The Critical List : Medical Students at UCI Find Out Where They’ll Serve Residencies

They’re young, they’re smart and according to TV dramas, they’re ambitious professionals.

For a few hours on Wednesday morning, though, UC Irvine medical school students screamed, smoked cigars, sprayed champagne and conducted themselves in a way that was, well, undoctorly .

It was the annual Match Day ceremony, where 86 fourth-year medical students found out where they will begin their medical careers.

“This is why we put ourselves through hell for four years,” said Jimmy Lee, 27, who will become a resident at Santa Clara County Hospital. “I’m so psyched!”

Students waited with family members and friends on the patio of Irvine Hall and accepted envelopes containing the names of hospitals where they will do their grueling residency. One medical student opened his envelope with a scalpel for good luck; and each student tossed a dollar bill into an opened doctor’s bag, with the contents going to the last student whose name was called. The money is meant to pay for the emotional trauma of being the last to know.

“You have a lot of reasons to be congratulated and to celebrate,” College of Medicine Associate Dean Alberto Manetta told the students. Sixty percent of UCI medical students were placed at their first-choice hospital, he said.

Across the country, students at 127 medical schools went through the same process Wednesday.

UCI student Paz Nuanez, 30, ripped open her envelope and read it with disbelief. She got her first choice. “Hey everybody,” Nuanez screamed, “come and visit me in Hawaii!”

Nuanez, one of seven children in a Filipino family, grew up in the small San Joaquin Valley farming town of Lathrop. After her three-year residency in Wahiawa, Hawaii, she plans to return to Lathrop to be the town’s first family practitioner. Residents currently have to drive to other cities like Stockton and Manteca to see a doctor, she said.

“Growing up, the only doctors you’d see were family practitioners,” Nuanez said. “They take care of everyone and they work with all sorts of people. . . . They follow families all through life.”

Nuanez said she has bucked the workaholic stereotype of medical students by putting her husband and 9-year-old daughter high on her list of priorities.

“There are some people in medical school that are very competitive and study all the time,” Nuanez said. “But you’ve got to balance it out so you don’t go crazy.”

Nuanez said she liked aspects of medical school that allowed her to talk and relate with patients. Considering the teaching trend at UCI, that may be a more prominent part of classes for future medical students.

“We are now introducing clinical material early on in the curriculum,” Manetta said in an interview. “Physicians must have good interview skills with patients, for example, and there’s no need to wait until the third year for them to develop these skills.”

Manetta said the medical school is moving away from the traditional system of filling students’ first two years with huge amounts of reading before allowing them to work with patients in their second two years. Faculty members also are designing a curriculum that draws students into active discussions instead of listening passively to lectures.

The medical school is directing students’ attention to health problems in communities, such as teen-age pregnancy and AIDS, Manetta said. The physicians-to-be also are encouraged to think about the costs of health care when they eventually prescribe medicine and order tests for patients.

Manetta said he has seen a moderate increase in students who decide to go into primary-care fields after their four years of medical school. Changes in the health-care system mean primary-care physicians often are in more demand than specialists, he said.

Ed Wagner, a member of the Class of ‘95, said he plans to do his residency in internal medicine, which is considered a field of primary care. “It’s a strong field,” Wagner said.

Wagner shied away from celebrating Wednesday. A top hospital in Philadelphia accepted him, he explained, but he had his heart set on hospitals in Oregon or Colorado.

He tried to stay cheerful, though, knowing that at one time his medical career once seemed impossible.

Wagner, a Newport Beach resident, himself has been the subject of intense medical examinations and treatment. While classmates were preparing for the start of medical school in 1990, he begrudgingly had to postpone his education when he found out he had an aggressive form of cancer.

He went through more than a year of chemotherapy and four surgeries at UCI Medical Center. “I was sick all day, every day,” he said.

Three weeks after his last treatment, Wagner started UCI medical school, still very thin and bald from the side effects of chemotherapy. “It was very exhausting,” said Wagner, 28. “But what kept me going was that I really wanted to start med school. It was the beginning of my life again.”

There were tough times: One classmate got hit by a car and went into a coma; another died, possibly by suicide, shortly before exam week. “Is this the right place to be?” Wagner recalls wondering.

His family, friends and girlfriend helped push him through, he said.

Wagner said his experiences during chemotherapy changed his onetime goal of becoming a surgeon. Now he hopes to eventually specialize in cancer treatment.

“I’ve seen it from the other side and saw the problems patients have, and I feel I have something to offer,” Wagner said.

“It’s a calling,” he said. “I feel like I should be there. I need to be there. I want to be there.”

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The Match Game At UC Irvine’s College of Medicine, 86 fourth- year students found out Wednesday where they will train as resident doctors. Most received heir first choice in residency training programs: First choice: 62% Second choice: 14% Third choice: 8% *

Primary Healing More than half of the students will train in a primary- care field, with about four in 10 entering some specilaty. The breakdown: Specialty: 44% Ob-Gyn: 9% Pediatrics: 6% Other primary field: 2% Family practice: 22% Internal medicine: 16% Note: Numbers do ot add up to 100% because of rounding. Source: UCI College of Medicine.