Legislative panel hears requests to expand Idaho medical residencies; analysts cite high retention and workforce impact

Committee analysts and residency program directors told the Joint Finance-Appropriations Committee that expanding in-state graduate medical education (GME) is a key lever to increase Idaho’s physician workforce and that residents provide significant clinical capacity while training.

Kevin Campbell, budget and policy analyst for the Legislative Services Office, said Idaho residency programs are structured as partnerships among sponsoring hospitals, health systems and the state; historically the state’s share of the per-resident cost was roughly one-third. “The relationship is asked to contribute a portion of the cost of a residency, which in 2026 is a minimum of $210,000 per year,” Campbell said. He told the committee Eastern Idaho Medical Residency (EIMR) has 56 residents and that residency spending is paid as trustee and benefit payments to sponsoring institutions.

Why it matters: Idaho ranks among the lowest states in physicians per capita; analysts told the committee that training physicians in-state increases the likelihood they remain in Idaho. Campbell cited American Medical Association findings that 55% of graduates of Idaho residencies and fellowships remain in Idaho — a retention rate that places the state among the higher-performing states for retention.

Major program details and requests discussed: - Eastern Idaho Medical Residency (EIMR): the program sought $240,000 ongoing for four additional psychiatry residents, bringing psychiatry slots to a stable multi-year level; EIMR has been growing psychiatry slots and expects psychiatry training to be a multi-year ramp-up (psychiatry is typically a four-year program). Dr. Matthew Larson, psychiatry program director in Idaho Falls, said psychiatry demand is high: “It takes 3 and a half months to get into me,” and waiting times for psychologists and testing can be about a year. - Boise Internal Medicine: the program has 41 residents. The FY2026 request included approximately $60,000 ongoing for one additional internal medicine resident (reflecting the state’s historical one-third share of the per-resident cost for that program). - Family Medicine Residency (FMR, multiple sites): FMR spans several sites (Full Circle Health, ISU program in Pocatello/Rexburg/Rupert, Kootenai in Coeur d’Alene, and others). The family medicine network has roughly 130 residents across programs; recent requests included funding for a new St. Alphonsus (Nampa) program (six new residents and one fellowship) and other incremental resident additions across ISU and rural sites.

Presenters emphasized two policy points: first, residents provide immediate clinical services while training — Dr. Larson said residents in his psychiatry program see patients daily and significantly expand service capacity in areas such as Idaho Falls and the state mental hospital — and second, training slots are a durable retention strategy. Dr. Elke Shaw-Tullock (Division Administrator for Public Health) and program directors said state funding makes many programs financially viable by covering roughly a third of the annual per-resident cost.

Cost and capacity context provided to the committee included: - Estimated per-resident cost: roughly $210,000 per resident per year (state’s portion historically was approximately $60,000–$70,000 depending on program and year). Committee speakers asked whether the state’s share should be increased to reflect current costs. - Retention: analyst Kevin Campbell reported a 55% retention rate for graduates of Idaho residency and fellowship programs (AMA figure cited to committee); some programs (family medicine) reported retention rates as high as about 65%.

Legislators asked about program capacity and next steps. Program directors said several additional positions are “ready to go” if the committee funds them: a child psychiatry option tied to University of Utah partnership in Pocatello and a sports medicine fellowship were cited as near-term expansions that could start quickly with funding. Dr. Brandon Mickelson, family medicine program director in Pocatello, said the state’s 10-year expansion plan (begun in 2018) has increased residency capacity significantly and that continued support would stabilize programs and trainee pipelines.

Ending: No votes were recorded during the hearing. Program directors urged continued funding to complete multi-year program buildouts that they said would increase Idaho’s physician supply and provide daily clinical care during training.