It was Match Day madness for students at the UH Mānoa’s John A. Burns School of Medicine on Friday.

Match Day is the nerve-wracking time of year when med school seniors find out where they will spend their residencies.

More than 70 Hawaiʻi med students gathered in a jam-packed auditorium with family and friends. Decked in lei, each student was handed a white envelope. All at once – they tore them open.

Inside, a single sheet of paper tells them which residency program theyll be training in after graduation.

Internal medicine student Braxton Fukutomi proudly poses with his mom, Match Day letter in hand. He secured a residency spot here in Hawai'i with Kaiser Permanente.Credit Vina Cristobal / JABSOMEdit | Remove

Amid the screams of joy from students who paired with their top choice were also tears of disappointment from those who did not.

Dr. Larry Burgess, director of students affairs at the med school, says Match Day is a culmination of a very hectic senior year.

“Over the past year, they’ve had to worry about ‘Gee, what speciality am I going to go into?’ ‘Where am I going to train?’ And they’ve had to pass a lot of very difficult tests so that they can get medical licensure. So this provides a lot of closure to that difficult year for them.”

The good news is more than 70 future physicians will graduate in May and begin their residencies on July 1. The bad news is a majority of these med school students are leaving the islands for residency training on the Mainland...and they may not come back.

How Can Hawai'i Retain Young Doctors After Medical School?

HAWAIʻI'S DOCTOR SHORTAGE

Internal medicine student Keolamau Yee is lucky. She’s one of 27 students out of the more than 70 this year who don’t have to leave Hawaiʻi for post-grad training.

“I’ll be here at UH next year,” says Yee.

Winning one of Hawaiʻi’s highly coveted residencies is rare, says Burgess.

“It’s a fact -- about two-thirds will go away and do residencies,” he said. “And part of it is there are some specialties that we’re not going to have residencies for.” These include areas like radiology, neurology and anesthesiology.

The other problem is a 20-plus-year-old cap on federal funding for U.S. residency programs.

“We had over 800 applications for the four slots that we’re filling this year,” says Dr. Jennifer Walker, interim director of the state’s only Neighbor Island residency program in Hilo.

“Our faculty have come from all over the nation to be able to train residents here at Hilo Medical Center and it’s really, unfortunately, a national set number that holds steady the number of training programs available," says Dr. Walker.

For those who do go away for their resident training, there’s no guarantee they’ll be back to help alleviate the state's persistent doctor shortage.

The latest physician workforce assessment found the state is short a little over 500 doctors. That number is closer to 800 if you count island-specific health care needs.

“It’s difficult in Hawaiʻi because our cost of living is high and our salaries are lower than the rest of the country,” said Dr. Kelley Withy, executive director of the Hawaiʻi Pacific Basin Area Health Education Center, in an interview in September 2017. She is in charge of conducting the annual workforce survey.

If the state hopes to alleviate the doctor shortage, "We would have to probably double to triple the size of all the training programs,” says Withy.

Back at the Match Day ceremonies, a joyfully tearful Celine Hayashi celebrates. The med student was paired with her top residency choice in family medicine in Seattle.

“I have to move,” says Hayashi, laughing.

But unlike many of her peers who are going away, she says she plans to come back.

“Oh, yes, absolutely. I’m from Maui and I plan to go back to Maui,” says Hayashi.

The challenge for those concerned about Hawaiʻi's physician shortage is how to convince more budding doctors like Hayashi to also return.

Updated: March 18, 2019, 12:55 p.m.