology spokesman Elaine Iandoli. Of the accepted students, 36 are from Arkansas, while the rest are from nearby states, including Texas, Missouri and Mississippi, she said.
The campus also has seen its wait list grow to 169 students, she said. The students will pay about $50,000 annually for tuition, Speights said, adding that the private school will not get state funding. The tuition is comparable to out-of-state tuition at UAMS.
Under the agreement, ASU is offering a bachelor of science degree that would allow premedical students to take that curriculum at the Jonesboro university for three years, ASU System spokesman Jeff Hankins said. If those students have a good-standing grade point average and score well on the Medical College Admission Test, he said, they can be admitted into the New York Institute of Technology and earn a bachelor's degree after the first year of medical school.
televisions and iPads
Armstrong said she was excited to be in the first class.
"Being a part of the inaugural class is not something that comes around very often," she said. "We're the only class right now in Arkansas. It's exciting to think of the potential that this class has in Jonesboro."
Each student will be equipped with an iPad that comes preloaded with a class schedule and other resources. The renovation to Wilson Hall, which used to house humanities courses, included the addition of several laboratories, group study rooms and technological upgrades.
The instructional rooms will have a platform with cameras and several televisions so the students can see what the professor is doing. Students will be able to play back lectures or labs on the televisions in the study rooms. The classes also can be live-streamed from the New York campus to Jonesboro and vice versa. Basic-science faculty members will sit in on live-streamed lectures to help facilitate learning, Speights said.
"And it allows a lot of things," he said. "No. 1, it allows for quite a diverse faculty because now all of a sudden we're not hiring the same amount of faculty here that they have there to deliver the same subject. We're able to hire different faculty with different research and pool together everything and it kind of complements both campuses."
Ross-Lee is leading the buildup at the Jonesboro campus. The medical community is learning that to have enough doctors, they have to grow their own, she said.
"A-State is going to grow its own," she said, adding that she has been impressed with Arkansas' community. "I think my biggest impression was that the need was deeper than I thought it was and the health care community acknowledged that need and saw us as being a part of the solution. I know that without a workforce you can't solve it. We're part of the solution."
residency shortage
Many medical schools have tried to offset their states' projected physician shortages by finding ways to increase the number of medical students. But it isn't that easy. While students can work their way through medical schools, the problem lies in postgraduate education -- namely, residency programs. And most doctor licensures require some form of postgraduate training.
Osteopathic medical students can apply to residency programs for that field and the allopathic field, but it doesn't work the other way around.
This year, 35,476 active applicants to the National Resident Matching Program competed for 27,860 first-year allopathic positions, according to the program's website. Matches aren't guaranteed because there are usually more applicants than there are positions, and the positions draw applicants nationwide and even internationally.
During that same period, 2,255 osteopathic residencies were filled of the 3,228 available spots, according to the American Osteopathic Association. The New York Institute of Technology's osteopathic students have had a 100 percent match rate for the past two years.
But by 2020 the residency programs will be under one track instead of the two. Still, there will be a residency position shortage, said Dr. Dan Rahn, UAMS chancellor.
"So there is a growing mismatch between the number of first-year residency positions nationally and the number of graduates coming out," he said. "If both of these schools are up and operating -- there will be 115 projected [graduates for] the branch of [the New york school] in Jonesboro and 150 projected for the new school in Fort Smith -- that's 265 new medical school graduates a year when these programs are mature."
A message left for Kyle Parker, the CEO and president of the planned private osteopathic medical school in Fort Smith, went unreturned.
UAMS has about 160 graduates a year. As it stands, not all of its students are matched to a residency program on the first try. The problem is that the federal government has placed a cap on the number of residency positions at hospitals that have had programs in place since 1996.
Residency salaries are paid by the hospital and later reimbursed through the federally funded Medicare. Hospitals that have never before had residency slots are eligible for the reimbursement, but the medical centers still foot the bill on the front end.
Both UAMS and Speights have been working with hospitals across the state to create new residency slots. For example, Speights said, St. Bernards Regional Medical Center in the Jonesboro area has started an internal residency program with five in training. Still, Dr. Pope Moseley, dean of UAMS' College of Medicine, said if 20 residency positions were created in the state, that really amounts to about six slots a year.
Speights has helped to get four new residency programs in three hospitals approved so far, including the one at St. Bernards. He is working on getting up to six more approved.
"So now all of a sudden, we're growing our own," he said. "So now we're training and growing our own physicians to meet the needs of the people of Arkansas."
The first class, some of whom are still figuring out what programs interest them, will get to that point in three years.
Armstrong said she is considering surgery, like her father, but doesn't know what type. She also is considering primary care.
Mostly, she said she's just looking forward to learning about medicine.
"I just love the holistic approach of osteopathic medicine," she said, adding that the school's location was ideal -- close to home. "I wanted to feel like a part of something bigger. [ The New York school's campus in Jonesboro] made me feel like I was collaborating with students in another state. It seemed like the whole package."
A Section on 04/10/2016