Residency directors tell JFAC expanding in‑state residencies boosts workforce; requests focus on psychiatry, family and internal medicine slots

Directors for Idaho residency programs told the Joint Finance‑Appropriations Committee on Jan. 21 that state support for graduate medical education is producing clinicians who treat Idaho patients now and that additional residency slots are needed to address shortages in psychiatry, primary care and other specialties.

Kevin Campbell, a Legislative Services analyst, reviewed residency finances and numbers, and said the state often contributes one‑third of the per‑resident cost while health systems and sponsoring institutions cover the remainder. "To create a doctor takes at a minimum, 3 additional years longer for some specialties," Campbell said, explaining why residency capacity is the critical bottleneck in the physician pipeline.

Director Matthew Larson, who runs the psychiatry training in Idaho Falls, sought funding that would fund psychiatry residency slots in Eastern Idaho. The Eastern Idaho Medical Residency (EIMR) requested $240,000 in fiscal 2026 to support four additional psychiatric residents, which the analyst said would bring psychiatry slots to a total of 12 in that program. Larson told the committee that psychiatry wait times are long — "It takes 3 and a half months to get into me" — and said the program already delivers clinical care while trainees are in residency: "You still have 16 additional doctors practicing psychiatry in Idaho Falls... just from my program," he said.

Boise Internal Medicine requested $60,000 ongoing for one additional resident for FY2026; the program currently has 41 residents. Family Medicine residencies — a network of programs (Full Circle Health, Idaho State University, Kootenai Clinic and others) — reported roughly 130 residents statewide and requested funding for several new residents and one fellowship in collaboration with St. Alphonsus Medical Center in Nampa. Campbell summarized prior appropriations and noted that the American Medical Association reported a 55% retention rate for graduates of Idaho residencies in 2022, a figure the analysts and program directors used to argue for continued state investment.

Program directors described a three‑way funding partnership: sponsoring institution, health‑system partner(s), and the state. Program leaders said costs per resident have risen (Campbell noted a 2026 per‑resident figure of approximately $210,000 in presentation remarks), and that the state share historically averaged about $60,000 per resident but may need to increase with rising costs to keep programs viable.

Committee members asked about evaluation and alternatives. Vice Chair Miller asked how loan‑repayment incentives, scholarships and residency expansion compare; Adams and program directors described those policies as complementary parts of a pipeline — more residencies, more residencies slots, more scholarships and more graduate medical education all help but each operates on different stages of the pipeline.

Directors stressed immediate clinical value. Dr. Mo Hagman (Boise Internal Medicine) told the committee that without state funding the programs would have to reduce the number of physicians trained: "We would likely not disappear entirely, but...we would have to reduce the number of physicians we're training." Dr. Brandon Mickelson (Pocatello family medicine) described residency‑level obstetrical training and said family medicine residents in Idaho routinely graduate with substantially more deliveries and hands‑on experience than national averages, serving communities that lack OB‑GYN coverage.

Ending: Directors urged the committee to sustain the multi‑year residency expansion. Several speakers called the current funding model an "Idaho solution" with demonstrable local returns; program leaders said some additional slots are ready to start pending appropriation.