By Exec Edge Editorial Staff
On the morning of March 20, medical students at UNLV’s Kirk Kerkorian School of Medicine gathered with their families in a room buzzing with nervous energy. At noon Eastern time, along with tens of thousands of peers at medical schools across the country, they tore open envelopes to learn where they would spend the next three to seven years of their lives — and, in many cases, build their entire careers.
Dr. Ryan Hafen, anesthesiologist at U.S. Anesthesia Partners’ Nevada practice in Las Vegas and program director for HCA Sunrise Health’s anesthesiology residency.
It was Match Day, the annual rite of passage that determines where graduating medical students will train as resident physicians. Run by the National Resident Matching Program, the Match uses a sophisticated algorithm to pair the preferences of students with those of residency programs nationwide. Students rank their preferred programs; programs rank their preferred students. A computer reconciles the two lists, and on one Friday in March, futures are sealed.
For Dr. Ryan Hafen, anesthesiologist at U.S. Anesthesia Partners’ Nevada practice in Las Vegas, the day carried a particular weight. As program director for HCA Sunrise Health’s anesthesiology residency, Nevada’s only anesthesiology residency, Hafen has spent years cultivating relationships with medical students long before they ever sit for an interview. A member of the faculty at UNLV, Hafen leads the anesthesia interest group at the university, hosts dinners and delivers lectures, all in an effort to identify and attract the best candidates to his eight-seat program.
“I try to get to know the students that want to do anesthesia not just for three months during the interview season, but for three to four years when they’re medical students,” said Hafen. “Then I know who to really build a class with.”
The investment is paying off. Nine of the students who matched into anesthesiology from Nevada’s medical schools this year will train with USAP Nevada as apart of HCA Sunrise Health’s anesthesia residency. And Hafen’s track record over his four years leading the program is striking: over 50 percent of recent graduating residents have either stayed with USAP or remained practicing in the state. This summer, there will be 11 independent anesthesiologists working in Nevada that came through the USAP residence program, and Hafen expects almost all of the 2027, 2028 and 2029 classes to stay in-state.
A State in Need
Nevada ranks 45th in the nation for active physicians per capita, with roughly 218 doctors for every 100,000 residents — well below the national average of 272. A 2025 report from the University of Nevada, Reno School of Medicine estimated that Nevada would need more than 2,300 additional physicians just to reach the national average. Nearly two-thirds of the state’s population lives in areas designated as having a shortage of primary care providers. The nationwide shortage of anesthesia clinicians is well-chronicled.
The data point most relevant to Match Day, however, is one that researchers have documented for decades: physicians overwhelmingly tend to practice where they complete their residency training. For a state already struggling to attract and retain doctors, every resident who trains elsewhere and never returns represents a compounding loss.
“The statistics are very, very clear-cut,” Hafen said. “Where you train in residency is statistically where you’re going to end up starting your career and likely providing your expertise and care for the rest of your career.”
That reality makes Hafen’s program — and his ability to recruit from Nevada’s three medical schools, UNLV, Touro University Nevada in Henderson, and the University of Nevada, Reno — a matter of public health infrastructure as much as medical education.
Eight Seats, Eight Hundred Applicants
Anesthesiology is among the most competitive specialties in American medicine. Hafen’s eight-position program receives between 800 and 1,000 applications every year — a ratio of roughly 100 applicants for every available seat. Nationally, there are more medical students seeking anesthesia residencies than there are positions to train them, meaning that after the Match, virtually no unfilled spots remain.
The competition reflects the specialty’s appeal: intellectually demanding work, strong compensation and a lifestyle that many physicians find sustainable. For a program in Las Vegas to consistently attract top candidates and then keep them in Nevada after graduation is an achievement that speaks both to the quality of the training and to Hafen’s personal approach.
“I put a lot of time and energy into this whole process,” Hafen said. “And the payoff is watching residents we’ve developed for four years become good anesthesiologists and then start their careers here. It makes all the paperwork worth doing.”
This year’s Match was the largest in history. A record 44,300 applicants secured first-year residency positions, according to the NRMP, drawn from a pool of more than 53,000 who applied. It is a process with no parallel in American professional life — a binding, algorithm-driven placement system more reminiscent of a military assignment than a corporate hiring process.
The Bigger Picture
Hafen’s role as a residency program director illustrates a dimension of U.S. Anesthesia Partners that extends well beyond the operating room. USAP clinicians across the country hold faculty appointments, lead training programs and shape the future of the profession — positions that reflect the organization’s scale and clinical reputation as the nation’s premier anesthesia practice.
USAP is a physician-owned, clinician-led organization of more than 4,500 anesthesiologists, certified registered nurse anesthetists and certified anesthesiologist assistants working in more than 700 facilities across the country.
Hafen looks forward to Match Day each year, but he is candid about the limits of what one eight-seat program can accomplish.
“Graduating eight anesthesiologists a year for this amount of population,” Hafen said, “is like pouring a glass of water into Lake Mead and hoping the water levels rise.”
Still, Hafen is optimistic. Each year his program produces physicians who stay and serve. The residents joining USAP this year will add to a growing network of Nevada-trained anesthesiologists who are building careers and families in the communities where they trained.
“Every year, we’re watching the residents we developed for four years become fantastic anesthesiologists and then start their careers right here,” Hafen said. “That’s the ultimate payoff. It’s incredibly rewarding and gratifying — and it tells me we’re doing our part to help solve the physician shortage and train the next generation for Nevada.”
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